It’s the time of the year when cough, cold and flu symptoms dominate health conversations. Pharmacy teams are likely to experience an influx of customers with questions about identifying and managing common winter viral infections.
“It will come as no surprise that colds and coughs are common illnesses in the winter season and are ailments that many customers will seek support for from a pharmacy team,” says Lucy Morris, Numark patient services manager.
“Apart from recommending paracetamol and ibuprofen to manage symptoms such as aches, pains and fevers, pharmacy teams should ensure they can confidently link to other products to provide relief for a cold or cough,” she says. “This is a great way to link sell, so pharmacists should consider promoting products such as nasal inhalers, throat lozenges and pocket tissues.”
Cough it up!
Most winter coughs triggered by a viral infection will clear up on their own (without antibiotics) within three to four weeks. However, these coughs can be irritating and potentially debilitating, even leading to sleepless nights, fatigue, depression and stress incontinence. Occasionally, a viral cough can lead to acute bronchitis, so severe or ongoing coughs should be assessed by a doctor (see box on page 14 for more on chronic cough).
Dry or non-productive acute coughs (lasting up to three weeks) are usually triggered by a tickly sensation in the throat, and regular coughing may also make the throat sore. A chesty cough is usually caused by congestion in the airways, due to a build-up of phlegm or mucus, making the chest feel heavy or tight.
When it comes to treatment, it may take trial and error for pharmacy customers to find what works best for them. Some people find that raising the head end of their bed helps to limit a chesty cough, while drinking plenty of fluids or sucking sweet lozenges may help to soothe a tickly throat. It is advisable to avoid smoking as this can make a cough worse.
The NHS recommends the following first-line management options for an acute cough:
- Take paracetamol or ibuprofen to treat any pain
- Take hot lemon and honey (not suitable for babies under one year due to the risk of botulism and because it is a sugar and may cause tooth decay)
- Take a herbal medicine called pelargonium (for people aged 12 and over).
Pharmacy customers can also try a cough syrup, cough medicine or cough lozenges containing an expectorant or a cough suppressant, although these won’t stop a cough completely. According to National Institute for Health and Care Excellence (NICE) guidance on managing acute coughs (published in February 2019), decongestants, antihistamines and cough medicines containing codeine are unlikely to help an acute viral cough at all.
“Coughs should resolve in a couple of weeks,” says Sue Snelling, Oxford Online pharmacy manager. “There are a range of mixtures that can help dry or chesty coughs and a herbal product that helps both types of cough. If a cough lasts for more than three weeks or a high temperature develops, then a GP should be seen.”
