Cold Remedies Research Articles

Survey of Description on Package Inserts of OTC Drugs

The "self-medication tax deduction" system began in Japan in January 2017, allowing people to encourage the use of OTC drugs. Package inserts contain important information for consumers regarding their use. In this study, we first checked whether the items, as required in the notifications of the Japanese Ministry of Health, Labour and Welfare, are described in the package inserts of cold remedies and analgesic antipyretics in OTC drugs. The descriptions of almost all packages checked in this study were based on the notifications, but those of a small number of them were not. Next, we examined the description of the items, unrequired in the notification, but worthy for proper use of drugs; e.g., the description of prohibition for use by "patients with severe hypertension" in case of ibuprofen-containing products, and the description was found in only seven of 180 products. Manufactures should make package inserts along with notifications, including the description for proper use of drugs.

Traditional remedies for colds and flu

Traditional remedies for colds and flu

Adverse Event Trends Associated with Over-the-counter Combination Cold Remedy: Data Mining of the Japanese Adverse Drug Event Report Database

OTC combination cold remedies are widely used in Japan. In the present study, we aimed to evaluate the adverse event profiles of OTC combination cold remedy based on the components using the Japanese Adverse Drug Event Report (JADER) database. The JADER database contained 430587 reports between April 2004 and November 2016. 1084 adverse events associated with the use of OTC combination cold remedy were reported. Reporting odds ratio (ROR) was used to detect safety signals. The ROR values for "skin and subcutaneous tissue disorders", "hepatobiliary disorders", and "immune system disorders" stratified by system organ class of the Medical Dictionary for Regulatory Activities (MedDRA) were 9.82 (8.71-11.06), 2.63 (2.25-3.07), and 3.13 (2.63-3.74), respectively. OTC combination cold remedy containing acetaminophen exhibited a significantly higher reporting ratio for "hepatobiliary disorders" than OTC combination cold remedy without acetaminophen. We demonstrated the potential risk of OTC combination cold remedy in a real-life setting. Our results suggested that the monitoring of individuals using OTC combination cold remedy is important.

Self-medication practices and rational drug use habits among university students: a cross-sectional study from Kahramanmaraş, Turkey.

BackgroundSelf-medication refers to the use of medicines to treat self-diagnosed diseases without consulting any healthcare professionals. Irrational drug use and self-medication have serious negative consequences both on health and economy. Therefore, the aim of this study is to assess the habits related to rational use of drugs (RUD) and to estimate the prevalence of self-medication practices among university students.MethodsThis cross-sectional study was conducted on university students in Kahramanmaraş. From May 2017 to June 2017 a total of 960 students filled a “Rational Use of Drugs Questionnaire”.ResultsThe prevalence of practicing self-medication in students was 63.4%. The most common medicines that the students had consumed without prescription were analgesics by 39.5%, antibiotics by 36.9% and cold remedies by 24.0%. The rate of students who declared that they were familiar with RUD and “rational use of antibiotics” (RUA) was 45.9%. Reading/checking the instructions in the prospectus (OR = 1.529, 95% CI [1.176–1.990]), understanding the context of the prospectus (OR = 1.893, 95% CI [1.387–2.584]), compliance with the duration of antibiotic treatment (OR = 1.597, 95% CI [1.231–2.071]) and consulting a physician in case of a side effect (OR = 1.350, 95% CI [1.037–1.757]) were significantly higher among students who were familiar with RUD as compared to who were not.DiscussionSince the awareness of RUD among university students was found to be inadequate, it has critical importance to hold educational activities with the cooperation of physicians, health organizations, universities, non-governmental organizations and media to avoid negative consequences of irrational drug use and self-medication.

Codeine and tramadol can cause breathing problems for children

Codeine and tramadol are opioid medicines that may be used to treat pain. Codeine is also in some cough and cold remedies.

細菌をやっつける風邪薬 : リゾチームの働き(化学実験虎の巻)

細菌をやっつける風邪薬 : リゾチームの働き(化学実験虎の巻)

Comparison of the Benefit Feeling Rate Based on the Sho of OTC Kakkonto, Cold Remedy and Cold Remedy with Kakkonto Combination Product

Kakkonto (KK), a traditional Japanese Kampo formulation for cold and flu, is generally sold as an OTC pharmaceuticals used for self-medication. Kampo formulations should be used according to the Sho-symptoms of Kampo medicine. These symptoms refer to the subjective symptoms themselves. Although with OTC pharmaceuticals, this is often not the case. We surveyed the relationship of agreement of Sho with the benefit feeling rate (BFR) of patients who took KK (n=555), cold remedies with KK (CK, n=315), and general cold remedies (GC, n=539) using internet research. BFR of a faster recovery was greater in participants who took the medication early and who had confidence in their physical strength in all treatment groups. BFR was significantly higher in the GC group than in the KK group for patients with headache, runny nose, blocked nose, sneezing, and cough. BFR was also significantly higher in the GC group than in the CK group for headache (males) and cough (females). BFR was the highest in the KK group for stiff shoulders. All cold remedies were more effective when taken early, and the larger the number of Sho that a patient had, the greater the BFR increased. Therefore, a cold remedy is expected to be most effective when there are many cold symptoms and when it is taken at an early stage of the common cold.

Marrubium vulgare L.: A review on phytochemical and pharmacological aspects

Marrubium vulgare L. (family: Lamiaceae), also known as white horehound, is widely used as herbal remedy for chronic coughs and colds. It is used in various disorders related to skin, liver, gastric, heart and immune system. This review abridges phytochemical, pharmacological studies and medicinal uses of M. vulgare and provides scientific proof for various ethnobotanical claims in order to identify gaps, which will give impulsion for novel research on M. vulgare based herbal medicines. This review summarizes selected scientific evidence on phytochemistry and pharmacological properties of M. vulgare over the past 48 years (1968 to 2016). The work reported on M. vulgare was reviewed from various sources like books, internet source i.e. google search engine, pubmed, sciencedirect and chemical abstract. The exhaustive literature was studied and critical analysis was done according to their phytochemical and pharmacological properties. Phytochemical investigations on different parts of M. vulgare have been reported the presence of flavonoids, steroids, terpenoids, tannins, saponins and volatile oils (0.05%). The aerial parts contain marrubiin, together with ursolic acid and choline. Pharmacological activities like, anti-nociceptive, anti-spasmodic, anti-hypertensive, anti-diabetic, gastroprotective, anti-inflammatory, anti-microbial, anti-cancer, antioxidant, and anti-hepatotoxic activity have been reported. M. vulgare has therapeutic potential in the treatment of inflammatory conditions, liver disorders, pain, cardiovascular, gastric and diabetic conditions. Aerial parts of M. vulgare is a good source of labdane type diterpene especially marrubiin which is present in high concentrations. However, further scientific studies are needed to explore clinical efficacy, toxicity and to explore the therapeutic effect of major secondary metabolites like diterpenes, phenylpropanoid and phenylethanoid glycosides of M. vulgare.

General practice consultations and use of prescription drugs after changes to school absence policy.

New rules for absence with stricter requirements for documentation were introduced in upper secondary schools in the autumn of 2016. We investigated the use of general practice services and dispensing of prescription drugs among 16 – 18-year-olds in the autumn of 2016 and compared this with equivalent figures for the period 2013 – 15. We retrieved information on consultations in general practice (GP) and dispensing of prescription drugs to 15 – 18-year-olds in the period 2013 – 16 from the Directorate of Health’s system for control and payment of health reimbursements (KUHR) and the Norwegian Prescription Database respectively. The number of consultations and dispensing of drugs were compared to previous years using Poisson regression (reference year 2015). The incidence rate ratio (IRR) was used as an outcome measure. The number of GP consultations for 16 – 18-year-olds was 30 % higher in the autumn of 2016 than in the autumn of 2015 (IRR 1.30, 95 % confidence interval (CI) 1.29 – 1.31). In the same period, the dispensing of drugs to this age group increased by 8 % (IRR 1.08, 95 % CI 1.08 – 1.09). Among the diagnosis groups, respiratory tract infections had the largest increase (IRR 2.21, 95 % CI 2.17 – 2.25). The largest increase in drug dispensing was found for remedies for coughs and colds (IRR 1.73, 95 % CI 1.65 – 1.80). The increase in consultations in general practice and dispensing of drugs to 16 – 18-year-olds coincided in time with the introduction of new rules for absence from school. We hold it to be highly likely that the changes were caused by the stricter rules for documentation of absence from school.

Branded and generic cold and flu remedies will work the same if the ingredients and dose are the same

Branded and generic cold and flu remedies will work the same if the ingredients and dose are the same

A case series of eperisone-induced immediate hypersensitivity

Eperisone is a widely used muscle relaxant and believed to be relatively free of adverse drug reactions. However, a rare case of fatal anaphylaxis has been reported in the literature. Poor awareness due to its rarity and combined administration with other drugs are the major hurdles in diagnosing eperisone-induced anaphylaxis. We experienced 3 cases of immediate hypersensitivity reaction oc curring after eperisone administration. Case 1, a 63-year-old female, was admitted via the Emergency Department with urticaria, generalized erythroderma, sore throat, chest discomfort, and dyspnea within 1 hour after administration of common cold remedy. Case 2, a 58-year-old male, visited our allergy clinic to detect culprit drugs. He experienced itching, urticaria, hypotension for several hours after administration of the pills for back pain in the last 3 years. Case 3, a 58-year-old male developed urticaria and dyspnea af ter administration of medication for a headache. He also experienced urticaria and facial edema after administration of the common cold remedy. Among the medications, eperisone hydrochloride was proven as the culprit drug and others were excluded through oral provocation tests. We advised them to avoid eperisone and issued drug safety card. Clinicians should be aware that eperisone hydrochloride is a potential culprit agent of fatal anaphylaxis. (Allergy Asthma Respir Dis 2017;5:228-231)

Observational Study of a Multi-Active Ingredient Over-the-Counter Cold Remedy Following Active Pharmacist Recommendation

Real-world user satisfaction with a fixed dose combination over-the-counter cold remedy (Vicks Symptomed Complete Cytrynowy hot drink; VSCC) was evaluated in a prospective, non-comparative, observational study involving 176 pharmacies in Poland from February to April 2015. 1391 participants completed a questionnaire in the pharmacy and several paper questionnaires at home following use of the product at their own discretion. Participants returned their completed questionnaires to the pharmacy. 1356 participants were included in the intent-to-treat analysis. Participants highly valued the advice from their pharmacist (97%, P < 0.0001, important vs. not important) and thought the quality of that advice was good (93%, P < 0.0001, good/very good vs. very bad-fair). 96% of participants found VSCC to be effective in some way against their cold symptoms (P < 0.0001, effective vs. not effective) and 68% of them stated that it was better than any other cold therapy they had used before (P < 0.0001, better/best vs. same/worse). Adverse event reporting was very low.

Acute, Subacute, and Cell Toxicity of the Aqueous Extract of Lippia citriodora

Background: Lemon verbena (Lippia citriodora) has a long history as a folk remedy for the common cold, asthma, colic, fever, diarrhea, indigestion, insomnia, and anxiety. The increasing use of Lippia citriodora and the lack of scientific data on its safety profile make necessary an evaluation of its toxicity. Objectives: The present study evaluated the acute, subacute, and cellular toxicity of the aqueous extract of L. citriodora leaves. Methods: The acute and subacute toxicity of the plant was evaluated with a single intraperitoneal (IP) injection of aqueous extract at the dosage range of 0, 1, 2, and 5 g/kg of body weight (acute model) in mice and rats and 21 days’ administration at the dosage range of 0, 50, 100, and 200 mg/kg of body weight. For subacute toxicity, food intake, water intake, body weight, hematological and biochemical parameters, and histopathological changes were evaluated. In our in vitro study, the effect of different concentrations (0, 50, 100, and 200 µg/mL) in HepG2 cells was evaluated using MTT assay. Results: In the acute toxicity study, the calculated LD50 was 5g/kg of body weight. The subacute toxicity study did not show a significant change in any of the hematological, biochemical, or pathological findings compared to the control group, except for a reduction in triglyceride levels. The cytotoxicity assay also revealed that the viability in all groups was greater than the IC50 value. Conclusions: Results from the present study elucidated that treatment with the aqueous extract of L. citriodora leaves was well tolerated via daily IP injection at doses up to 200 mg/kg for a period of 21 days and did not produce any toxicity. The safety of L. citriodora aqueous extract was also confirmed by cell viability assay.

Chemical Composition and Antimicrobial Activity of Fresh Rhizome Essential Oil of Zingiber Officinale Roscoe

Background: Zingiber officinale Roscoe (Zingiberaceae) is a rhizomatous perennial herb found in tropical Asia. It is extensively used worldwide as a spice, flavoring agent and herbal remedy for cold, throat and chest infections and cough. The present study was carried out to analyse an essential oil from the fresh rhizomes of Z. officinale of Ghaziabad region and to evaluate its antimicrobial activity. Materials and Methods: The fresh rhizomes were hydrodistilled to get the essential oil which was analysed by GC and GC-MS techniques. The oil was evaluated for antimicrobial activity by disc diffusion method. Results and Discussion: The essential oil was characterized by high percentage of sesquiterpenes (66.66%), monoterpenes (17.28%) and aliphatic compounds (13.58%). The predominant sesquiterpene was zingiberene (46.71%) followed by valencene (7.61%), β-funebrene (3.09%) and selina-4(14),7(11)-diene (1.03%). The major monoterpenes were characterized as citronellyl n-butyrate (19.34%), β-phellandrene (3.70%), camphene (2.59%) and α-pinene (1.09%). The essential oil exhibited significant antimicrobial activity against Bacillus subtilis, Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Candida albicans and Aspergillus niger. Conclusion: The essential oil mainly contained a large number of sesquiterpenes and monoterpenes and exhibited significant antimicrobial activity against pathogenic microorganisms.

Analysis of a distinct speech disorder seen in chronic manganese toxicity following Ephedrone abuse

IntroductionIn the last fifteen years a new cause of chronic manganese toxicity has been recognized. It follows recreational intravenous injections of Ephedrone, synthesized from a cold remedies contained pseudoephedrine. Potassium permanganate is used as an oxidant. It presents with severe parkinsonism-dystonia and a characteristic dysarthria. ObjectivesWe performed a focus perceptual study of dysarthria in Ephedrone induced parkinsonism and compared the findings with the speech disorders seen in Parkinson's disease (PD) and Progressive Supranuclear Palsy (PSP). MethodsA digital voice recording, perceptual speech analysis (Darley, 1975) [18], serial neurological assessment and Brain Magnetic Resonance (MR) imaging were performed at the Lviv regional Clinical Hospital. The results were analysed at the Institute of Neurology in London. ResultsDysarthria developed after 8.5±3.2months of daily intravenous Ephedrone abuse and was an initial symptom in a third of cases. It was characterised by a robotic-flat prosody, whispering or continuous phonation, an inability to regulate pitch and volume, frozen lip articulation, a variable degree of dystonic tightness, difficulties in speech initiation and palladia, There was no nasality and swallowing was normal. In some patients speech deteriorated even after the discontinuation of Ephedrone.MR imaging, performed soon after drug cessation showed T1 signal hyperintesity in striatum and pallidum, especially in the Globus Pallidum interna. ConclusionEphedrone induced chronic manganese toxicity can lead to a mixed hypokinetic-dystonic dysarthria with a distinct dystonic pattern. Perceptual speech analysis can be a helpful ancillary investigation in the differential diagnosis of parkinsonism, and may permit the recognition of chronic manganese toxicity.

A new flavone glycoside from the leaves of Agastache rugosa (Fisch. & C.A.Mey.) Kuntze

Agastache rugosa (Fisch. & C.A.Mey.) Kuntze has been widely used as a food spice and a remedy for colds in Korea, China and Japan. In this study, one new flavone glycoside (1) along with six flavonoids (2–7), nine phenyl glycosides (8–16) and three megastigmane glycosides (17–19) were isolated from the leaves of A. rugosa. By extensive spectroscopic methods including 1D and 2D NMR, and MS data, the structure of the new compound (1) was elucidated as acacetin 7-O-β-(6″-(E)-crotonylglucopyranoside). From present investigation, compound 1 and 7–19 were isolated for the first time from the genus Agastache and 1, 16, 18 and 19 in the Lamiaceae family.

Evaluation of Postmortem Drug Concentrations in Bile Compared with Blood and Urine in Forensic Autopsy Cases

For drug screening and pharmaco-/toxicokinetic analysis, bile as a major drug excretion route in addition to urine may be used in forensic autopsy cases; however, there are limited published data on correlations between bile and blood or urine drug concentrations. The present study retrospectively investigated drug concentrations in bile, compared with blood and urine concentrations, reviewing forensic autopsy cases during 6 years (January 2009-December 2014). Drugs were analyzed using automated gas chromatography-mass spectrometry following solid-liquid phase extraction. Compared with peripheral blood concentrations, bile concentrations were higher for most drugs; however, caffeine concentrations were similar. Bile concentrations were mostly lower than urine concentrations for amphetamines, caffeine and methylephedrine, but were usually similar to or higher for other drugs. Significant correlations were detected between bile and peripheral blood concentrations for amphetamines, several cold remedies, phenobarbital, phenothiazine derivatives and diazepam, as well as between bile and urine concentrations for amphetamines, caffeine, diphenhydramine, phenobarbital and promethazine derivatives. These findings suggest that bile can provide supplemental data useful in routine forensic toxicology, for the spectrum of drugs mentioned above, as well as for investigating pharmaco-/toxicokinetics and postmortem redistribution when analyzed in combination with drug concentrations at other sites.

Tulbaghia--A Southern African Phytomedicine.

The phytomedicine Tulbaghia consists of the fresh or dried subterranean organs of various Tulbaghia species. The genus is endemic to Southern Africa and includes about 20 species, of which only T. alliacea and T. capensis are naturally found in the winter rainfall climate area (the Western Cape). The genus forms part of the Alliaceae family and is a geophyte (plants with an underground perennation organ and leaves that die back annually). Their habitat can range from semi-desert to wet and boggy terrain. Wild garlic is most commonly prepared as an infusion or boiled in water and taken orally. Externally, as a medicated bath, wild garlic is used to treat paralysis and rheumatism and to reduce the temperature in a feverish patient. Internally, rhizome or bulb preparations are taken orally to treat fever; as a remedy for colds and influenza, asthma, tuberculosis, and stomach problems; as an antihypertensive; or to expel intestinal worms. It is also used as a prophylactic against winter infections. Rhizome pieces are often placed in castor oil to make eardrops. For fever and high blood pressure, a tea is made from the bulbs or rhizomes and a small cup taken three times daily. The leaves of the plant are used to treat esophageal cancer and may also be eaten as a vegetable. The demand for Tulbaghia in both formal and informal markets has grown exponentially. Sustainable harvesting focuses on only harvesting enough of the plant so that it still has the capacity for self-renewal. However, because both the above-ground and underground parts of Tulbaghia are commonly used in African traditional medicine, destructive harvesting of the whole plant is inevitable, thus necessitating the large-scale organized propagation of these plants. It is therefore important to establish a new strategy for the sustainable harvesting of these plants as commercial crops.

Zinc effect on human lymphatic malformation cells in vitro

ObjectivesLymphatic malformations (LM) are clinically characterized by episodes of inflammatory episodes. Often, an upper respiratory illness or trauma will lead to painful swelling in the distribution of the LM. Zinc is an element involved in numerous aspects of cellular metabolism and is a common dietary supplement and cold remedy. We surmise that zinc may act as a therapeutic anti-inflammatory agent for lymphatic malformations and their cellular components.We investigate the apparent cytotoxic effect of zinc ion on lymphatic malformation cells in vitro. MethodsFresh surgical lymphatic malformation specimens from 10 patients were collected and processed in a laboratory. Tissues were processed and lymphatic malformation cells were isolated and grown. Immunohistochemistry and cell morphology were used to confirm LM cells. HUVEC cells were used as controls. Zinc chloride solution was added to the cells and its effect observed. ResultsLM cells were isolated from five of the 10 specimens. Of these, the cells of only one specimen were able to be amplified to confluence. Five specimens were contaminated.Immunohistochemical staining (CD31, D2-40, and LYVE-1) and cell morphology of our specimens were consistent with lymphatic malformation while HUVEC control cells were negative. Zinc has a cytotoxic effect on BEL isolates in vitro with no obvious effect on cell morphology or growth rate of the control HUVEC cells. When compared with the published toxic zinc concentration for most cell types in the literature (100μM total zinc in vitro), our result indicates that LM cells may have a lower tolerance to zinc (10μM total zinc in vitro). ConclusionZinc has an apparent morphological effect on lymphatic malformation cells in vitro. Compared with other cell types, LM cells have a lower tolerance to zinc. While this result looks very promising for future therapeutic use of zinc in acute lymphangitis, further studies are necessary, such as finding the IC50 of zinc for lymphatic malformation in vitro and also in vivo.

Effects of exposure to human medicines in cats and dogs

Medicines, including both prescription-only and over-the-counter products, are very readily available in the home and are a common source of poisoning in companion animals. Recent studies have shown that analgesics, in particular, are frequently involved in the accidental poisoning of animals, both in Europe and the US. Some medicinal products, such as cold and flu remedies, can contain a variety of ingredients and it is important to obtain details of the exact product involved. This article describes some common medicines found in the home, focusing on over-the-counter products in particular; lists the clinical signs that can occur in the case of an overdose; and describes differences between species where appropriate, as well as briefly outlining treatment.