Wednesday, February 10, 2016

Alcohol in medicines can affect some kids

Many cough and cold liquids and other over-the-counter products contain some alcohol. Most people wouldn't give this a second thought, and rightly so, but now and then the amount of alcohol in medicines becomes extremely important.

Alcohol in medicines can affect some kids


by Michael R. Cohen

Many cough and cold liquids and other over-the-counter products contain some alcohol. In the formulation, this helps to dissolve certain ingredients or preserve the product. Most people wouldn’t give this a second thought, and rightly so, but now and then the amount of alcohol in medicines becomes extremely important. One situation is with young children.

Not too long ago we received a report from a woman whose 11 year old child began having seizures while taking a shower. The family immediately called for help. Paramedics took the child to a nearby hospital for examination. All scans and x-rays were negative. Doctors then ordered blood tests on the child. The family was surprised to learn that the child had an elevated blood alcohol level, which was most likely the cause of the child’s symptoms.

Doctors asked the child’s mother if there was anything new or different that this normally healthy child was taking. It was then the child’s mother remembered giving the child SSS Tonic, an over-the-counter high potency liquid iron/B vitamin supplement. The product contains 12 percent alcohol, which is equivalent to a 24 proof beverage. The child was only taking this supplement for a few days and was taking the correct recommended daily dose.

Typically, giving these products at the recommended doses is safe and not a cause for alarm. But some children may not be able to tolerate the small amounts of alcohol that are in such products. In younger children, ethanol causes low blood glucose (an important sugar for brain cell function) because it suppresses the normal body functions that convert a liver substance called glycogen, which in children is not stored in quantities as large as adults. In kids who haven’t eaten for a while, even small quantities of ethanol can cause hypoglycemia.

The child in this case had no other problems once the supplement was stopped.

A few of the many other products that contain alcohol include certain formulations of Benadryl, Cheracol Plus, Dimetane, Donnatal, Geritol, Novahistine, Robitussin, Sominex, Triaminic, Tylenol and Vicks. Some remedies can contain up to 25 percent alcohol.

Alcohol can also be found in other household non-beverage products like mouthwashes, rubbing alcohol and after shave lotion. Lately, there’s been a great deal of concern expressed about kids drinking alcohol in hand sanitizers. Although most of the concern has been about teens that do this intentionally to get drunk (sanitizers are about 120 proof), there have been occasional cases where young kids get ahold of the container and squeeze some out. Usually it’s hard to squeeze out a lot and it’s too bitter anyway for them to drink much. But we do know of one case where a 4-year-old girl became acutely ill and needed treatment in a hospital. So keep these bottles away from kids.

Carefully read the labels on all over-the-counter medicines and dietary supplements. Look at both the active and inactive ingredients and check to see if the product contains alcohol. Avoid giving medicines and dietary supplements that contain alcohol to children under the age of two. Never give more than the recommended dose on the label unless instructed by your child’s doctor. Also, never give the next dose before it is time unless instructed by your child’s doctor. You should also avoid giving children more than one product that contains alcohol. There are many out there so watch for this. It’s possible for it to be in prescription liquids too, so ask the pharmacist.

Parents should always be aware of any changes in behavior or any type of reaction their child may have. This is especially important when new medicines or dietary supplements are being introduced. Contact your child’s doctor or pharmacist with any concerns you may have.

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About this blog

Check Up is a blog for savvy health consumers, covering the latest developments, discoveries, and debates from the Philadelphia area and beyond.

Portions of this blog may also be found in the Inquirer's Sunday Health Section.

Charlotte Sutton Health and Science Editor, Philadelphia Inquirer
Tom Avril Inquirer Staff Writer, heart health and general science
Stacey Burling Inquirer Staff Writer, neuroscience and aging
Marie McCullough Inquirer Staff Writer, cancer and women's health
Don Sapatkin Inquirer Staff Writer, public health
David Becker, M.D. Board certified cardiologist, Chestnut Hill Temple Cardiology
Michael R. Cohen, R.Ph. President, Institute for Safe Medication Practices
Daniel R. Hoffman, Ph.D. President, Pharmaceutical Business Research Associates
Hooman Noorchashm, M.D., Ph.D. Cardiothoracic surgeon in the Philadelphia area
Amy J. Reed, M.D., Ph.D. Anesthesiologist and Surgical Intensivist in the Philadelphia Area
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