Saturday, March 1, 2008

Sick kids, the FDA and snot

Happy belated Leap Year everyone. I was going to post this yesterday, but I've been a bit busy with sick kids.

I celebrated this rare event by cleaning up snot and calming coughs. My wife is off at a conference for several days and I am home alone with three sick kids. They all have colds. Two of them are functional, but the third has been hit hard. They are all producing snot by the gallon. I went to Sam's Club yesterday and bought "Puffs with lotion" by bulk. It is much gentler on their noses, especially since I need to wipe them every 10 minutes. If only snot could be used like plasma, I'd be sitting on a goldmine.

To make matters worse, there is a lot of confusion as to what type, if any, of cold medicines children can take. Recently the FDA released a recommendation that OTC cold medicines should NOT be given to children less that 2 years old. They are still reviewing what the 2-11 crowd can handle.

From the internet research I did, the major problem is not necessarily that the OTC drugs are bad or dangerous but 1) parents overdose their children and 2) most of these drugs have not bee proven effective in children.

1) Parent must learn to read labels and pay attention to what they are giving their children. Every medicine lists the dosage. There are some that are not suggested for children under 6. So, these should not be given to a 2 year old.[1] Giving multiple medicines can result in an accidental overdose[2]. I prefer to purchase single ingredient medicines and treat only the symptoms that need treating. I may give a medicine with acetaminophen for pain and then a medicine with phenylephrine HCl for the stuffy nose.

What concerns me about the labeling and dosage is that for some medicines, the dosage is the same for children 2-6 years old. Well, there is a huge difference between a 6-year old and a 2-year old. Shouldn't the dose be based on weight? The acetaminophen I have is dosed that way.

2) Because the drugs have not been proven effective does not mean they have been proven ineffective. Most things are not tested in children. They are tested in adults for effectiveness and the dose is adjusted for children. In my opinion, this is a problem. Children are not little adults. They are physiologically different. Making the dose smaller does not necessarily mean it is safe and effective.

I must plead my ignorance here, in that I do not know what OTC drugs have been specifically tested in children in controlled clinical trials. I hope the drug manufacturers fund more tests in the future especially in light of the current and future FDA policies.

A recent series of tests indicated that that honey was just as good as cough suppressants. Based on my non-double blind, non-placebo-controlled study with a population of 2, honey works pretty good. Or at least it seems to. A spoonful of honey helped calm coughs enough to help my kids sleep.

[1] DUH!!!!
[2] Not "overdose" in the "too much heroine and died" sense.


Anonymous said...

I think acetaminophen in the most problematic componet in children meds - it is much easier to overdose on it with a todler than with adult(that has healthy liver). I would rather give a low dose aspirin to kids unles they are alergic to it.

When we were kids the most popular cold medication was tea made from dried linden flowers, sweetened with honey. It worked as a decongestant and expectorant (it made one sweat profusely). It also tasted pretty good - it makes a very flavorful tea.

If you live near some linden trees you can collect your own, in May when the flowers open up and attracts lots of bees. (The smell of flowering lindens is awesome). You rip it off together with the light-colored elongated pseudoleaf that is part of the flower.

(It has to be flowers, the linden leaves do not work well - the tea from leaves tastes disgusting and makes one sleepy.)

mjenks said...

If you want to put your snot collecting in perspective, you should check out the Dirty Jobs where goes out and collects hagfishes. Oh my lord, that was disgusting. Especially when he pulled a couple out of the barrel and they were expelling slime like ejaculate. I laughed. I gagged. I didn't complain about wiping some snotty off some noses.

In fact, even now, I'm a little nauseated.

mjenks said...

Oh, and I used to have a linden tree outside my apartment in South Bend. OPD is right. It smells very lovely when in bloom.

Chemgeek said...

Every other biological fluid has some value: plasma, blood, sperm...

To bad there isn't a market for snot. I'd be rolling in the dough!

Chemgeek said...

Oh, and the linden tree thing is intriguing, but not too practical right now. March is MN's 2nd snowiest month.

mjenks said...

Understandable about the linden tree. I think you can still buy linden-based tea (one of the lab instructors at ND had some that he would serve every time that the students came over to eat...I guess he thought we could use it).

I also forgot about one of my favorite Calvin & Hobbs. It involved Calvin telling his mom that he was starting to collect snot for mucus donations and she told him that the notion was disgusting and the final frame showed a very pensive Calvin reporting, "I have a jar for you clean out."