Cough and cold medicines are usually consumed orally in tablet, capsule, or syrup form. They may be mixed with soda for flavor and are often abused in combination with other drugs, such as alcohol or marijuana.
Because they are easily purchased in drugstores without a prescription, cough syrups, pills, and gel capsules containing DXM—particularly “extra strength” forms—are frequently abused by young people.
Should children be administered medicines for cough and cold? Evidence collected over a couple of decades suggests that these are not only ineffective as cures, but also have dangerous side effects such as respiratory depression, apnoea, seizures and cerebral haemorrhage. Alarmingly, says a study conducted in Delhi and Haryana, prescribing such medicines is rampant among child specialists.
Researchers from Safdarjung Hospital and Ram Manohar Lohia Hospital in Delhi and Pandit B D Sharma Institute of Medical Sciences in Rohtak asked pediatricians at five hospitals in the two states to give their advice in two hypothetical cases of medically stable children suffering from cough and cold in the age groups of less than two years and two-to-five years. According to the results blished in the latest issue of published in the latest issue of Saudi Pharmaceutic Journal.
The danger of prescribing cough and cold medication (CCM) lies in the unwarranted way they affect the body. Dr Sudha Chandelia, corresponding author of the study, told TOI that anti-allergic drugs were the most common CCM prescribed followed by decongestants. “In adults, toxicity studies on the use of CCMs have not been carried out, but there is evidence showing side-effects in children,” says Chandelia. “We were shocked to find so many specialists prescribing CCM in the hypothetical cases.”
Dr S K Kabra from AIIMS, pointed out how curbing the body’s instinct through medication is counter productive. Explaining that coughing is a protective reflex that helps clear secretions or foreign bodies from the airway , Kabra said the medications could give temporary relief, but it exposed the child patients to the risk of severe side-effects such as respiratory depression. “It can also affect heart and brain functions,” he added.
Dr Vandana Kent, senior paediatric consultant at Rockland Hospital, reiterated that cold and cough are self-limiting conditions caused by allergy or viral infections.”Non-pharmacological measures – steam inhalation, drinking warm fluids and saline nasal drops – should be considered to relieve the symptoms,” she said.
“Giving antibiotics and anti-allergic drugs without consulting a doctor is dangerous, particularly in the case of children,” said Dr J S Bha sin, pediatrician at BLK super-specialty hospital. How widespread the practice is can be gauged from the fact hat Bhasin receives a case or wo almost every week of ex reme sedation caused by over-the-counter drugs in children.
Given the potential for adverse side-effects, in 2009 Canada imposed mandatory labelling that required the drug manufacturers to state that products for cough and cold medication should not be used over-the-counter among young children. A recent study published in Canadian Journal of Public Health claimed that the cautionary step had led to a decline of CCM use for children by over 3% since.
Experts in India have called for awareness programs for doctors and the public check this natural instinct administer CCMs, mostly over-the-counter, due to health risks they represent.