Syracuse Parent and CNY Family

Dr. Monica Jones is a pediatrician with Syracuse Pediatrics. Reach her at www.syracusepediatrics.com. To send a health-related question to the doctor, write to editor@syracuseparent.net

Cold medicine makers pull remedies off shelves
Posted on Sat, November 3rd, 2007
Written by: Monica Jones, MD, Pediatrician/Syracuse Pediatrics
email: editor@syracuseparent.net

We have all been there –up late with our kids at night who have a cough that sounds like they might soon cough up a lung. As a parent we would do anything to make them better. As a pediatrician I have been asking parents to avoid over-the-counter cough and cold medications for years. Now in the wake of a possible FDA ban, the makers of some of the big named cough and cold medicines are pulling the products off the shelves. I applaud these companies for pulling these money-making products and doing what is right for children. So what’s the big brouhaha?

OK let’s start at the beginning. What makes most kids cough? Colds. Colds are caused by viral infections—also known as upper respiratory infections. The body then makes lots of mucous which leads to nasal congestion and coughing. Viral infections do not respond to antibiotics so when you are sick from a virus, all you can do is treat the symptoms.

Most colds last one to two weeks. So why not use the OTC (over the counter) medicines?
Most OTC medicines are a combination of Tylenol or Motrin and either dextromethorphan or pseudoephedrine (or both). People do not realize that if they use these medicines and then give Tylenol for fever, children can easily be overdosed.

Dextromethorphan is used to suppress cough. In children, there is no evidence that it works at all. It can also have serious side effects both related to the medicine itself and to suppressing a cough. Dextromethorphan can cause symptoms such as lethargy, hyper-excitability, abnormal limb movements, and coma. Another important aspect is that cough, as annoying as it might be, is protective. Cough is a reflex designed to keep our airways and lungs clear of anything that might try to get in, including mucous from a cold.

Stopping a cough can put children at risk of pneumonia. Cough suppression is especially dangerous in children with other illnesses such as asthma, cystic fibrosis and heart disease.
Pseudoephedrine is a decongestant. Here too, there is little evidence that it is effective in young children but we know it can cause serious side effects. Some of these are elevated blood pressure, fast heart rate, agitation, insomnia, psychosis and seizures. We also know that the more they are used, the less they work and then it can even make congestion worse.

Several different groups went to the FDA and asked for a ban on these products because they were not shown to be effective in young children and the increasing fear that they are also dangerous. The CDC reported several deaths that were attributed to use of OTC cough and cold medicines.
There are still some very effective things you can do to help your child get through this cold. FLUIDS, FLUIDS and FLUIDS. First, place a cool mist humidifier in your child’s room. For young infants, place a few drops of nasal saline in their nose and then suck out the nose with a bulb syringe.

Make sure your child is drinking lots of clear fluids, which helps thin out the mucous. Prop up the head of the bed for younger children to help relieve cough from postnasal drip at night. Finally, plain Tylenol or Motrin is OK to help reduce fever and discomfort.
Remember to always call your child’s pediatrician if you are not sure what to do.

Dr. Monica Jones is a pediatrician with Syracuse Pediatrics. Reach her at www.syracusepediatrics.com. To send a health-related question to the doctor, write to editor@syracuseparent.net