What medicine should be given to people with respiratory diseases?

[Core answer first] First of all, let’s be clear: there is no “panacea” that applies to all respiratory diseases. Before taking medication, you must first clarify the disease type (infectious/non-infectious), pathogen (virus/bacteria/mycoplasma/allergen, etc.), patient’s age, basic medical history, allergy history. Commonly used clinical drugs are divided into two categories: cause-related treatment and symptomatic treatment. All drugs must be used under the guidance of professional doctors/pharmacists, and blind combinations are prohibited.

When the season changes in the past two years, the number of appointments in the respiratory department is very high. Last week, I met a sophomore girl who had a cough for less than half a month. I searched for "respiratory disease package" on the Internet. Really, too many people just take medicine when they have a sore throat, cough, or fever, regardless of whether it is correct or not.

Let’s first talk about the most common infectious respiratory problems, such as common colds, flu, mycoplasma pneumonia, and bacterial tonsillitis. If it is an upper respiratory tract infection caused by common rhinovirus or adenovirus, to put it bluntly, there is no need to take any special medicine at all. If the fever is uncomfortable, take some ibuprofen or acetaminophen to reduce the fever, drink more water and rest, and it will heal on its own in about a week. Many people take amoxicillin as soon as they start. It is really unnecessary. Antibiotics cannot kill the virus. If you take too much, it will mess up the intestinal flora. In severe cases, it will become drug-resistant. If it is found to be influenza A or B, oseltamivir will be most effective if taken within 48 hours of the onset of the disease. If it exceeds 48 hours, there is no need to take it if there are no high-risk factors. Symptomatic treatment will suffice.

If blood tests reveal high levels of white blood cells and C-reactive protein, indicating a bacterial infection, then antibiotics such as cephalosporin, amoxicillin, and penicillin will need to be used, and they must be taken according to the course of treatment. Do not stop taking it after two days when you feel better. Residual bacteria are prone to resurgence and drug resistance. For mycoplasma pneumonia, which has been very popular in the past two years, ordinary cephalosporins are useless. Macrolide drugs such as azithromycin must be used. Adults can also use levofloxacin, but children must not take levofloxacin as it will affect bone development. This should be kept in mind.

In addition to the problems caused by these infections, many people's respiratory discomfort has nothing to do with germs. For example, allergic rhinitis, which causes sneezing, runny nose, and itchy nose as soon as spring comes, or asthma, which causes wheezing when catching a cold. These are non-infectious respiratory diseases. No matter how many antibiotics you take, it will be useless. Generally, antihistamines such as loratadine and cetirizine, combined with budesonide nasal spray, are used for allergic rhinitis. For asthma, inhaled corticosteroids such as Symbicort and Seretide are mostly used. Long-term and regular use can be well controlled, and there is no need to take other medicines.

Speaking of which, I have to mention the controversial use of cough medicines. There are indeed two different clinical views. One is that if the dry cough is particularly severe and cannot sleep at night, or even causes pain in the ribs and headaches, making it impossible to live a normal life, then you can use some central antitussives such as dextromethorphan to suppress the symptoms first and ensure that you get better quickly. However, there are also many veteran respiratory experts, especially those who treat pediatrics and geriatric diseases, who are particularly opposed to the casual use of antitussives. They believe that coughing itself is a protective mechanism of the body, which is to expel phlegm and secretions from the airways. Stop the cough as soon as it comes up. Blockage of phlegm can easily induce pneumonia and atelectasis. Especially for the elderly, children, and patients with chronic obstructive pulmonary disease and bronchiectasis, they should give priority to phlegm-reducing drugs such as ambroxol and acetylcysteine. After the phlegm is cleared, the cough will naturally be cured. When I got mycoplasma infection last winter, I coughed so much that my lungs came out at night. I didn’t take any antitussives. I drank warm honey water every day (children under 1 year old should never touch honey) and washed their noses with saline. It took about 10 days to get better. This depends on the individual situation. There is no absolute right or wrong.

After talking about the Western medicines that everyone often takes, we should also talk about the Chinese patent medicines that are widely used now. Many people think that Chinese patent medicines are mild and have no side effects, but this is not the case. For example, Lianhua Qingwen, Pudilan, and Lanqin are all heat-clearing and detoxifying medicines. They are suitable for hot colds with fever, sore throat, speechlessness, and dry stool. If you are afraid of the cold, have diarrhea when a cool breeze blows, and have cold hands and feet, taking these medicines will aggravate the symptoms. Some people take these medicines as preventive medicines and drink them every day. In the end, they damage the spleen and stomach. If you eat something cold, you will have diarrhea. It is not worth the loss. Both traditional Chinese medicine and Western medicine have mentioned this. Chinese patent medicines must also be used for syndrome differentiation and cannot be taken casually.

I would like to remind everyone that many compound cold medicines, such as the commonly purchased 999 cold medicines, such as 999 Ganmao Ling and Pediatric Aminophen Xantamine, already contain acetaminophen. If you take this and then take antipyretics such as ibuprofen and Sanli Pain, it can easily lead to an overdose of acetaminophen, which may cause diarrhea and rashes in mild cases, or even cause liver damage or even liver failure in severe cases. There are such cases every year, and it really is not to scare people.

To put it bluntly, respiratory diseases can be light or serious. If you take the right medicine, you can be active for a few days, but if you take the wrong medicine, it will cause trouble to the body. If you really feel uncomfortable, don't carry it or search for prescriptions and take random medicines. Go to a community hospital to get blood drawn for about ten yuan, and you can roughly figure out what's going on. It's much better than just thinking about it based on online posts. After all, your body is your own, so don't use yourself as a guinea pig for testing medicines, right?