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Post by chiefychiefychief on Apr 22, 2014 8:06:29 GMT -5
Dr. I, what is your thought on codeine use in children? A study done last year believed it was over prescribed and that it may be dangerous, especially for young children (apnea). There is also a black box warning.
Also, what are some good alternatives for cough and also pain control in children that may be safer, come in liquid form and that aren't too expensive?
Thanks in advance,
Josh
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Post by Bjs04f on Apr 22, 2014 9:57:27 GMT -5
Honey
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Post by kemple on Apr 22, 2014 18:17:30 GMT -5
Agree with Brandon, I believe Izsak had said honey actually has better treatment rates anyway.
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Post by chiefychiefychief on Apr 23, 2014 13:47:33 GMT -5
I'm aware of the dark honey for cough, but what are other alternatives for cough and pain in liquid form? I know oxycodone is sometimes used, but is it safer in its absorption profile?
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Post by Bjs04f on Apr 23, 2014 13:57:42 GMT -5
it seems like nothing. They are removing kids cough stuff as it has no benefit under 6yo. Uptodate mentions dextromethorphan if its interrupting sleep, feeding etc but causious use
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Post by chiefychiefychief on Apr 23, 2014 22:31:05 GMT -5
Ok, honey for cough, sure, it was mentioned in the article as an alternative for codeine. No meds under a certain age, that's fine. Is honey all we have for cough?
Now focus on the pain aspect. Motrin, of course, tylenol maybe... What about stronger meds? Are we worried about the same hyper-metabolizers if we give liquid oxycodone?
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Post by drizsak on Apr 24, 2014 4:48:50 GMT -5
I have been using hydrocodone/acetaminophen (7.5/325 per 5 ml) for pain. Occasionally I will use codiene if they have been known to tolerate and it has worked in the past. There has been no reports on issues of hypermetabolizers with hydrocodone that I am aware of. The hypermetabolizer problem with codiene was in the ENT literature post T and A's though I am sure they would also hypermetab in all cases (orthopedics etc). My first line for pain control in ortho in ibuprofen and I use hydrocodone as a last resort.
As far as cough goes I use/recommend HONEY based on the Israeli study, not perfect but as effective if not more so then OTC cough preps. Occasionally I have used hydrocodone for bad cough (maybe 3-4 times in 30 years). I have also used nebulized lidocaine for BAD cough in the ED only with limited success.
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