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Update on Cough and Cold Management

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   The common cold is the most ubiquitous upper respiratory infection (URI) in people of all ages. Although most URIs are self-limiting, these viral infections accounted for more doctors office visits between 1980 and 1996 than any other infectious disease. Unlike the flu, which can be prevented by vaccination and treated with antiviral drugs, modern medicine can provide only symptomatic relief for the common cold. Most of the medications used are over-the-counter (OTC) drugs.

   Many OTC drugs are “generally recognized as safe and effective” through the FDA’s OTC monograph process without the rigorous testing required for prescription drugs. Numerous cough and cold remedies have not shown significant efficacy in clinical trials. In January 2008, concerns about the safety and efficacy of OTC cough and cold medications in young children resulted in an FDA Public Health Advisory strongly recommending against use in children under 2 years of age. An FDA Advisory Committee recently recommended against the use of these products in children younger than 6 years due to doubtful efficacy. The agency is currently evaluating use in children 2 and 11 years of age.

   Healthcare providers are in an ideal position to: (1) explain the recent FDA recommendations to parents seeking OTC cough and cold products for their children; (2) explain the limited benefits of OTC drugs in relieving cold symptoms in patients of all ages; and (3) recommend appropriate products for each patient.


Publication Date: 06/01/2008
Expiration Date: 07/01/2011
CE Credit: 1.5 (0.15 CEU)
Type of Activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.


Elaine D. Mackowiak, Ph.D., RPh, Professor, Department of Pharmacy Practice, Temple University School of Pharmacy, Philadelphia, PA. Dr. Mackowiak’s academic responsibilities include teaching nonprescription drug courses and ambulatory care courses for 35 years and professional work experience for 40 years in community, independent pharmacy practice.

Disclosure Statement

Dr. Mackowiak reports no financial or other relationship with any product discussed in this issue, or its manufacturer.

Target Audience

This accredited program is targeted to pharmacists and nurses.

Goals & Objectives

At the conclusion of this program, participants will be able to:

    1. Describe the mode of cold virus transmission and differentiate colds from allergies and flu based on symptoms. List differences in the cold symptoms experienced by children and adults.
    2. Discuss the role of zinc, vitamin C, and echinacea in the prevention and treatment of the common cold.
    3. Discuss the efficacy, adverse effects, and contraindications for use of each drug class commonly used to treat cold symptoms in children and adults.

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

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Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a provider of continuing pharmacy education.

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Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

ACPE Universal Activity Number: 428-0000-08-006-H01-P

Exam & Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Chief Editor and CE Administrator

Terry M. Baker, PharmD

Managing Editor

Tracy Farnen, PharmD

Associate Editors

James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA

Consultant Pharmacist
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA

Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Detroit, MI

Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Detroit, MI

Senior Editorial Advisor

Gerard Hatheway, PharmD, PhD

Editorial Advisors

Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD

Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners

Emily K.
Meuleman, RN, C, MS

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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