GPs told of cough mixture dangers

Cough mixtures are at best useless and at worst dangerous for children, according to new practice guidelines for GPs.

A health manual produced by The Children's Hospital, Westmead warns that, although GPs are under "considerable pressure" to prescribe cough medicines, cough suppression is potentionally dangerous.

"Cough suppression is an unphysiological response It may be harmful in asthma and other chronic lung conditions, leading to retention of secretions, obstruction and secondary infection", it says.

The manual, edited by pediatrician Professor Kim Oates with Dr. Kathryn Currow and Dr. Wendy Hu from the hospital's emergency department, suggests that, although cough suppressants such as codeine and destro-methorphan are effective in adults, the dose required to suppress coughing in children can cause side-effects.

Decongestants such as pseudo-ephedrine can cause irritability, sleeplessness and hallucinations.

Blacktown GP Michael Fasher said the manual was a useful resource, and the reference to the benefits of allowing the natural process of coughing to proceed was particularly helpful.

"There's such a raft of information out there, which can make parents feel that if they haven't got a medicine for their children, they're not doing enough," Dr. Fasher said.

"I think relieving parents of that guilt is a useful thing."

Professor Oates, chief executive at The Children's Hospital, Westmead, said GPs were also discouraged from prescribing anti-vomiting drugs (called anti-emetics) to children because they could mask the cause of illness.

He said drugs used to treat diarrhoea could actually prolong illness in children and do nothing to solve the underlying problem.

"Up to 30 per cent of GP visits involve children, and it's often looking things up on the Internet or in textbooks."

Anna Patty, Health Reporter
Daily Telegraph
, Monday 16 July 2001

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