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| 5/23 |
| 2006/1/9-12 [Health/Disease/General] UID:41308 Activity:kinda low |
1/9 Cough syrups are placebos.
http://www.usatoday.com/news/health/2006-01-09-cough_x.htm
\_ I catch common cold regularly and in my experience Robotusin
and similar products are POS. A cup of tea with lemon and/or honey
works much better. If you're somewhere outside near a coffee shop,
buying a large cup of latte also helps (I get it with a single
shot of expresso since I don't like the coffee by itself that
much).
\_ What effect are you expecting robitussin to have?
\_ cough suppression
\_ robitussin is guifenesin (see below). the DM variety
uses a muscle relaxant. Looking at other, more informative
reports, it looks like they're saying the dextromorphan
dosage is too low to have any pronounced effect. any higher
though and its narcotic properties would make them dangerous
\_ dangerous? Dude, you've obviously never done Robo
properly. And don't even get me started on Romilar.
\_ dextromethorphan doesn't supress coughing, although it's supposed
to, and I've seen several studies on this.
guaifenesin is supposed to help make a cough more productive, and
this is the first time I've read that there's no scientific
evidence that it helps in this way. I have my doubts that the
USA Today author is completely correct.
\_ Agreed. This feels like a BBC style misinterpretation of
a medical journal report.
\_ I don't think you're agreeing with what you think you are.
The grandparent-poster agrees with the USA Today article.
\_ oops, grandparent-poster misspoke in last sentence.
corrected. sorry.
\_ Executive summary available from the source:
http://www.chestnet.org
"Cough and the Common Cold
1. Patients with acute cough (as well as PND
and throat clearing) associated with the common
cold can be treated with a first-generation
A/D preparation (brompheniramine and
sustained-release pseudoephedrine). Naproxen
can also be administered to help decrease
cough in this setting. Level of evidence, fair;
benefit, substantial; grade of recommendation, A
2. In patients with the common cold, newer
generation nonsedating antihistamines are ineffective
for reducing cough and should not be
used. Level of evidence, fair; benefit, none; grade of
recommendation, D
3. In patients with cough and acute URTI,
because symptoms, signs, and even sinus-imaging
abnormalities may be indistinguishable
from acute bacterial sinusitis, the diagnosis of
bacterial sinusitis should not be made during
the first week of symptoms. (Clinical judgment
is required to decide whether to institute antibiotic
therapy.) Level of evidence, fair; benefit,
none; grade of recommendation, D"
\_ I use the regular Robotussin (guaifensin only) with good
results. My coughs do become more productive. I guess even if
it's a placebo it works for me.
\_ Try whiskey. Same placebo effect, more fun!
\_ mm... DXM... hehehe. Good times. |
| 5/23 |
|
| www.usatoday.com/news/health/2006-01-09-cough_x.htm Cough syrup left out in the cold By Rita Rubin, USA TODAY If your biggest decision about how to treat a cough is whether to take cherry- or grape-flavored syrup, you might find the following a little hard to swallow: The American College of Chest Physicians is advising cold sufferers not to waste their money on over-the-counter cough syrups or drops, either for themselves or for their children. Of the estimated 829 million visits to doctors' offices each year in the USA, nearly 30 million visits are for coughs, according to the chest doctors. In what is believed to be the first "evidence-based" guideline on the matter, the new advice is part of a massive set of practices on treating coughs of all types. Published in this month's issue of the journal Chest, the guideline is based on a review of scores of studies dating back several decades. It concludes no scientific evidence exists that suppressants, such as dextromethorphan, or that expectorants, drugs such as guaifenesin used to thin out mucus, relieve coughs due to colds. "Cough is so common, and there are medicines that actually work," says guidelines committee chair Richard Irwin, a professor of medicine at the University of Massachusetts Medical School. If you feel you must take medication, he says, "take something that has been shown to be helpful." The new guidelines conclude that OTC sedating antihistamines, such as dexbrompheniramine, plus a decongestant, such as pseudoephedrine, do appear to be effective in relieving coughs due to colds, as does naproxen. Penn State pediatrician Ian Paul, whose 2004 study found no benefit from cough syrups in children, says drinking fluids, saline nose drops, humidified air and Tylenol or ibuprofen can soothe coughing kids. A spokesman for Wyeth Consumer health care, maker of Robitussin products, refuted the chest physicians' conclusions. "Our stance is that the FDA has reviewed dextromethorphan and guaifenesin and found the two ingredients to be both safe and effective," Fran Sullivan says. "Also, we don't believe that consumers would purchase these products and re-purchase these products if they weren't efficacious for them." OTC cough medicines have been shown to have a strong placebo effect, Irwin says. And coughs due to colds eventually go away on their own, he says. A doctor should be seen for persistant coughs, which may be caused by something more serious than a cold, he says. |
| www.chestnet.org The American College of Chest Physicians (ACCP) is a medical specialty society of physicians, surgeons, allied health professionals, and individuals with PhD degrees who specialize in diseases of the chest: pulmonology, cardiology, cardiovascular and cardiothoracic surgery, hypertension, critical care medicine, and related disciplines. The ACCP creates a unique multidisciplinary approach to cardiopulmonary medicine where pulmonologists, cardiologists, thoracic surgeons, and others can come together at College events for an experience not available from other sources--examination of a topic from a perspective that encompasses all of the major specialties involved. |