jts Posted January 2, 2013 Share Posted January 2, 2013 Anybody out there have a favorite anti-tussive for peds over 2 yrs of age with common cold/cough? Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted January 2, 2013 Moderator Share Posted January 2, 2013 sudafed 15 mg/5 ml. 1 tsp every 6 hrs. a lot of pts with cough in this age group have postnasal drip as the etiology. if the kids are over 6 there is a 30/5 suspension. same directions. Link to comment Share on other sites More sharing options...
jen0508 Posted January 4, 2013 Share Posted January 4, 2013 i just recommend otc delysm or robitussin until they are old enough for tessalon perles. one of my coworkers uses c-phen. Link to comment Share on other sites More sharing options...
Joelseff Posted January 4, 2013 Share Posted January 4, 2013 Benadryl Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
Contrarian Posted January 5, 2013 Share Posted January 5, 2013 Black tar Heroin... (kidding..!!!) Vics Vapor rub slathered on the chest at bedtime works wonders for dampening the nighttime cough and allowing the kid to sleep without being awakened every few minutes by the cough. Link to comment Share on other sites More sharing options...
Joelseff Posted January 5, 2013 Share Posted January 5, 2013 Black tar Heroin... (kidding..!!!) Vics Vapor rub slathered on the chest at bedtime works wonders for dampening the nighttime cough and allowing the kid to sleep without being awakened every few minutes by the cough. Ooh Yah can't forget the vicks! Sent from my myTouch_4G_Slide using Tapatalk Link to comment Share on other sites More sharing options...
Moderator ventana Posted January 5, 2013 Moderator Share Posted January 5, 2013 Let them cough. No pills vicks and lovin humidifier do you really think we need to mess with mother nature at 28 months? Let the human body heal and do not give multisymptom cold meds to kids under 9 human body did fine for all of history till 20 years ago when direct to consumer advertising now makes us think the answer is in a pill On a side note. I just love the patient whole tells me h#ll mo I did not get the flu vaccine, when I am dx the flu with them and then demands abx for the flu! Oh do I enjoy the counseling session that follows! Speaking of the flu. In western MA we are in the midst of worst flu season in many year. This week hav already seen about 70 cases of flu like illness. Fever over 101 with myalgias, going through galllons of hand wash daily! Link to comment Share on other sites More sharing options...
jen0508 Posted January 5, 2013 Share Posted January 5, 2013 Side note- We are seeing alot of the flu also in the south. Have any of you guys ran into Type B? I had one the other day (only one we've seen this season). Link to comment Share on other sites More sharing options...
KCMA79 Posted January 5, 2013 Share Posted January 5, 2013 I avoid cough meds for children be they OTC or script. Instead I suggest using a vaporizer/humidifier. I just dont have much faith in cough meds particularly the OTC meds. I have also had good success with bundling the kid up and taking them outside and letting them breath cool air, this seems to work well with a croupy cough. Link to comment Share on other sites More sharing options...
Boatswain2PA Posted January 5, 2013 Share Posted January 5, 2013 I haven't seen influenza B in Midwest yet. Seen about 4 flu A last week, and a whole lot of RSV. Link to comment Share on other sites More sharing options...
Guest Paula Posted January 5, 2013 Share Posted January 5, 2013 My colleague had a positive Influenza B at the Walk-In clinic she is at in the upper peninsula, Michigan. So, it's pretty far north! Link to comment Share on other sites More sharing options...
Teasip Posted January 5, 2013 Share Posted January 5, 2013 Study (non-pharm sponsored) released Jan. '05 as I recall asked this question with regard to OTC cough options in all populations. Only recommendation of the gazillion choices on the shelves was an NSAID (naproxen specifically) and diphenhydramine. With regard to the pt. wanting abx. for "sinusitis" and flu? This is what is driving me out of primary care. Regardless of what pt. education studies show, very few folks over my thirty years have bought into the idea that antibiotics aren't indicated. Had one female storm out three weeks ago with the "I know what I need" argument for her "sinus infection" (and the "killing them with kindness" didn't work either) even though I've got the treatment recommendations from a 4/12 expert panel posted and highlighted on the cork board in the exam room staring them in the face for them to look at (it's a "long read" since there are only three treatment recommendations for the majority of folks [<10% need an abx. for "sinusitis"], and one of them is what NOT to give them). Back on topic, you might suggest the teaspoon of honey at bedtime idea (barrier between the PND and pharyngeal tissue, which also benefits sore throats) and for those who are "older", mix in some whiskey (assuming that they aren't allergic to pollen and can consume honey) since this has actually been shown to have some medicinal benefit. Bottom line, it sucks to be sick but you're going to cough for 7-10 days, if not longer, regardless of therapy; elevate the head of the bed, and don't forget PTE/localized CWP which might imply the presence of ............pertussis, which you've got to catch in the first 10 days or so. Remember, it's also known as the "100 day cough", for reasons which somehow escape me. BTW, anyone able to rattle off the four (actually five, since there's a disclaimer on one of the four) symptoms which could imply an increased risk for bacterial sinusitis thus necessitating a trial of antibiotics? EMEDPA, better not let the AAP know you're recommending decongestants to the kids :wink:. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted January 5, 2013 Moderator Share Posted January 5, 2013 they work.... Link to comment Share on other sites More sharing options...
Teasip Posted January 5, 2013 Share Posted January 5, 2013 I must confess that even though AAP says that they are the number cause for pediatric ED visits, and thus don't use them, I never saw a one that I thought was directly associated with decongestant usage. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted January 5, 2013 Moderator Share Posted January 5, 2013 not a fan of anti-tussives or anti nausea meds for kids(aside from zofran) due to side effect profile. sudafed suspension, however is golden. probably write it 3-4x/shift for kids 2-10. Link to comment Share on other sites More sharing options...
Moderator ventana Posted January 6, 2013 Moderator Share Posted January 6, 2013 localizing pain, unilateral d/c, s/s > 7 days (but I use 2-3 weeks), failure of conservative measures, and fever If they do not have most these I do not give ABX..... Last study I ready - NE states in USA prescribed 16X's more ABX then Europe - does Europe not treat ABX infections???? No we just continue to over treat viral infections with ABX...... In my limited experience the amount of Abx prescribed seems to increase with the longer you are in practice - those near retirement write it like it was taking a sip of water..... Link to comment Share on other sites More sharing options...
Teasip Posted January 6, 2013 Share Posted January 6, 2013 The guidelines that I printed out and posted in the exam rooms from 4/12 look for four findings: 1) purulent nasal discharge 2) documented fever (typically greater than 101 degrees) 3) significant sinus pressure (localized) 4) sx. duration >10 days, OR "double sickening", got sick, started getting better, then got worse again with above symptoms (the double sickening is the asterisk to number 4) Treatment guidelines if above not met? Nasal saline lavage (Neti pot), intranasal steroids if prior history of allergic rhinitis, and NO antihistamines/decongestants. If abx. given, 7 day course with Augmentin preferred (not 10 days). All this is fine and good but my clientele expect to be better yesterday. Link to comment Share on other sites More sharing options...
Just Steve Posted January 6, 2013 Share Posted January 6, 2013 Neti Pot is just evil...no idea how people can tolerate that. Link to comment Share on other sites More sharing options...
LIPPER Posted January 6, 2013 Share Posted January 6, 2013 Honey 1-2 tbsn. A tried and true home remedy. Link to comment Share on other sites More sharing options...
MediMike Posted January 6, 2013 Share Posted January 6, 2013 Back on topic, you might suggest the teaspoon of honey at bedtime idea (barrier between the PND and pharyngeal tissue, which also benefits sore throats) and for those who are "older", mix in some whiskey (assuming that they aren't allergic to pollen and can consume honey) since this has actually been shown to have some medicinal benefit. Anecdotally I can relate some pretty great results of a tablespoon of honey mixed into warm milk/hot chocolate with 1-2oz of Baileys... Link to comment Share on other sites More sharing options...
kidnid Posted March 15, 2013 Share Posted March 15, 2013 cough/cold OTC or script meds are not recommended for kids under 6 yrs age. Too many side effects... a good humidifer vicks benadryl works wonders. Also avoiding dairy 3/4 hrs before the kid sleeps helps a lot with decreasing mucous production. and yes let the mother nature heal !! pearl: By propping the child one one side ( with help of pillow) instead of lying on the back will help a lot !, personal exp :). The physiology behind it is decreasing the post-nasal drip !! thats the main culprit for severe cough at night.. Link to comment Share on other sites More sharing options...
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