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The ABCs of Children’s OTCs

Author: Mary Keating

For:  Family Living Magazine

Date:  January 2005

1400 words (including sidebar stories) 

Three-year-old Tommy’s been coughing non-stop and there’s an unbroken river of mucus coming from his nose. The doctor says it’s a virus and sends Tommy and his dad home with instructions to drink plenty of fluids and get lots of rest. Desperate, his mom heads to the store and an over-the-counter (OTC) cold remedy.

Once there, she is faced with a wall of cold remedies that doesn’t include a parent’s primer on how to select the right medication.

Although these products are available without a prescription, they are far from harmless. According to the Pharmacy Today magazine, medications are given incorrectly to children 50 percent of the time.

Taking a moment to review the tips for using OTCs, learning about the nine most common ingredients in pediatric OTC cold medications, and brushing up on the five classifications/usage for OTC cold meds will make your child safer and will ease the frustration of trying to find the right medication on the wall of cold medications when your child is feeling miserable

 Ten Tips on Using Pediatric OTCs:

1         Determine if medication is truly necessary. Beth Huston, mother of four, she tends to lean toward the “wait it out and watch the symptoms” philosophy. The main reason to give a cold medication is to make your child feel better. If the cold is not bothering him and he is eating and sleeping well, you may not want to give him anything. Remember that OTC cannot cure or prevent a cold or the flu. They are used only to temporarily relieve minor symptoms.

 In adults, normal body temperature is considered to be 98.6°F. This is not always the case for children, who generally have higher temperatures than adults. When considering what is a “normal” temperature for children, it is better to use a range (i.e. 97.5°F to 100.4°F) rather than a single number because body temperature fluctuates by as much as 3°F during the day.`

2         Give the least amount of ingredients as possible. In other words, if your child only has a stuffy head, then you do not need to give him a cough suppressant or a fever reducer. George Sedlmayer, a former State Board of Pharmacy member and a pharmacist at Fred Meyer in Pocatello advises people to avoid multi-ingredient medicines. 

“Multi-ingredient medicines are a shotgun approach, which often leads to taking an extra drug or two for symptoms you don’t have,” he said. “The safest approach to cold relief is to read the label and choose a drug specific to a symptom.”

3         Remember that children are not small adults. Cutting adult strength tablets in half or trying to estimate a child’s dose of an adult strength liquid can result in an accidental overdose. Similarly, giving older children liquid medications that are especially formulated for babies can also result in dosing errors, says Sedlmayer.

4         Know your child’s weight. Sedlmayer says weight is the best way to determine the correct dose.

5         Use a medicine dropper, dosing cup or other device that comes packaged with the medication. Kitchen spoons and other household utensils vary in size and are not accurate enough to measure doses of medicines, using them can result in giving too much or too little medication.

6         Do not tell a child that medicine is candy. Educate them about the dangers of medicines

7         Watch for multiple OTC overdoses. Sedlmayer strongly suggests that people first check the active ingredient(s) used in each OTC medication and make sure that you are not giving your child more than one product that contains the same active ingredient without realizing it. Second, check for usage duplication. For example, two cold medications may contain different active ingredients, but both of those ingredients act as fever reducers. That’s usage duplication, and should also be avoided.

8         Stop using the medication if it is not working. If symptoms persist or get worse, contact a pediatrician or other healthcare professional.

9         Secure all medications in a safe place away from a child’s reach

10     And finally, read the label and understand what all the ingredients do. If in doubt, ask a doctor or a pharmacist. Read and follow label instructions carefully. OTCs are serious medications that can do harm if taken incorrectly, always read the entire label information before giving a child any OTC product. Remember, some OTC products come in different strengths. Beware.

Read the label

You wouldn’t ignore your doctor’s instructions for using a prescription drug, so don’t ignore the label when taking an OTC medicine. Here is what to look for: 

  • “ACTIVE INGREDIENTS”: therapeutic substances in medicines
  • “PURPOSE”: product category (such as antihistamine, antacid, or cough suppressant)
  • “USES”: symptoms or diseases the product will treat or prevent
  • “WARNINGS”: when not to use the product, when to stop taking it, and how long to take it.
  • “OTHER INFORMATION”: such as storage information
  • “INACTIVE INGREDIENTS”: substances such as binders, colors, or flavorings.

 The most common pediatric ingredients in pediatric OTCs

When dealing with Pediatric OTC cold medications, 99 percent of all medications have one or a combination of only nine (9) active ingredients. Knowing what these nine active ingredients do will save you time, money and frustration.

Remember there are over 30 different pediatric cold remedies on the market. The less expensive single ingredient generic or store-brand drugs are just as effective as the well-advertised brand-name products which contain the same ingredients. If in doubt, check with the store pharmacist.

Here they are:

Acetaminophen, an analgesic, is used to relieve mild to moderate pain and to reduce fever.

 Brompheniramine, an antihistamine, relieves red, irritated, itchy, watery eyes; sneezing; and runny nose caused by allergies, hay fever, and the common cold. It also may relieve the itching of insect bites, bee stings, poison ivy, and poison oak

Chlorpheniramine, an antihistamine, relieves red, itchy, watery eyes; sneezing; and runny nose caused by allergies, hay fever, and the common cold. It may also relieve the itching of insect bites, bee stings, poison ivy, and poison oak.

Dextromethorphan, an antitussive, is used to relieve a nonproductive cough caused by a cold, the flu, or other conditions.

Dipenhydramine Hydrochloide, an antihistamine, used to relieve or prevent the symptoms of hay fever and other types of allergy. They work by preventing the effects of a substance called histamine, which is produced by the body. Histamine can cause itching, sneezing, runny nose, and watery eyes. Also, in some persons histamine can close up the bronchial tubes (air passages of the lungs) and make breathing difficult. The main medication containing dipenhydramine is benadryl.

Guaifenesin, an expectorant, thins the mucus in the air passages and makes it easier to cough up the mucus and clear the airways, allowing you to breathe more easily. It relieves the coughs of colds, bronchitis, and other lung infections.

Ibuprofen, an anti-inflammatory, is used to relieve pain, tenderness, and inflammation (swelling). It is also used to reduce fever and to relieve headaches, muscle aches, aches and pains from the common cold, backache, and pain after surgery or dental work.

Loratadine, an antihistamine, is used to relieve hay fever and allergy symptoms, including sneezing; runny nose; and red, itchy, tearing eyes. Loratadine may cause less drowsiness than other antihistamines.

Pseudoephedrine, a decongestant, relieves nasal discomfort caused by colds, allergies, and hay fever. It relieves stuffy nose, opens nasal airways, and drains sinuses. The main medication containing pseudoephedrine is Sudafed.

The Classifications/Usage

Antihistamines – relieve or prevent the symptoms of hay fever and other types of allergy. They also help relieve some symptoms of the common cold, such as sneezing and runny nose. Examples: brompheniramine (brome-fen-EER-a-meen ) , chlorpheniramine (klor-fen-EER-a-meen) , diphenhydramine (dye-fen-HYE-dra-meen ),

Decongestants – clear nasal congestion. Exmaples: pseudoephedrine (soo-doe-e-FED-rin).

Antitussives – tell your brain to stop coughing. Examples, dextromethorphan.

Expectorants – help thin mucus so it can be coughed up more easily. Example, guaifenesin.

Analgesics and Anti-inflammatories – relieve aches and pains and reduce fever. Examples: acetaminophen, aspirin, ibuprofen. Warning, teenagers and children should not be given aspirin.

A final word

Remember, the best remedy for the cold or the flu is to get plenty of rest and drink lots of fluids. If in doubt about what cold medication to give to a child, check with a Doctor, a health professional or a pharmacist. And don’t forget the basics: a god vaporizer and some saline drops.