Over-the-counter cough and cold preparations: Approach to pediatric poisoning
- Shan Yin, MD, MPH
Shan Yin, MD, MPH
- Assistant Professor of Pediatrics, University of Cincinnati School of Medicine
- Division of Emergency Medicine, Cincinnati Children's Hospital
- Medical Director, Cincinnati Drug and Poison Information Center
- Section Editor
- Michele M Burns, MD, MPH
Michele M Burns, MD, MPH
- Section Editor — Pediatric Toxicology
- Assistant Professor of Pediatrics and Emergency Medicine
- Harvard Medical School
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — UpToDate
- Deputy Editor — Adult and Pediatric Emergency Medicine
- Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
Orally administered over-the-counter (OTC) cough and cold medications contain a variety of active ingredients including acetaminophen, antihistamines, dextromethorphan, decongestants (eg, alpha adrenergic agonists such as phenylephrine or pseudoephedrine), and ethanol. These medications frequently cause significant toxicity in children younger than six years of age.
Topical agents, such as imidazoline ophthalmic and nasal drops (eg, tetrahydrozoline or oxymetazoline), and camphor containing products are also frequently used to control cough and cold symptoms and can have major toxicity.
The approach to pediatric poisoning from OTC cough and cold medication in children will be reviewed here. The toxicity to children posed by individual ingredients (eg, acetaminophen, dextromethorphan, imidazolines, or camphor) and the use of cough and cold medications in children are discussed separately:
●(See "Clinical manifestations and diagnosis of acetaminophen (paracetamol) poisoning in children and adolescents" and "Management of acetaminophen (paracetamol) poisoning in children and adolescents".)
●(See "Anticholinergic poisoning".)
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- Oral agents
- Topical agents
- TOXICITY BY INGREDIENT
- Phenylephrine and similar decongestants
- Tetrahydrozoline and similar imidazolines
- ADDITIONAL RESOURCES
- SUMMARY AND RECOMMENDATIONS