Hey Mildoc

[crokett]

There was the recent announcement that kids under 6 should not be given the antihistamines, etc for colds and coughs because of the risk of overdose and they aren't that effective for kids anyway. IIRC the American Academy of Pediatrics also supported this recommendation.

As the father of a 3yr old and 7mo old who have both been seriously sick and slept better while taking meds, are you familiar with this study? Do you know what protocol was used to determine effectiveness? As far as I know the control for most medicines is a placebo. I doubt my 3yr old would understand the placebo effect and I know my 7mo old wouldn't.

[Hellrazor]

David, Stupid people + lawyers are the reason for this. Too many people ignore the directions or know better and do something stupid. Then they decide to sue someone for big $$$.

[MilDoc]

Are drugs "effective" at relieving colds? No. Do they "speed recovery?" No. Colds are caused by viruses, and have to run their course. At young ages that can be as long as 14 days. As you age the time gets shorter due to better immunity.

What do they do? They make kids drowsy, sleepy, in most cases, a known antihistamine "side effect." So they sleep better. Just like what my mom gave me - whiskey / lemon / honey (and no, I don't recommend that either.)

And, sorry Hellrazor, but kids have had seizures, and been killed, by even appropriate doses given correctly.

As I stated before, 90% of over-the-counter medicines are there to make $$$, not to "cure" you because they don't, and can't, do that.

[Greg in Maryland]

David, Stupid people + lawyers are the reason for this.

Pediatric cold medicines have never been tested on children, the dosage for children has simply been extrapolated from adult dosage, the medicines have dubious efficacy, the complexity of the ingredients can be problematic and the medicines can and do cause harm to infants and children. That is why it is recommended that parents do not give these medicines to infants and children. Not a bunch of trigger happy lawyers.

The American Academy of Pediatrics has recommended this action since 1997 -- for 10 years! A Google search will turn up some interesting information and discussion of the pros and cons of using these medicines, their efficacy and realistic alternatives. Here is a interesting read from the American Medical Association: http://www.ama-assn.org/amednews/200...relatedcontent

Our pediatrician strongly recommends against the use of these medicines and has done so for years. It is quite a tough time to comfort an infant or child with a cold and these medicines seem like a good solution. However, they really are not.

Greg

[MilDoc]

Not to mention that folk's want a "pill" for everything!

Colds. The flu. Obesity. "Sinuses" (which in most adults are actually migraines).

[Hellrazor]

And, sorry Hellrazor, but kids have had seizures, and been killed, by even appropriate doses given correctly.

That can be said for every drug ever manufactured.

[MilDoc]

That can be said for every drug ever manufactured.

True. But the risk / benefit ratio of effective drugs makes it worth the risk. When there is no benefit from a drug, than the risk is 100% for 0% benefit.

[leehljp]

Paul,

A question for you along this line.
DOES the added rest and the pain relief effect of these medicines induce the body and the immune system to fight the virus better?

Or does said medicines hamper the immune system (make it drowsy too) as much anything else?

This probably is theoretical or IFFY at best. Comments?



GLAD YOU ARE STILL ONLINE! How is the move coming?

[crokett]

What Lee said.

And is it the antihistamines don't work? The pain relievers don't work? Or both?

[MilDoc]

Pain relievers relieve pain. They also inhibit the bodily production of prostaglandins, cyclooxygenase, inducible nitric oxide synthase (iNOS) as well as proinflammatory cytokines, all of which function to inhibit viral reproduction. In other words, your body's response to viral infection helps to fight it off, and pain relievers in general reduce this ability.

Does this matter in the short run? Probably not. You'll still get over your cold. But with more severe viral infections I'd avoid them if possible.

The role of anti-histamines is a bit more complicated. Viral infections can induce histamine production (as well as other chemicals) and one effect of histamine is to induce higher blood flow, increasing the body's ability to fight an infection. There are other effects as well that aid in viral killing. So, overall, antihistamines don't help either when it comes to getting rid of the virus itself.

Again, how important in the great scheme of things? Who knows. I do know it's not nice to fool with Mother Nature.

[leehljp]

Pain relievers relieve pain. They also inhibit the bodily production of prostaglandins, cyclooxygenase, inducible nitric oxide synthase (iNOS) as well as proinflammatory cytokines, all of which function to inhibit viral reproduction. In other words, your body's response to viral infection helps to fight it off, and pain relievers in general reduce this ability.

Does this matter in the short run? Probably not. You'll still get over your cold. But with more severe viral infections I'd avoid them if possible.

The role of anti-histamines is a bit more complicated. Viral infections can induce histamine production (as well as other chemicals) and one effect of histamine is to induce higher blood flow, increasing the body's ability to fight an infection. There are other effects as well that aid in viral killing. So, overall, antihistamines don't help either when it comes to getting rid of the virus itself.

Again, how important in the great scheme of things? Who knows. I do know it's not nice to fool with Mother Nature.

OK Dr. Paul, send me the consultation bill!

Thanks for the info!

[MilDoc]

And is it the antihistamines don't work? The pain relievers don't work? Or both?

How about a shorter, less technical answer.

They work to reduce your symptoms to some extent, but do nothing to fight off a cold or the flu. And, in fact, after taking them, your cold may actually last a few days longer since they inhibit the body's ability to fight off and kill the virus.

Do I take meds when I have a viral infection? Not if I can avoid it. But if I feel totally miserable, I might take some, especially at night, for a few days only. And the last time I did that was over 7 years ago.

But, to get back on track, with children - no, I would use nothing but Tylenol if they needed it for pain, not just for fever. This country is so fever phobic it's pathetic. Just why do we think what the body does to fight infection must be bad?

And given the possible side effects in kids, even at the "proper" doses, is it really worth it? Funny. Kids got over colds jst fine 50 years ago. They still do.

[Kristofor]

How about a shorter, less technical answer.

They work to reduce your symptoms to some extent, but do nothing to fight off a cold or the flu. And, in fact, after taking them, your cold may actually last a few days longer since they inhibit the body's ability to fight off and kill the virus.

I agree with you on the general philosophy, but all people really care about are the symptoms.... If you have a cold for 3 days or 10 days doesn't really matter if it doesn't make you feel 'sick'...

I could have a cut on my forearm stitched up without a shot of lidocane if the arm was strapped down and couldn't move. The end result would be that it took longer for the process to happen (the doctor had to give a shot in addition to the time to do the stitches) but I wouldn't care because the benefit of symptom (pain) relief easily trumps the extra time (we'll ignore, added stress, chance of heart attack etc. that was just an example).

That said, if there's really no benefit for small children on how they feel/sleep/etc. then there's no reason to take even a small risk. But anechdotal evidence feels like there is a benefit at least when it comes to helping children sleep (which could lead to better parent sleep, less job stress, less parent illness, less family stress, less child abuse, etc.).

I wonder if the unintended consequence of this will be MORE children being overdosed when parents end up using adult products that they "know" work on childern...

Kristofor.

[scmhogg]

Feeling some guilt now. Always gave our little one Dramamine for "car/air sickness" put him soundly asleep, everytime. He never got sick so I guess it worked. Wrong, wrong, wrong....

Steve

[jking]

Are drugs "effective" at relieving colds? No. Do they "speed recovery?" No. Colds are caused by viruses, and have to run their course. At young ages that can be as long as 14 days. As you age the time gets shorter due to better immunity.

Something I've grown curious about over the last year. In my teens through late 20's I used to get one cold each year. It would last 2-3 weeks. I always referred to it as my "yearly cold". Since our son was born, I've noticed the last year or two I will have maybe three colds during the course of the year. They only seem to last about a week. I've had one where I had symptoms for only a few days.

Obviously, I've made the connection that I probably get these from my son since he usually has a cold right before I do. Am I just getting weaker strains of the cold?