Paracetamol (also called acetaminophen) by mouth is the recommended drug for relieving pain at home. It is reasonably effective and it will also lower a fever. Possible side-effects include skin rashes, blood disorders and, if taken for long enough in a large enough dose, kidney damage. Never leave an adult’s paracetamol tablets within reach of a child because poisoning can seriously damage the liver.
Aspirin is no longer considered suitable for children because of the possibility of a potentially serious condition known as Reye’s syndrome. More potent pain relievers are available from the doctor if necessary.
Decongestant nose drops containing ephedrine or phenylephrine are sometimes recommended for a cold in order to keep the Eustachian tubes open and so prevent middle ear infection. However, after three days of regular use, there is often renewed congestion which makes things worse than before. Also, the drops may irritate the lining of your child’s nose and prolong the cold. Nose drops are probably worth using if your child usually has middle ear infection following a cold. They can also be used temporarily for a baby with a cold who has difficulty in feeding because he can’t breathe through his nose and suck at the same time.
Drugs such as chlorpheniramine, promethazine, trimeprazine, triprolidine, diphenhydramine and carbinoxamine are used for some allergic skin conditions such as reactions to insect bites and stings, for urticaria, for hay fever and for travel sickness. They have little effect on allergic asthma. Possible side-effects include drowsiness and an inability to sleep restfully, and a few children become hyperactive. Antihistamines are sometimes included in cold and cough remedies because they tend to dry up the secretions in the nose and respiratory tract and so provide some relief. However, this very action may lower natural resistance to the infection. When applied on the skin, antihistamines can sometimes cause an allergic skin reaction.
Cough suppressants damp down a cough and expectorants are supposed to liquefy secretions so that they can be coughed up more efficiently. Coughing should only be treated with suppressant drugs, such as dextromethorphan or codeine, if it is preventing your child from getting enough sleep to aid recovery, or if it is very painful. Expectorants aren’t recommended because they seem to be of little use.
Cough sweets don’t contain sufficient concentrations of drugs to be of any use, but they increase the production of saliva, which can soothe a sore throat.
Bronchodilators are drugs such as salbutamol, orciprenaline and theophylline which widen the airways and are usually given in aerosol form. Adrenaline by injection may be necessary for a severe asthma attack, and corticosteroids such as beclomethasone in aerosol form are also useful. Sodium cromoglycate from a special inhaler is effective if used right at the beginning of an allergic asthma attack. It can cause a slightly sore throat, especially if the child has a respiratory infection. This drug is also used to prevent hay fever.
Many different classes of antibiotics are used to treat infections with bacteria and fungi. Some of the better known ones are the penicillins (such as ampicillin, phenoxymethylpenicillin and amoxycillin), erythromycin and co-trimoxazole. Antibacterial drugs such as nitrofurantoin and nalidixic acid are alternatives used for urinary tract infections. Antibiotics are usually given by mouth and can also be used in preparations for the skin, eye and ear. Antifungal antibiotics include nystatin and griseofulvin. Antibiotics aren’t effective against infection with viruses or protozoa. Your doctor chooses the antibiotics according to the type of bacteria he believes is likely to be responsible for a particular infection. Sometimes it helps him to decide if a specimen from the infected area is tested by the pathology laboratory.
A problem with antibiotics is that bacteria tend to become resistant to them and this is one reason why their use is restricted to prescription only. Possible side-effects include allergy and the risk of infection with other micro-organisms such as monilia.
Drugs contained in the base of a skin preparation include antiseptics, antibiotics, anti-viral agents, steroids, zinc, calamine, anti-parasitic drugs, anti-sunburn substances, anti-itching agents, local anaesthetics and astringents. The base is chosen according to the job it has to do. A watery or alcoholic lotion is used for cooling acute conditions with unbroken skin. Calamine lotion is used to cool the skin in scabbed and dry skin disorders. Powders are used between folds, pastes are used for scaly skin, and creams and ointments are used for various conditions. Sensitivity to antibiotics, local anaesthetics and antihistamines can be a problem in some children.