Over-the-Counter Confusion

By ALLISON PERKINS Staff Writer

Ingredients key in childrens medicine

Dr. Rebecca Keiffer of Wendover Pediatrics stresses that its the ingredients, not the brand name, that are important when choosing a medication.

The key is to look at the list of active ingredients and tailor the medication to your childs symptoms, she says. Generic medications are just as effective as brand names. Different brands come in handy, she says, for choosing taste.

Child dosages are based on weight, not age, so parents need to check the chart on the medication closely. When in doubt, Keiffer says, call your pediatrician.

Amy Hallisey. pharmacist at Target Pharmacy on Lawndale Drive, says parents need to pay close attention not only to dosage amounts, but to the medicines extra ingredients, specifically, if it includes a fever reducer or pain reliever. Children should not be given Tylenol or Motrin in addition to a medication that includes either. That could lead to an overdose. Fever reducer and pain reliever are the same drug.

If children spill or spit up medicine, Hallisey says you should err on the side of caution and call the pharmacist or doctor to see if you should redose. Its often difficult to know how much medication a child swallowed, and depending on the potency of the drug, some medications should not be given again until the next scheduled dose.

Finally, like adults, if a child is taking a medication for a chronic illness, parents need to ask the pharmacist or pediatrician which over-the-counter drugs are compatible with his daily medicine.

— Allison PerkinsTreating a common cold? These answers may help

Q. Is a cold a virus or bacterial infection?

A. Pharmacists cannot tell patients which they have. Only a doctor can make that determination. Antibiotics, given by prescription, can only be used for bacteria. Viral infections usually have to run their course.

Q. Can I get over a cold without taking any medication?

A. Amy Hallisey. pharmacist at Target Pharmacy on Lawndale Drive, says pharmacists generally will try to give people the least amount of medicine they need to help them through a cold. Her nonmedicinal advice includes using a humidifier at night to clear the nose and throat, keeping hydrated and resting.

Q. What does generic mean?

A. Generic and brand-name drugs are the exact same drug. The brand name is produced by the company with the original patent for the drug. That company produced the drug first and for many years is the only company producing the drug, meaning it can charge more. After many years, the patent expires and other companies can produce the drug in generic form.

Q. What about medicines with more than one class?

A. Some brands mix the classes of drugs. NyQuil, for example, has an antihistamine, decongestant, expectorant and cough suppressant all in the same bottle. Hallisey says it is OK to take one medication that includes several drugs or buy four separate medicines with each of the four drugs and take all four medications at the same time. It is not safe to take several medications — each with several, duplicate ingredients — at the same time. Cold sufferers can sometimes expect to use several medications with one cold because the symptoms usually evolve and change in just a few days.

Q. Liquid, pills or gelcaps?

It doesnt matter what form the medicine comes in, and that is often what the company is marketing, Hallisey says. All the brand names use the same drugs, so people are really choosing taste and form when they choose a brand name. But pills, gelcaps, liquid and even the new strips that dissolve on the tongue all work as well.

Q. What do cough drops do?

A. Those yummy drops may temporarily soothe the throat, but they have no medicine in them, Hallisey says. They may have vitamins and menthol, but there is no medication. Some people might do just as well by using a piece of hard candy, she said.

Q. Should I use nasal sprays?

A. Hallisey does not recommend decongestant nasal sprays to help clear clogged noses. The sprays, she says, are very potent, and patients easily form a physiological addiction that actually changes the inside of their nose, causing them to need the spray to breathe clearly. She recommends using them only in the most extreme cases, for no more than three days.

— Allison PerkinsCoughing? Sniffling? Sneezing? Ignore the commercials. Forget the brand names.

The best way to fight a cold? Ask a pharmacist.

Its a science, says Amy Hallisey, pharmacist at Target Pharmacy on Lawndale Drive. One of the roles of the pharmacist is to help fine-tune over-the-counter (medications) for the individual.

There is no single over-the-counter drug that will zap a cold. Instead, medicines are used to make noses leak less and keep coughs quiet until the illness runs its course.

And unfortunately, there is no one drug that works the same for everyone.

If you have a sore throat, its not a black-and-white answer, Hallisey says. We need to know if its from postnasal drip or something else before we can recommend a medicine.

More than 10,000 over-the-counter medications, including vitamins and herbal remedies, are available in the United States, Hallisey says.

Its easy to feel overwhelmed when youre standing in the middle of a brightly colored pharmacy aisle, head pounding, nose running and throat scratching, looking up and down the rows of boxes and bottles for relief.

Again, Hallisey stresses, ask.

This is free advice and you dont get much of that nowadays, especially in health care, she says.

In a perfect world, customers would tell the pharmacist their symptoms in detail, including the gross stuff: Is their nose runny? Are they spitting up mucus? Is it thick? Is it green?

Even more importantly, the pharmacist needs to know what other illnesses patients suffer. Diabetes, asthma and high blood pressure are just a few diseases that could be aggravated by over-the- counter medications.

But when its 10 p.m., the pharmacy is closed and your toddler has a dry, hacking cough and runny nose, you cant afford to wait.

Heres a basic guide to understanding the labels on over-the- counter drugs and determining the right medicine for the right symptom.

Contact Allison Perkins at 373-7157 or aperkins@news- record.comFOUR BASIC DRUGS

There are four basic ingredients, or classes of drugs, used in cough and cold medications. When reading the package, ignore the brands and words such as treats cough, cold, flu symptoms, stuffy nose.

Instead, look for these four words: antihistamine, decongestant, expectorant, cough suppressant. These tell you exactly what the medicine does. They are usually found on the front of package in much smaller type, below the brand name.

Hallisey says she buys generic brands whenever possible because they use the same drug as name brands and cost less because they dont have the fancy marketing.

Antihistamines

Treats allergic reactions, nasal allergies, runny nose, itchy eyes and insomnia.

Side effects: Most cause drowsiness and dry up the body. Claritin, generically known as loratidine, is the only over-the- counter antihistamine that does not cause drowsiness. Claritin is more expensive because it is in a newer class of drugs. The antihistamine diphenydramine, the same ingredient found in Benadryl, is also the active ingredient in sleeping medications such as Nytol and Tylenol PM. People with diabetes, thryoid, prostate problems, glaucoma, asthma, bladder obstruction and urinary retention need to check with their doctors or pharmacists before taking these medications.

Cough suppressants

Will not prevent coughing, but affects the cough reflex in the brain, Hallisey says, and helps control the dry, hacking cough that is hard to stop. Hallisey says Delsym is the strongest cough suppressant available without a prescription. It has a sustained release to help patients through the whole night and tastes the best, but is more expensive. Most cough suppressant with the ingredient dextromethorphan (DM) usually has a bad taste, she said. If Delsym doesnt help, she says, no over-the-counter cough suppressant will.

Side effects: Cough suppressants can be abused in high doses to make patients feel drunk. There is no generic in this formula with extended release like Delsym.