"Doctor, my baby has been coughing badly for 2 days, it's too bad, what medicine to take is getting better fast?" Do you have any recommendations? ”
This is one of the most common problems doctors hear in pediatric clinics.
When the child coughs, he often eats well and sleeps badly, and parents will find ways to alleviate the child's pain. But Xiaojiu should remind parents that they should deal with children's coughs and must not take medicine indiscriminately!
First, 2 kinds of "cough medicine", do not use it for children
"It is a three-point poison of medicine", especially for children," parents should be more cautious, because children's physical development is not yet mature, and they are more sensitive to the response to drugs. Here is a key reminder of the following 2 kinds of cough medicines, do not use them for children.
Child's drug prohibition 1: cough medicine containing codeine
In 2017, the State Drug Administration (CFDA) issued an announcement explicitly stating that codeine drugs are banned for children under 12 years of age. For children and adolescents aged 12-18 years, it should be used only if other NSAIDs are unable to relieve pain. In addition, it should not be used by children and adolescents aged 12-18 with chronic respiratory diseases.
In 2018, the State Drug Administration revised this previous announcement to clearly state that children under the age of 18 should be banned from codeine-containing cold medicines.
Image source: CFDA
Back in 2016, the American Academy of Pediatrics (AAP) had called on health care workers and parents to stop using codeine-containing drugs to children because of mounting evidence that it could pose a life-threatening or serious adverse effect in children.
Codeine is a natural opioid alkaloid drug, although it can analgesic, cough, sedative, but the pharmacological effect is similar to morphine, long-term use of large doses is easy to addictive, resulting in drug dependence. In addition, the misuse of codeine-containing drugs can also lead to confusion, respiratory depression, and life-threatening safety.
Especially in children, the risk of respiratory depression is higher and should not be used. In daily life, common codeine-containing drugs are compound licorice tablets, compound licorice mixture, compound licorice oral solution, strong loquat cream, pediatric antidiarrheal tablets, cough granules, etc., parents should avoid giving it to their children.
Children's drug prohibition two: cough medicine containing promethazine
Promethazine has antiemetic and sedative effects, is widely used in cough treatment, its adverse reactions include irritability, hallucinations, abnormal muscle tone, etc., may lead to respiratory depression in young children, and even death, so it is banned in children under 2 years of age.
In 2006, the FDA warned that promethazine hydrochloride injections could cause fatal respiratory depression and should not be used in children under 2 years of age. For children 2 years of age and older, the lowest effective dose is recommended.
Mainland China also has relevant recommendations, such as:
The Pharmacopoeia of the People's Republic of China and The Instructions for Clinical Medication (2010 edition) records that because promethazine injection has the effect of inhibiting the respiratory center, premature infants and newborns are banned, and children under 2 years of age should be used with caution;
The "Guidelines for the Clinical Use of Chinese Physicians and Pharmacists" records that promethazine has a risk of respiratory depression or even death in children under 2 years of age and should be contraindicated.
In short, Xiaojiu recommends that parents do not give their children cough medicines on their own, and they should see the ingredients when taking medicines, and it is best to have the guidance of professional doctors.
Second, the child cough, how to deal with the correct parents?
If the child has a cough, it is not recommended that parents give the child medicine immediately.
In life, coughing is mainly caused by respiratory infections and is also a protective reflex of the respiratory tract. If you take cough medicine at every turn, if you do not solve the fundamental problem that causes cough, it may lead to more and more secretions, and even induce bronchitis or pneumonia.
The right thing to do should be:
(1) Observe cough manifestations and accompanying symptoms.
Dry cough is characterized by sputum absence or oligophlegm, which can be a monosural cough or paroxysmal cough; Wet cough is mainly manifested by sputum in the throat that is difficult to cough up, or sputum that is purulent or bloody and has an odor. In addition to coughing, observe whether the child has symptoms such as fever, chest pain, wheezing, hemoptysis, coughing up jam-colored sputum, vomiting, and difficulty breathing.
(2) According to the severity of the symptoms, decide whether to see a doctor
If the symptoms are mild, the child only coughs during the day, but does not affect eating, drinking, sleeping, can continue to observe, temporarily do not need to see a doctor. Prompt medical attention is recommended if any of the following conditions occur:
- Cough with blood, coughing up yellow-green pus and sputum, hoarse cough or barking, vomiting, accompanied by stridor or bruising of the skin;
- Fever, difficulty breathing, affecting eating and sleeping;
- 2 weeks did not get better, or even worsened; or some improvement, but cough for more than 4 weeks;
- Be under 4 months of age.
(3) Do a good job of home care and alleviate symptoms
You can use a humidifier appropriately or give your child a steam bath to keep your respiratory tract moist. If the cough is frequent at night, you can raise the shoulder above the shoulder to form a semi-recumbent position when sleeping, which is conducive to alleviating the cough. If necessary, the nasal cavity can be cleaned with normal saline and nasal secretions can be removed.
Third, 2 misunderstandings should be recognized
Some parents like to relieve their children's cough through dietary therapy, Xiaojiu reminds that there are 2 misunderstandings to pay attention to avoid:
First of all, rock sugar pear water can replenish moisture, moisturize the throat, and relieve dry itching in the throat, but there is no evidence that it can "relieve cough and moisturize the lungs". Second, a few studies have found that honey may have some cough relief effect, but for children aged ≤1 years old, consuming honey carries a risk of poisoning and should be avoided.
In fact, whether children or adults, when taking cough medicine, they must keep an eye on it, and it is best to use it under the guidance of a doctor to minimize the risk.
#Health Insight Program ##谣零零计划 #
Resources:
[1] Announcement of the State Drug Administration on Amending the Instructions for Cold Medicines Containing Codeine (No. 63 [2018]), NmPA, 2018-09-06
[2] Children have a cold and cough, what medicine is good to take? , Pediatric Channel of the Medical Community, 2019-08-12
[3] AAP: Stop Giving Codeine to Children. Medscape. Troy Brown, RN September 19, 2016
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