Upper respiratory infections

Upper respiratory infections
An upper respiratory infection (URI) results from a viral infection that causes inflammation of the nose and
throat. URIs usually last 10 to 14 days but can last considerably longer.
Symptoms
There are over 200 viruses that can cause URIs with one or more of the following symptoms:
● runny nose
● stuffy nose
● mucus in the throat
● scratchy or sore throat
● fatigue and weakness
● cough, with or without mucus
● fever below 101ºF
● muscle and body aches
● mild headache
Treatment
Because URIs are viral and antibiotics don’t work against viruses, treatment focuses on feeling better until the
body eliminates the virus. General treatment measures or nonprescription medications may help relieve URI
symptoms. Prescription medications are rarely necessary.
General treatment measures
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Drink at least eight ounces of noncaffeinated, nonalcoholic fluids every two hours to help soothe the
throat and relieve nasal congestion. Drink more if a fever is present.
Eat a well-balanced diet, including fruits, vegetables, and grains.
Take it easy. Modify exercise routines, if necessary, to avoid excessive weakness and fatigue.
Don’t smoke. Smoking is drying and irritates the nose and throat.
Don’t drink alcohol. Alcohol makes it harder for the body to fight off disease and interacts with many
medications.
Don’t take antibiotics that are "left-over," old, or someone else’s.
Nonprescription medication
If a condition such as high blood pressure or kidney disease is present, or if pregnancy is suspected, consult a
clinician before taking any medication. Carefully follow any instructions that accompany nonprescription
medication. Clinicians and pharmacists can provide specific instructions regarding dosage and any possible
side effects of medications.
Avoid multi-symptom cold remedies. Such products are usually expensive, contain unneeded medication, or
the individual ingredient doses may be too low to be effective.
All of the following products may be purchased at any pharmacy. It is safe to take any of these with each
other, but check with a pharmacist if in doubt.
Runny nose/congestion
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Decongestants: Phenylephrine or pseudoephedrine (must be purchased directly from the pharmacist)
may relieve runny nose and congestion. Pseudoephedrine can cause sleeplessness and decreased
appetite. Please note: if you are taking MAOI inhibitor medication, you should not use decongestants.
Nasal irrigation: Using an irrigation tool, such as a neti pot and saline solution (e.g., SinuCleanse,
Sinus Rinse) removes excess secretions from sinuses and makes it easier to breathe through the nose.
Humidification: A cool mist vaporizer (not steam, which can burn) or a hot shower may moisten nasal
passages and clear mucus. Vaporizers are a good, low-cost investment for dry winters but must be
kept clean and free of mold.
Nasal sprays: Saltwater or saline nasal sprays may ease nasal congestion and make mucus less thick.

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Do not use medicated over-the-counter nose sprays (such as Afrin) for more than three days.
Excessive use can cause congestion.
Cough
A cough is a protective reflex and usually is not harmful. Research has shown that most medications
specifically designed for coughs (e.g., dextromethorphan) don’t work.
The following are effective alternatives to cough suppressant medication.
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Naproxen: Some studies have found that the nonsteroidal anti-inflammatory drug, naproxen, can
decrease coughing associated with URI. For a cough, take 400 to 500 mg initially; then 200 to 500 mg
three times a day for five days. Because naproxen is a pain reliever, this will also help with aches and
pains.
Antihistamines: Studies have shown that first-generation (older) antihistamines such as
diphenhydramine, chlorpheniramine, and dexbrompheniramine are effective at suppressing coughs
resulting from URIs. They may also cause significant drowsiness. Newer, non-drowsy antihistamines
are ineffective in treating cough.
Guaifenesin alters mucus production and may help lessen coughing.
Hot or warm liquids, such as warm water or tea with honey and lemon, can soothe throat irritation and
prevent coughing.
Sore throat
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Phenol: lozenges and sprays containing phenol are particularly effective pain relievers for sore throats.
Gargling with warm saltwater (one teaspoon salt in one cup of hot water) may help ease the pain.
Fever/pain
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Acetaminophen, aspirin, and ibuprofen: Use according to label directions for pain and/or fever relief. If
symptoms are severe, alternate acetamino­phen (650 mg) and ibuprofen (400 mg) every two hours
for pain or fever relief. Avoid taking ibuprofen at the same time as similar medications, such as
naproxen. If under the age of 19, do not use aspirin, as it can contribute to Reye’s syndrome—a lifethreatening
illness of the brain and liver that usually follows a viral infection in children or teenagers.
Prevention
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Wash hands frequently and keep them away from the face. URIs generally spread when infected
droplets from coughing or sneezing land on objects. When a person touches these objects and then
their mouth, nose, or eyes, infection can result.
Use disposable tissues rather than cloth handkerchiefs to prevent re-infection.
Eat healthily. The benefits of consuming large amounts of vitamin C to prevent URIs are unknown.
When to seek care
If symptoms worsen or persist for more than 10 to 14 days after trying the self-care measures listed above,
contact a clinician. See a clinician as soon as possible if any of the following occur:
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temperature greater than 101ºF for more than two days
marked pain in the ears, face, or chest
wheezing or shortness of breath
persistent and severe sore throat, particularly if unable to swallow or open the mouth
severe headache or stiff neck
skin rashes or bruised skin
[HU445: 06/09]