Cold Self Care

The Common Cold
The Flu
Mono
Sinus Infections
Treating Viral Infections
Nasal Congestion
Sore Throat
Cough
Fever
Over-the-Counter Medications

The Common Cold

What is the common cold?

The common cold is also referred to as an upper respiratory infection. The term refers to inflammation of the upper respiratory tract and can be caused by many different viruses. There is no cure for the common cold and because they are caused by many different virus strains, they cannot be cured by taking antibiotics. Some over-the-counter medications may reduce your symptoms. It is important to determine if you have a cold or something more severe. See the links for the flu and treating a viral infection for more information.

How do you catch a cold?

Colds are spread mainly from person to person through coughs, sneezes, and mucus on a person's hands. You can pick up the virus from books, towels, door handles, etc. that people with a cold virus have touched. Many of the viruses that cause the common cold can live for several hours on hard surfaces. Colds are contagious only in the earliest stages, usually only the first three to four days of illness.

How long can a cold last?

Most colds can range from 4 to 5 days to as long as 7 to 14 days. Some colds may last in diminishing severity for 2 to 4 weeks.

For information about caring for four common cold symptoms, see the additional links for cough, nasal congestion, sore throat, and fever. For each symptom, you will find recommendations for self-care and advice to help you decide when to seek medical care. If you need medical care, you can schedule an appointment by calling the Student Health Service at 412-383-1800.

How can you tell if it is a cold or the flu?

Different viruses cause the cold and the flu. Cold and flu symptoms are similar but have different intensity levels. A cold usually begins with minor sniffling or sneezing, while the flu hits you all at once. A cold rarely moves into the lungs, but the flu can cause pneumonia. Fatigue and muscle aches are more severe with the flu. See the box below for comparisons of cold and flu symptoms.

Common Symptoms	Cold	Flu
Fatigue	No	Yes
Fever	No	100-104 F
Muscle Ache	No	Yes
Joint Pain	No	Yes
Loss of Appetite	No	Yes
Headache	No	Yes
Cough	Yes	Yes
Stuffy Nose	Yes	No
Diarrhea/Vomiting	No	No
© 1999 Glaxo Wellcome, Inc.

Preventing the Spread of the Cold Virus

Cover your mouth when sneezing and coughing.
Wash your hands, especially before handling food or touching your face.
Discard used tissues
Avoid sharing towels, utensils and cups.
Avoid kissing.
Eat a balanced diet.
Get an adequate amount of sleep.
Keep your stress level down.

Portions adapted and used with permission from The University of Rochester Health Service

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The Flu (Influenza)

What is the Flu?

The flu, also known as influenza, is a respiratory illness caused by influenza viruses. It is not an intestinal disease with vomiting and diarrhea. There are outbreaks of the flu every year, typically during the Fall and Winter months. The period from initial infection with influenza to onset of symptoms is approximately 1 to 3 days.

What are the symptoms of the Flu?

Although many symptoms may be similar to the common cold, symptoms are usually abrupt in onset, develop very quickly and include:

Fever
Chills
Weakness
Aches and pains, especially muscles
Headaches
Dry Cough
Fatigue

If you suddenly develop these symptoms at a time when influenza is present in the community, you probably have the flu. Even during a flu epidemic, however, other types of viral and bacterial illnesses may occur. Although the illness runs its course in several days, cough and fatigue may persist for several additional days or weeks. See the chart below to compare cold and flu symptoms:

Common Symptoms	Cold	Flu
Fatigue	No	Yes
Fever	No	100-104 F
Muscle Ache	No	Yes
Joint Pain	No	Yes
Loss of Appetite	No	Yes
Headache	No	Yes
Cough	Yes	Yes
Stuffy Nose	Yes	No
Diarrhea/Vomiting	No	No
© 1999 Glaxo Wellcome, Inc.

Seek immediate care from a medical professional if you experience:

Shortness of Breath
Confusion
Production of large volumes of phlegm
Wheezing
Relapse of flu symptoms after 10 to 14 days

These symptoms may indicate an illness other than the flu. Individuals with diabetes or with chronic heart, lung, or kidney disease should be under the care of a health professional as soon as they develop flu-like symptoms.

Treatment for the Flu

Since flu is caused by viruses, antibiotics will not work and may even be dangerous since they may cause side effects of their own. If you are able to seek treatment with the first 48 hours of onset of your symptoms, there are certain anti-viral medications (drugs that work against a virus, NOT an antibiotic) specifically for the flu that may be prescribed to help shorten the amount of time you feel sick from the symptoms of the flu. The only real cure for flu is time. In uncomplicated flu the fever lasts three to four days and recovery occurs within a week. While most flu symptoms disappear within a week, a dry cough and lack of energy may persist for a couple of weeks. Once the worst symptoms have passed, it is especially important to eat and rest well so that full recovery takes place as quickly as possible. Your activity level should be determined by how you feel. You may also:

Rest in bed.
Drink 1-2 quarts of light liquids (water, tea, soda pop, juice, clear soup, etc.) a day, avoiding caffeine. Eat what you feel like eating (low fat, "light" foods are best).
Take aspirin-free pain relievers such as Tylenol®, or Ibuprofen® every four to six hours to reduce fever and relieve aches and pains.

Aspirin use during flu and chicken pox has been associated with Reye Syndrome, a rare but serious disease. Therefore, children and teenagers 18 years old and younger should not use aspirin for treating these illnesses. Products containing "acetaminophen" (a non-aspirin product used for relieving aches and pains and for reducing fever) should be substituted for aspirin.

Warning: Avoid using aspirin or aspirin-containing products.

Complications from the Flu

The risk of complications and death associated with influenza is highest for individuals with diabetes, heart, lung (including asthma), or kidney disease; and other chronic diseases, which lower the body's resistance to infection. Persons over age 65 are also at greater risk of developing complications associated with flu. Anyone in one of these categories should call immediately to schedule an appointment to be evaluated. The Student Health Service phone number is 412-383-1800.

The most serious complication associated with flu is pneumonia. Shortness of breath, sharp chest pain on deep breathing, or fever lasting beyond five days are symptoms that may indicate pneumonia. If you experience any of these, you should be examined by a health care professional. Please call to schedule an appointment at the Student Health Service.

Preventing the Flu
The best way to help prevent getting the flu is with an annual flu vaccine. It is a vaccine that consists of either the live virus (which is administered into the nose) or the killed virus (an injection into the arm) and is given in the Fall months, usually October or November of each year. The Student Health Service offers several flu clinics each fall, and you may also receive them at the Health Center.

If you are pregnant, ask your physician's advice before receiving the influenza vaccine (or any vaccine or drug).

To help maintain resistance to infections:

Stay home when you are sick - avoid extra visits to the dining halls and library
Get adequate rest
Exercise regularly
Eat nutritiously
Clean your hands often with soap and warm water
Cover your nose and mouth when sneezing or coughing
Discard your tissue after using it once
Avoid sharing towels, utensils, and cups
Keep your stress level down
Avoid kissing

There is no medical evidence that over-the-counter medications, antibiotics, or large doses of Vitamin C are effective in preventing flu (or colds).

Centers for Disease Control and Prevention (CDC): Influenza (the Flu): Questions & Answers

Portions adapted and used with permission from The University of Rochester Health Service.

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Mono

What is mono?

Mono or Mononucleosis is an illness caused by a virus, usually the Epstein-Barr virus (EBV). Many people catch mono as children, and have mild flu-like symptoms. Even as adults, most people who get mono are only sick a few weeks. EBV first infects the mucus membranes of the mouth, nose and throat. From there, it spreads to a type of white blood cell that travels throughout the body, spreading the virus with it.

How do you get mono?

Mono is passed from person to person through the saliva. Kissing is one likely way to spread the infection, along with sharing drinks or eating utensils of an infected person. Mono has a long incubation period. From the time a person is infected until symptoms start can be as long as 1-2 months. If you have mono now, you may have been infected weeks ago.

Many people are infectious without symptoms and some people never even feel sick. It is possible to no longer feel sick, but still produce the virus for several weeks or even months. You may have been infected by someone who wasn't having symptoms. Fewer than 10% of people who get mono know whom they caught it from. 80-95% of adults in the U.S. have had mono by the time they are 40; only about 20% know that they have had it.

Most people who have had mono become immune. They won't get sick again if they are exposed to the virus in the future. If you have mono, only people you have kissed are likely to catch it. Other friends, family or co-workers are safe.

Symptoms of Mono

Classic mono symptoms:

Swollen lymph glands
Sore throat
White patches at the back of the throat
Fever
Fatigue (extreme tiredness)
Headache
Poor appetite
Muscle aches
Nausea
Skin rash

Treatment of Mono

Antibiotics are not used to treat mono because it is caused by a virus. Some people don't miss school or work if they take it easy and get as much rest as possible. Because the spleen often swells with mono, spleen rupture is a possible serious and life-threatening complication. Its first symptom is abdominal pain and/or pain spreading into the left shoulder.

What you should do:

Get plenty of rest.
Eat healthy foods.
Don't drink alcohol.
Drink lots of fluids.
Take acetaminophen or ibuprophen for pain/fever. (Do NOT use aspirin).
Protect the spleen by avoiding strenuous activity such as hard exercise, contact sports, or heavy lifting for several weeks.

When to Seek Medical Care

If you think you may have mono, call the Student Health Service at (412) 383-1800 to schedule an appointment. A throat culture or blood test may be needed to determine the cause of your symptoms.

Call immediately for an appointment if you have:

Abdominal pain and/or pain in your left shoulder.
Jaundice (yellow color in eyes or skin) or dark urine.
Trouble breathing.
Inability to swallow fluids.
High fever or fever that lasts more than 2 days.
Other symptoms that don't improve after 7 days.

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Sinus Infections

What causes a sinus infection?

A sinus infection, or sinusitis, means that your sinuses are infected or inflamed. Sinuses are hollow air spaces, or pairs of cavities in the front of the skull that are usually open to allow for the exchange of air and mucus. Therefore, anything that causes a swelling in the nose - such as an infection, allergic reaction, or congestion, can affect the sinuses. Air or pus trapped in a blocked sinus may cause pressure on the sinus wall, causing pain.

Most cases of acute sinusitis start with a common cold, which is usually caused by a virus. Viral colds do NOT cause symptoms of sinusitis, but may inflame the sinuses. Both the cold and the sinus inflammation usually go away without treatment in about 2 weeks.

Most health people harbor bacteria, such as Streptococcus pneumoniae and Hemophilus influenzae, in their upper respiratory tracts with no problems until the body's defenses are weakened or drainage from the sinuses is blocked by a cold or other viral infection. Thus, bacteria that may have been living harmlessly in your nose or throat can multiply and invade your sinuses, causing an acute sinus infection.

Chronic inflammation of the nasal passages can also lead to sinusitis. If you have allergic rhinitis or hay fever (otherwise known as "allergies"), you can develop episodes of acute sinusitis. Acute sinusitis is more common in some people than in the general population. Health care experts estimate that 37 million Americans are affected by sinusitis every year. (NIH).

What are symptoms of a sinus infection?

Because your nose can get stuffy when you have a condition like the common cold, you may confuse simple nasal congestion with sinusitis. A cold, however, usually lasts about 7 to 14 days and disappears without treatment. Sinusitis often lasts longer and typically causes more symptoms that just a cold. There are three main types of sinusitis:

Acute, which lasts for 3 weeks or less.
Chronic, which usually lasts for 3 to 8 weeks but can continue for months or even years.
Recurrent, which are several acute attacks within a year.

The typical symptoms of sinusitis may include:

Fever
Weakness
Tiredness
A cough that may be more severe at night
Runny nose or nasal congestion that has persisted for more than 7 to 14 days
Headache or facial pain around your eyes. Infection of the maxillary sinuses can also cause your upper jaw and teeth to ache and cheeks to be tender to touch.
Loss of smell and taste.
Drainage of mucus down the back of your throat (post nasal drip).

What are symptoms of a sinus infection?

Many cases of acute sinusitis will end without antibiotics. If you have allergic disease along with sinusitis, you may need medicine to relieve your allergy symptoms. If you already have asthma then get sinusitis, you may experience worsening of your asthma and should be evaluated by your health care provider.

If you think you may have sinusitis, you should be evaluated at the Student Health Service. After you have been examined, you may be given any of the following:

Decongestant to reduce congestion
Antibiotics if a bacterial infection is present
Pain relievers to reduce pain (avoiding Aspirin products)
Steroid nasal sprays to reduce inflammation

Note: You should only use over-the-counter (OTC) nose drops and sprays for no more than 3 days. If you use these medications for longer periods, they can lead to even more congestion and swelling of your nasal passages.

Although home remedies cannot cure sinus infections, they may provide some comfort. Some other things you may try:

Inhaling steam from a vaporizer, from a hot cup of water, or from a hot shower can soothe inflamed sinus cavities.
Saline nasal drops.
Gentle heat applied over the inflamed area.
Drinking at least six 8 oz. glasses of fluid per day.
Getting extra rest.

You should take care to avoid alcohol while treating a sinus infection. Drinking alcohol can cause nasal and sinus membranes to swell. Avoiding caffeine is also a good idea as caffeine is a diuretic, which pulls fluid from your body, and can cause your mucus to become thicker.

Seek medical care if:

The fever is 101 or higher that persists for more than two days.
The congestion does not clear up within two weeks.
You cough or sneeze mucus that is green, brown, or bloody.
Your sinuses are tender and painful.
You have a chronic lung (including asthma) disease, diabetes, heart or kidney disease.
Difficulty breathing.
Severe coughing episodes.

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Treating Viral Infections

If you are diagnosed with a viral upper respiratory infection, you will not be given an antibiotic. The common cold is caused by a viral infection and not treated with antibiotics. Antibiotic treatment does not cure viral infections and, in fact, may be harmful if given when not needed. Typical symptoms include a cough, nasal congestion, sore throat, headaches, muscle aches, and fatigue. Pressure in the ears and sinuses, low-grade fever, chills and chest discomfort may also be present. On average, adults have 2 to 4 colds per year and children average 6 to 8 colds per year. The most common virus that causes upper respiratory infections is the rhinovirus. Transmission occurs primarily by hand contact with the infectious agent, usually by touching a doorknob, shaking hands, or sharing phones. Symptoms usually develop within a few days of exposure and usually last about 7-10 days. In some cases, the cough may persist after the other symptoms have resolved. The main treatment objective is to relieve the symptoms caused by the virus. The treatments below will help you feel better while your body's own defenses are combating the virus.

General Instructions

Rest until you feel in better health. Getting 8-10 hours of sleep when you are sick is helpful.
Drink at least six 8-ounce glasses of water per day.
Gargle to soothe a sore throat. A gargle can be made with ½ teaspoon of table salt in 8 ounces of warm water. Sore throats can also be soothed with ice chips, sore throat spray, or lozenges.
Use a cool mist humidifier to relieve congestion and moisten dry mucous membranes. Use a Steam Vaporizer to promote drainage of nasal sinuses.
Take acetaminophen (Tylenol) or ibuprofen (Advil) to help relieve fever and/or body aches and sore throat. Children and teenagers should not take aspirin since it can cause Reye's Syndrome, a rare but often fatal condition.
Decongestants, such as pseudoephedrine may relieve your nasal congestion, ear congestion or popping in ears.
Cough medicines can be used to help control your cough.
Wash your hands often since colds are spread from your hands; cover your mouth when you sneeze or cough since the viruses can also be spread through the air.
If not improved in 7 days, a new symptom occurs, or you have concerns, call to schedule an appointment at the Student Health Service.
Nasal decongestants (nose sprays or drops) can relieve a stuffy nose. They should be used sparingly and not more than 3 days because of rebound swelling.
Nasal saline (salt solution) will help break up thick mucus blocking the nose & sinuses.

Reminders

Cold and flu medications relieve symptoms but do not actually kill viruses. Although you cannot kill a virus, you can take medications that will help you feel better

Cold and flu medications relieve symptoms but do not actually kill viruses.
Use medication as directed by your health care professional or the package instructions.
Never take left over or old antibiotics
Antibiotics do not kill cold or flu viruses, or help aches, pains, or fever.

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Nasal Congestion

Reminders

There are two main causes for nasal congestion. When you have a cold, flu, or other infection, your body uses it as a mechanism to help fight against viral or bacterial infections. The second cause for nasal congestion occurs when you have an allergy to food, chemicals, or other substances like pollen or dust. Your body produces too much histamine which causes your nose to run and your eyes to water. If your symptoms persist for a couple weeks and you are unsure to the cause of the nasal congestion, you should schedule for an evaluation with a health care provider at the Student Health Service.

Self care for nasal congestion:

Stay away from places where people smoke. If you smoke, stop smoking.
Drink at least six 8 ounce glasses of fluid per day. Water, hot tea with honey and/or lemon, soup, and juice are all good choices.
Get extra rest.
You may want to avoid caffeinated products while taking decongestants, since they are both stimulants.
Breathe in moist heat in the shower or from a vaporizer to break up congestion.
Decongestants, which contain an active ingredient such as pseudoephedrine (e.g. Sudafed®), can dry up mucus in the head, chest, and nose. Decongestants shrink mucus membranes and open nasal passages.
If you have a cold, it may be contagious. Cover your mouth when coughing or sneezing to prevent the spread of infection.

Seek medical care if:

The fever is 100.5 F or higher or persists for more than two days.
Difficulty swallowing.
If you have a fever and are a smoker.
If you have any chronic lung disease (including asthma), diabetes, heart or kidney disease.
Shortness of breath, chest pain, severe headache, or stiff neck.
Severe coughing episodes.
Confusion, or unusual drowsiness.
The congestion does not clear up within two to three weeks.
You cough up or sneeze mucus that is green, brown, or bloody.
Your sinuses are tender and painful.
You have allergy symptoms that persist for more than three weeks.

Portions adapted and used with permission from The University of Rochester Health Service.

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Sore Throat

Causes

Most sore throats are caused by a viral infection of the throat, tonsils, or nasal passages and are associated with a cold or the flu. A dry (nonproductive) cough and lighter colored mucus are usually present. Sometimes they can affect the vocal cords and may cause you to temporarily lose your voice or become hoarse. Viral sore throats are less likely to be accompanied by a fever than a bacterial sore throat. Most viral sore throats can be treated with self-care and do not require the attention of a health care provider. Antibiotics are ineffective for treating viral infections.

Many sore throats are also caused by allergens or irritants. The other less common, but more serious, cause of sore throats are bacterial infections, such as strep bacteria. The throat appears very red with white or yellow patches or pus on the throat or tonsils. The neck glands or lymph nodes are often swollen. A fever higher than 101 F may be present. Sore throats caused by bacterial infections should be examined by a health care provider. They can be treated with antibiotics. Another common viral illness that can cause symptoms similar to strep throat may be mono. For more information on mono, follow the link on the menu page.

Symptoms of strep throat:

A sore throat that persists for 3-4 days.
A fever of 101 or higher.
Swollen glands in the neck.
White or yellow patches on the tonsils or back of the throat.

Self care for a minor sore throat:

Drink at least 6 to 8 glasses (8 oz.) of fluid a day to replace fluids lost when you have a fever and to loosen mucus secretions in your throat for a more productive cough. Warm beverages, such as tea with lemon, may help soothe your throat.
Gargle with warm salt water (¼ tsp. in ½ cup warm water) every few hours. If you have postnasal drip, gargle frequently to prevent throat irritation.
Eat and drink cold foods and liquids, i.e. popsicles and ice water.
Suck on a piece of hard candy or a lozenge.
Avoid smoke, alcohol, and caffeine. Both alcohol and caffeine can increase your likelihood of becoming dehydrated.
Use a cool-mist vaporizer or humidifier in the room where you spend the most time. Steam from a hot shower or a pan of water placed near a heater will also increase the humidity.
Take acetaminophen (Tylenol®) or ibuprofen (Advil®) as directed for pain or fever. Be sure to read and follow the dosage instructions. Do not use aspirin.
Elevate your head with extra pillows at night.

When you should seek medical care for your sore throat:

A fever of 101 F or higher with no other cold symptoms.
White or yellow patches on your tonsils.
You have a chronic lung (including asthma) disease, diabetes, heart or kidney disease.
A skin rash with your sore throat.
Great difficulty swallowing or breathing.
Hoarseness or enlarged lymph nodes that persist longer than 7 days.
Chills, a high fever, and coughing up green or yellow mucus.
A mild sore throat that has lasted more than 2 weeks.
You have been exposed to strep recently.

Portions adapted and used with permission from The University of Rochester Health Service.

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Cough

Coughing is your body's way of trying to clear the lungs and airways. Coughs may be caused by viral or bacterial infections, allergies, or by irritants, especially cigarettes. It is important to determine if your cough is caused by an infection, an allergy, or an irritant. A fever and thick, colored mucus may be signs of a bacterial infection, which should be treated by your health care provider.

There are two major types of coughs:

Productive: This type of cough brings up mucus or phlegm.
Non-Productive: A non-productive cough is dry and does not bring up any mucus.

Self care for a productive cough:

Drink plenty of liquids and use a vaporizer or hot shower steam to loosen congestion and thin mucus.
Take an over-the-counter expectorant, such as Robitussin to help thin mucus. Do not take a cough suppressant so much that you are no longer bringing up mucus.
Stay away from places where people smoke and/or stop smoking.
Drink at least six 8 oz. of fruit juice, water, soup, or other replenishing liquids daily.

Self care for a non-productive cough:

Drink plenty of fluids. Hot beverages, especially those with honey, soothe the throat.
Take an over-the-counter cough suppressant with dextromethorphan. Note: If you have diabetes, you may need to use a sugar-free cough preparation. If you are on a type of antidepressant known as an SSRI, you may want to be careful when taking dextromethorphan. If you are unsure, consult your pharmacist or health care provider before using over-the-counter cough suppressants.
Take a decongestant, such as Sudafed, if you have post-nasal drip, which you can feel at the back of your throat.
Suck on cough drops, lozenges, or hard candy to soothe and moisten your throat.
Elevate your head with extra pillows at night.

Seek medical care if:

You have a fever of 101 F or higher that persists for more than 2 days.
You cough up bloody, brown, or green mucus.
You experience shortness of breath or severe chest pains.
The cough lasts longer than 10 days.
You have a chronic lung (including asthma) disease, diabetes, heart or kidney disease.

Portions adapted and used with permission from The University of Rochester Health Service.

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Fever

A fever helps fight infection by creating an environment that is less conducive to the growth of bacterial and viral organisms. Chemicals released into the bloodstream signal your body's temperature regulators to increase your body temperature. Muscles shiver to generate heat. Normal body temperature may range from 97 to 99 F.

If you have ruled out factors other than illness that can cause a fever, it is then important to determine if you are dehydrated or if your fever is dangerously high. Since a fever is one of your body's natural healing mechanisms, you may not want to reduce it unless you are uncomfortable or it is too high.

Seek medical care if:

The fever is 101 or higher or persists for more than two days.
You have other symptoms of influenza, strep throat, mono, or sinus infection.
You cough up or sneeze mucus that is green, brown, or bloody.
You have a chronic lung (including asthma) condition, diabetes, heart or kidney disease.
Difficulty breathing.
Difficulty swallowing liquids.

Portions adapted and used with permission from The University of Rochester Health Service.

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Choosing Over-The-Counter (OTC) Medications

Most cold symptoms can be relieved with over-the-counter (OTC) medications. Below is a list of OTC medications to use with the various symptoms of a common cold. These medications can be purchased at the Student Health Pharmacy, located on the fifth floor of the Medical Arts Building. You do not need to make an appointment to purchase over-the-counter cold care medications.

It is important to read the labels of each product. Most cold and flu preparations contain a combination of ingredients. If you take more than one product, you may actually be getting a double dose of an active ingredient and/or not getting enough of another. Use OTC medications for temporary use only, unless instructed by your health care provider. If you unsure of any interactions with other medications you may already be taking, please ask the pharmacist or your health care provider as some OTC medications may interact with prescription medications.

Important Reminder: Young adults should avoid taking aspirin for cold symptoms. Aspirin has been implicated in the development of Reye's Syndrome, an uncommon, but serious complication of viral illnesses. Tylenol® or Ibuprofen is a better choice.

For nasal congestion, thick mucus, sinus headache:

Tylenol® (Acetaminophen) or Ibuprofen to relieve pain.
Sudafed® (Pseudoephedrine) to clear congestion.
Robitussin® (Guifenesin) to thin mucus
Afrin® for short-term (3 day) use only
Saline nasal drops

For congestion with cough:

Sudafed® (Pseudoephedrine)
Robitussin DM® (Guifenesin/Dextromethorphan) to thin mucus and suppress cough. (Avoid taking if on antidepressants.)
Saline nasal drops

For runny nose/sore throat/fever:

Tylenol®
Ibuprofen
Sudafed®
Saline nasal drops

For fever:

Advil® (Ibuprofen)
Tylenol® (Acetaminophen)

For sore throat:

Advil® (Ibuprofen)
Extra Strength Tylenol®
Cepastat Lozenges®

Portions adapted and used with permission from The University of Rochester Health Service.

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