OIA2004 MANAGEMENT OF FLU & COUGH

Common cold

A self-limiting viral infection of the upper respiratory tract, typically lasting 7–10 days. Caused by rhinoviruses, coronaviruses, adenoviruses.

Influenza (Flu)

More severe viral illness caused by influenza A, B, C, or D. May lead to complications like pneumonia and bronchitis.

Cold vs Flu Symptoms

Cold: rare fever, common runny nose/sore throat. Flu: high fever, severe fatigue, dry cough, muscle aches.

Cold & flu transmission

Spread by droplets, direct contact, and contaminated surfaces.

Viral nature

Most cases are viral and self-limiting—antibiotics are not indicated unless secondary bacterial infection is confirmed.

High-risk populations

Infants, elderly, immunocompromised, people with chronic illnesses.

Environmental risks

Cold weather, crowded places, smoking.

Flu complications

Pneumonia, bronchitis, asthma exacerbation, otitis media, acute respiratory distress syndrome （ARDS）, heart problems.

Treatment goal

Symptom relief only—does not shorten illness duration or eliminate virus.

Paracetamol

Used for fever and pain; safe across most populations.

Ibuprofen

Anti-inflammatory; useful for muscle aches and sore throat; caution in GI disease.

Nasal decongestants mechanism

Stimulate α-adrenergic receptors → vasoconstriction → reduce swelling and congestion.

Examples of decongestants

Pseudoephedrine, phenylephrine, ephedrine, oxymetazoline.

Decongestant cautions

Avoid in children <6 years, hypertensive patients, those with BPH or heart disease.

Preferred decongestant formulations

Based on patient preference: tablets, syrups, nasal sprays, flavored powders.

Sedating antihistamines

Diphenhydramine — cause drowsiness but helpful for nighttime symptoms.

Non-sedating antihistamines

Loratadine, cetirizine, desloratadine — suitable for daytime relief.

Combination products

Many OTCs mix antihistamines with decongestants for multi-symptom relief.

Cough classification

Acute: <3 weeks; Subacute: 3–8 weeks;

Chronic: >8 weeks.

Dry vs productive cough

Dry: non-mucus, often viral/allergic.

Productive: mucus-producing, bacterial or chronic respiratory conditions.

Cough suppressants

Dextromethorphan, pholcodine — reduce cough reflex; use for dry cough only.

Expectorants

Guaifenesin — increase mucus hydration and clearance.

Mucolytics

Bromhexine, acetylcysteine, carbocisteine — break down thick mucus.

Demulcents

Simple linctus, glycerol — soothe throat and suppress minor irritation.

Contraindications to suppressants

Avoid in chronic productive cough, COPD, asthma — may worsen mucus retention.

Refer if cough lasts >3 weeks

Chronic cough may indicate asthma, GERD, chronic bronchitis, or medication side effect (ACE inhibitors).

Bacterial infection signs

High persistent fever (>39°C), purulent nasal discharge, chest pain, SOB — may need antibiotics.

Danger signs in cough

Blood-stained mucus, weight loss, night sweats, ankle swelling, chest pain.

Infants and young children

Avoid medications in children <2 years; use with caution in 2–6 years.

Hydration

Fluids thin mucus and ease symptoms; avoid caffeine and alcohol.

Rest

Adequate sleep and rest support immune recovery.

Steam inhalation or humidifiers

Moisturize airways and relieve nasal congestion.

Saline nasal spray

Safe for all ages; relieves stuffy nose by hydrating mucosa.

Honey

Safe and effective natural cough remedy in children >1 year.

Annual flu vaccination

Best defense against seasonal influenza; recommended for high-risk groups.

Hand hygiene

Frequent handwashing prevents spread of cold/flu viruses.

Cough/sneeze etiquette

Cover nose/mouth with tissue or elbow; dispose tissue immediately.

Lifestyle modification

Quit smoking, avoid allergen exposure, maintain nutrition and hydration.

Patient education

Explain that meds relieve symptoms, not cure; stress adherence and knowing when to seek help.

Red flag symptoms education

Teach patients to seek care for persistent high fever, SOB, chest pain, or signs of sepsis.