Rhinoviruses and coronaviruses cause most
colds during the fall and winter. Symptoms often include nasal obstruction,
discharge, sneezing, sore throat, cough and headache. A low grade fever may be
present, but fever to as high as 102o F can also occur. Symptoms
lasting for more than two weeks are more likely to be caused by allergies rather
than a cold.
General Measures
Fever should always be treated in the
pregnant patient with acetaminophen. All patients should be encouraged to drink extra fluids. A
cool mist vaporizer may help to relieve congestion.
Over the Counter (OTC) Cold Remedies
If the patient wishes to use over-the-counter
medications to address symptoms the following may be safely recommended:
|
Symptom |
Drug |
|
Hayfever, sneezing, runny nose, itchy watery
eyes |
Chlorpheniramine (Chlortrimeton)
Diphenhydramine (Benadryl)
Clemastine (Tavist
Allergy) |
|
Nasal congestion |
Pseudoephedrine (Sudafed)* |
|
Cough |
Dextromethrophan (Robitussin DM sugar free) |
|
Headache or fever: |
Acetaminophen (Tylenol) |
For multiple symptoms the combination medications
below may be used. However, the patient should attempt to limit medications to
treat specific symptoms when possible.
Nasal congestion, sneezing, runny nose, itchy
watery eyes
- Actifed Cold and Allergy
Ingredients: Pseudoephedrine
*,Triprolidine
Nasal congestion, sneezing, runny nose, itchy
watery eyes, fever, and headache
- Actifed Cold and Sinus
Ingredients: Acetaminophen,
Chlorpheniramine, Pseudoephedrine*.
Sinusitis
Colds occasionally lead to secondary
bacterial infections of the sinuses, requiring treatment with
antibiotics. Sinusitis with purulent nasal drainage and facial pain lasting for
more than 7 days may be treated with:
- Amoxicillin 2-3.5g/d x 7-10d
For penicillin allergic patients:
- Azithromycin (Zithromax) 500mg PO x 1, then 250mg PO qd x 4d (Z-Pak)
- TMP-SMX (Bactrim, Septra)*1 DS PO bid x 7-10d
*Avoid in first trimester.
REFERENCES:
1. Schatz M, Zeiger RS, Harden K, Hoffman CC, Chilingar L, Petitti D. The safety of asthma and allergy medications during
pregnancy. J Allergy Clin Immunol. 1997 100:301-6. 1997.
PubMed
2. Briggs GG,Freeman RK, Yaffe SJ, Drugs in
Pregnancy and Lactation 6th edition,Baltimore, MD: Williams & Wilkins,2002. p285
3. Martinez-Frias ML, Rodriguez-Pinilla E.
Epidemiologic analysis of prenatal exposure to cough medicines containing
dextromethorphan: no evidence of human teratogenicity. Teratology, 63:38-41.
2001
PubMed
4. Einarson A, Lyszkiewicz D, Koren G. The
safety of dextromethorphan in pregnancy : results of a controlled study. Chest.
119:466-9. 2001
PubMed
5. Shaw GM, Todoroff K, Velie EM, Lammer EJ:
Maternal illness, including fever, and medication use as risk factors for neural
tube defects. Teratology 57:1-7, 1998.
PubMed
6. Aselton P, Jick H, Milunsky A, Hunter JR,
Stergachis A. First-trimester drug use and congenital disorders. Obstet Gynecol.
65:451-5. 1985.
PubMed
7. Snow V, Mottur-Pilson C, Hickner JM
Principles of appropriate antibiotic use for acute sinusitis in adults.
Ann Intern Med. 20;134:495-7.
2001
PubMed
8. Antimicrobial treatment guidelines for
acute bacterial rhinosinusitis. Sinus and Allergy Health Partnership.
Otolaryngol Head Neck Surg.
123(1 Pt 2):5-31. 2000
PubMed
Created: 10/28/2002 Mark Curran, M.D.
Updated: 1/19/2003 Mark Curran, M.D.
