Influenza Pandemic Preparation and Response: A Citizen's Guide

They can be prescribed only by a physician. These are Oseltamivir (also known as Tamiflu) and Zanamivir (commonly called Relenza).

For antiviral medication dosages visit the CDC's website: www.cdc.gov/flu Limitations in the use of antivirals

• Antiviral medications are going to be in high demand during the pandemic.

Thus, most individuals will not have access to these medications once a pandemic begins.

• Antivirals are most effective if taken within 48 hours after the onset of the first symptoms.

• Antiviral medications are not always effective, so don't rely on them completely.

Basic Health Assessment and Treatment9

By recognizing the symptoms a patient has or the signs of the disease in the body, you can use the chart below to guide your treatment.

Here's how.

Symptom or Sign

• Low urine output
• High pulse rate (>80 but especially > 90)
• Shortness of breath
• Shaking chills and shivers
• Cyanosis (skin turns blue)
• Bleeding from mouth, coughing up blood, passing red blood per rectum, severe bruising
• Vomiting
• Diarrhea
• Severe stomach cramps
• Headache
• Fever
• Sore throat
• Cough

Likely Assessment

• Dehydration
• Dehydration or fever
• Pneumonia
• Viremia (virus in the blood) or pneumonia
• Respiratory failure, death likely
• A severe blood clotting abnormality has occurred due to the virus (DIC). Death is likely
• Virus affecting GI tract
• Virus affecting GI tract
• Virus affecting GI tract

Treatment

• Push fluids
• Push fluids
• Push fluids
• Keep warm
• Keep as comfortable as possible.

Give hydrocodone with promethazine for comfort, give diazepam for anxiety

• Keep as comfortable as possible. Give hydrocodone with promethazine for comfort, give diazepam for anxiety
• Use promethazine for vomiting, push fluids
• Push fluids, clear liquid diet
• Use hydrocodone and promethazine for comfort
• Ibuprofen and/or acetaminophen or hydrocodone if very severe
• Ibuprofen, acetaminophen, push fluids, keep warm or cool, consider tepid water baths if > 102 F. OK if <101 as this may help kill virus.

* Gargle with hot salt water, drink hot tea or hot water, ibuprofen and or acetaminophen

• Push fluids, drink hot tea for effect on breathing tubes, use hydrocodone tablet with or without promethazine to suppress cough if needed

Over-the-counter (OTC) Medications10

• To prevent adverse reactions or avoid extra medication that will have little or no effect, use an OTC remedy that treats only one symptom and/or has only one active ingredient.

• If you are taking more than one medication at a time, check the labels to avoid taking the same ingredient twice.
• Try regular strength products before using extra strength.

• Follow instructions on the label. Note possible side effects or drug/health conditions when the medication should not be used.

• Check the expiration date on medications in your home. Take outdated medications to a pharmacy for disposal.

• Keep all medications out of reach of children.

How to treat specific influenza symptoms in adults

Muscle pain and fever:

• Use acetaminophen (the best choice for older adults); for example, TylenolÆ. Note: if you take acetaminophen for a long time or in high doses, it can affect the liver and kidneys.

• Ibuprofen; for example AdvilÆ or MotrinÆ, is an alternative. Note: Ibuprofen can irritate the stomach.

Cough:

• Try a medication with Dextromethorphan(DM) for a dry cough that prevents you from sleeping or causes chest discomfort. DelsymÆ and Benylin-Dry CoughÆ contain DM (without other ingredients).

Stuffy nose:

• Use a decongestant.

Nose drops or sprays act quickly and have fewer side effects than medications you take by mouth. But they should be used only for two to three days to avoid rebound congestion.

If stuffy nose continues, consider an oral medication such as pseudoephedrine. Decongestants may cause dry mouth, sleep problems, rapid heartbeat, or other side effects.

• People who have long-term health problems or who are on other medications should not take decongestants without talking to a healthcare provider.

Sore throat:

• Try lozenges or throat sprays.

Dyclonine (for example SucretsÆ) works best to numb the throat. Products containing honey, herbs, or pectin soothe the throat.

How to treat specific influenza symptoms in children

Treat influenza symptoms in children with OTC medications only if necessary.

Muscle pain and fever:

• Acetaminophen (for example TylenolÆ) is best.

You may try Ibuprofen (for example, MotrinÆ) instead, but do not use it for babies less than 4-months old. Take the child's temperature before giving medication for fever.

Do not wake a child to give the medication. Children under eighteen months should NOT take acetylsalicylic acid (ASA), e.g., AspirinÆ or any products containing ASA. Combined with influenza, ASA can cause Reye's Syndrome, a very serious condition affecting the nervous system and liver.

Cough:

• Use a cough suppressant (DM) for a dry cough in children over 2-years of age, but only if the cough is disturbing the child's sleep. Do not use DM for a moist cough or for children with asthma.

Stuffy nose:

• Saline nose drops, such as SalinexÆ, may help a stuffy nose and cough. You may use decongestant sprays for children older than 6 months, and oral decongestants for older children, if needed.

Sore throat:

• Throat lozenges or a warm salt water gargle may help children older than 6 years of age.

Other measures to reduce symptoms

• Steam bath using a pot of hot water and a few drops of eucalyptus oil to help clear congestion
• Use of a humidifier
• Warm salt water as a gargle for soothing sore throat.

The Importance of Hydration

People with influenza flu are at high risk of becoming dehydrated, so maintaining adequate intake of liquids is a critically important function for care givers.