From the Guidelines
For cough and rhinorrhea in the emergency room, symptomatic treatments such as analgesics, nasal saline, decongestants, antihistamines, and cough suppressants are recommended to improve quality of life. The management of viral rhinosinusitis (VRS), which is characterized by cough, sneezing, rhinorrhea, sore throat, and nasal congestion, is primarily directed toward relief of symptoms 1.
Symptomatic treatments may include:
- Analgesics or antipyretic drugs, such as acetaminophen or ibuprofen, for pain or fever
- Nasal saline, which may be palliative and cleansing with low risk of adverse reactions 1
- Oral decongestants, which may provide symptomatic relief, but should be used barring any medical contraindications 1
- Antihistamines, which may provide symptomatic relief of excessive secretions and sneezing, although there are no clinical studies supporting their use in acute VRS 1
- Cough suppressants, such as dextromethorphan, which are often used for symptomatic relief of VRS symptoms, but evidence of clinical efficacy is lacking 1
It's essential to note that antibiotics are not recommended for treating VRS, as they are ineffective for viral illness and do not provide direct symptom relief 1. Topical intranasal steroids may have a role in managing VRS, but the magnitude of effect is small, and the decision to use them should be based largely on patient preference 1.
In the emergency room, a combination of these symptomatic treatments can be effective in managing cough and rhinorrhea, but it's crucial to evaluate the patient for underlying causes of their symptoms, such as influenza, COVID-19, or bacterial infection, before finalizing treatment.
From the FDA Drug Label
Purpose Cough suppressant Package/Label Principal Display Panel Compare to Delsym® active ingredient Dextromethorphan Polistirex Extended-Release Oral Suspension Cough Suppressant
A good treatment for cough in the emergency room is dextromethorphan (PO), a cough suppressant 2. However, there is no information provided about the treatment of rhinorrhea. For rhinorrhea, no conclusion can be drawn from the given drug labels.
From the Research
Treatment for Cough and Rhinorrhea in the Emergency Room
- The treatment for cough and rhinorrhea in the emergency room can be managed with various medications, including antitussives, antihistamines, and decongestants 3, 4.
- Antitussives, such as codeine or dextromethorphan, can provide symptomatic relief for dry or non-productive cough 3.
- Antihistamines, such as chlorpheniramine, can help relieve symptoms of allergic rhinitis, including rhinorrhea, sneezing, and coughing 4.
- Decongestants, such as pseudoephedrine, can help alleviate nasal congestion associated with allergic rhinitis 5.
Combination Therapies
- Combination therapies, such as antihistamine-decongestant-analgesic combinations, can be effective in reducing the duration of symptoms and alleviating symptoms of the common cold 6.
- However, the evidence for the effectiveness of these combinations is limited, and the benefits must be weighed against the risk of adverse effects 6.
- Intranasal corticosteroids may offer superior relief in allergic rhinitis compared to antihistamines, and combining antihistamines and intranasal corticosteroids may not provide additional beneficial effects 7.