Super Cold-Treatment Reference Spectacular!

I was recently the guest of Desiree Schell on Skeptically Speaking, where we spent an hour discussing the prevention and treatment of the common cold. Here are some of the references and sources I cited or referred to during the discussion. So read along as you listen to the podcast.

What’s with the new cough and cold products?

One of my earliest lessons as a pharmacist working in the “real world” was that customers didn’t always act the way I expected. Parents of sick children frequently fell into this category — and the typical vignette went like this for me:

1. Parent has determined that their child is sick, and needs some sort of over-the-counter medicine.
2. Parent asks pharmacist for advice selecting a product from the dozens on the shelves.
3. Pharmacist uses the opportunity to provide science-based advice, and assures parent that no drug therapy is necessary.
4. Parent directly questions the validity of this advice, and may ask about the merits of a specific product they have already identified.
5. Pharmacist explains efficacy and risk of the product, and provides general non-drug symptom management suggestions.
6. Parent thanks pharmacist, selects product despite advice, and walks to the front of the store to pay.

In many ways, a pharmacy purchase mirrors the patient-physician interaction that ends with a prescription being written — it’s what feels like the logical end to the consultation, and without it, feels incomplete. It’s something that I’m observing more and more frequently when advising parents about cough and cold products for children.

Neti Pots for Sinus Congestion: Validated science?

Neti pots have moved from the fringe to the mainstream over the past few years. Traditionally used to treat sinus problems, their popularity exploded in 2007 when Oprah covered them on her show. Requests flooded the pharmacy I worked at. The pharmacy’s owner ordered in a case, and they  disappeared in days. Given Oprah’s poor record at identifying credible sources of medical information, I was skeptical. But given the limited efficacy of drugs for congestion, physical removal with water seemed reasonable, whether with a neti pot, or simply snorting water out of the sink. It was clear to me that uncontrolled sinus congestion problems were not rare, because pouring a cupful of water into your nostril isn’t something one will do on a whim.

Cough and Cold Products for Children: Risk and No Benefit

Prior Science-Based Pharmacy posts have examined some of the most appalling examples of quackery found in the pharmacy – products like homeopathy and detox kits. It’s time to turn our attention to a group of “conventional” pharmacy items – cough and cold products for children. After being on the market for decades, they’re suddenly in the news. Many countries are banning them or relabeling them to warn against use in children. What’s happened to cause these changes?