November 22, 2010

Cold Medicine Removal Helps Drop Child ER Visits

According to a new study, the number of children going to the emergency room after taking too much cough and cold medicine was cut in half after drug companies took medications for their age group off the market.

Research shows that taking the medications off the shelves did what it was intended to do, but that there is still more that both drug makers and parents can do to protect kids from ending up in the ER.

"Overall, I think this is really good," Dr. Daniel Budnitz, the lead author on the study from the Centers for Disease Control and Prevention (CDC), told Reuters. But, "people might say, 'Wait a minute, these drugs can't be marketed anymore. It should be zero (emergency room) visits.'"

Manufacturers of cough and cold medicines came together in late 2007 and decided that they would stop selling these medications for use in kids less than two years old. 

Since then, the withdrawal has been updated to include cold and cough medicines for all kids less than 4 years old.

The U.S. Food and Drug Administration (FDA) recommended in January 2008 that parents should avoid the use of these products to treat children less than 2 "because serious and potentially life-threatening side effects can occur."

Dr. Eric Lavonas, the associated director of the Rocky Mountain Poison and Drug Center in Denver, who was not involved in the study, told Reuters that before the initial withdrawal, "there were no solid data to show that cough and cold medications actually work for kids, and they do cause side effects sometimes."

Dr. Michael Rieder, who studies drugs and drug effects in kids at the University of Western Ontario in Canada, told Reuters that the antihistamines and decongestants in some of these medicines can especially be a problem when kids take more than the recommended dose.

Budnitz and his colleagues looked at the number of kids going to emergency rooms for problems related to cough and cold medications before and after they were pulled.

About 2,800 kids younger than 2-years-old went to the ER in the 14 months before the original withdrawal was made after they had taken cough and cold medicine.  That number dropped to about 1,250 kids after the 14 months. 

"What this study shows is exactly what you expect," Lavonas told Reuters. "People are no longer buying these medications for use by small children, and as a result small children are not getting into them by accident."

Budnitz said that kids who show up in the ER for problems related to these medications often take too much when a parent is not looking, but sometimes it is the parents themselves that give the kid too much by mistake.

Lavonas told Reuters that cough and cold medicines made for older kids and for adults need to be designed so that it is much harder for kids to get into them and accidentally take a dangerous amount.  He also said that instructions on the medicine bottles should be more obvious about the appropriate dose for kids who are old enough to take them. 

Budnitz said that for parents, the important thing is to not give cough and cold medicines to kids younger than 4, and to make sure that all of the family's medicines are kept "up and away and out of sight."

Rieder said that when kids are sick, parents can give appropriate doses of Tylenol and make sure their child is comfortable and drinking plenty of fluids.

Lavonas told Reuters that if a kid does get into a cough and cold medication bottle and takes an in appropriate amount, then the ER may not necessarily be the first solution.

"If your child is not critically ill right in front of you, your very first call should be to your local poison control center," he said.

He said that most of the kids in the study did not need to go to the ER. 

The study was published in the journal Pediatrics.


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