Dangers of Over-The-Counter Medication Overdose

Overtreating respiratory symptoms with OTC medications without understanding their origin can be fatal.  SS

How children overdose on over-the-counter drugs

Doctor warns against self-prescribing, mixing medications

Published On: Apr 25 2012 09:54:25 PM CDT  Updated On: Apr 25 2012 10:32:07 PM CDT

HOUSTON -

Using over-the-counter medications with children can be tricky, but doing so while battling the sniffles and sneezes of allergy season can be fatal.

Two days before Valentine's Day, Kimber Brown was fighting a nasty bug. Her grandmother gave her a couple of over-the-counter medications. The 5-year-old died the next morning.

Dr. Chris Barnett, a compounding pharmacist, said mixing OTC medications to treat multiple symptoms can be complicated.

"It is just a reminder that it is important to be diligent about checking your medications and make sure you know exactly what you are giving and when. Combination products can be much easier and simpler, but you may be getting more than you bargained for and you may be doubling up on ingredients," said Dr. Barnett.

Brown's autopsy showed she had two times the limit of dextromethorphan, which is found in cough syrups, in her system.

The girl also had a high level of the drug cetirizine, which is an antihistamine found in the allergy medication Zyrtec. The coroner found it was the mixing of the two drugs that killed her.

"It is heart breaking because you can see it so easily happening to yourself. Moms, fathers, parents, we want to fix it. We want the kids to feel better and I would say right around 4 in the morning, we also want to get some sleep," Lisa Carey, a mother of four, said.

Carey is a Houston mother whose children range in ages from 5 to 23-years-old. Carey said she can understand how night-time desperation leads to grabbing whatever might work.

"Sometimes, we are willing to try anything. We will look at the label and say, 'Well maybe this will work,' or maybe this will finally give them some relief," Carey said.

Carey writes the Money Saving Parent blog. She said it is easy to see how a tight family budget can leave some parents playing doctor with symptoms that seem manageable.

"You may not have that $189 for an doctor's office visit, so you do look at what can I do in the house and what can I use over-the counter," Carey said.

What to avoid

Barnett warns parents to remember the situation can be about more than what the child has taken in that one moment. If the child is being treated for allergies, asthma or even eczema, those medications can cause a doubling up effect.

"If children have medications they take every day, whether it is prescription or over-the-counter, those have a potential to interact with those short-term drugs you are using to treat symptoms from a cold or the flu," Barnett said.

Click below to read more:

http://www.click2houston.com/news/How-children-overdose-on-over-the-counter-drugs/-/1735978/11862434/-/frdrv7z/-/index.html

Whooping Cough - An Under Recognized Cause of Prolonged Cough

Whooping Cough Scare In Middle School

Most kids vaccinated, but many adults are not

By Bridget LeRoy | April 5, 2012 - 12:30pm

    Pertussis, the highly infectious bacterial disease also known as whooping cough, has made an appearance at the East Hampton Middle School, where one case was reported last week. A letter from the Suffolk County Department of Health was almost immediately put up on the East Hampton Union Free School District’s Web site, and was given to staff and parents at all the schools in the East Hampton system.
    Dr. Gail Schonfeld of East End Pediatrics said on Tuesday that she has diagnosed four cases in the last three weeks, including a 3-month-old infant who was admitted to the hospital but eventually recovered.
    Most children have been vaccinated against the illness, and the vaccine is reported to be 95 percent effective. However, when a child, particularly a baby, gets infected with pertussis, the results can be very serious and sometimes fatal.
    Pertussis is spread through the air by the cough of an infected individual. A course of antibiotics is usually helpful, while cough syrups and elixirs are not.
    According to the Suffolk County Department of Health, in a letter that is posted on the East Hampton School District’s Web site, “A person with pertussis is infectious for 21 days from the start of the cough or until he/she has been on five full days of appropriate antibiotic therapy. Children and adults may be susceptible and still develop pertussis even if they are up to date with their vaccinations, as immunity to pertussis wanes over the years.”
    Whooping cough earned its name by the distinctive whooping sound made by someone with the illness as they attempt to draw in breath. “In between coughing fits, a patient could feel pretty good,” Dr. Schonfeld said. “But when they start coughing, they can’t stop. There is really thick mucus that blocks the airways, so there is a feeling of not being able to breathe.”
    Patients with pertussis often have other cold-like symptoms: fever, nausea, a runny nose. But it is the whooping and gasping for air that are the surest signs. In other countries, it is sometimes known as the “100-day cough.”
    According to the Web site for the World Health Organization, in 2008, 16 million people were affected worldwide and 195,000 children died from the illness.
    “Pertussis has been with us a long, long time,” Dr. Schonfeld said on Tuesday. “Only 10 percent of the cases were diagnosed until recently, but now we have a test that’s fairly accurate.” The test involves a “skinny little Q-tip” being inserted way back in the throat. “It’s not a really pleasant sensation,” she said.
    Up until 2005, she continued, there was no vaccine approved for children over 7 years old. Therefore, many adults could have the disease without knowing it. “If a cough lasts for more than a month in an adult, one-third of the time it’s pertussis,” Dr. Schonfeld said. Only a small percentage of adults in the U.S. have been vaccinated, but there is currently a campaign in progress to encourage adults — particularly those who spend time around a newborn — to get immunized.
    Another unpleasant fact: Getting pertussis once does not bring immunity to the illness. “You can get it more than once,” Dr. Schonfeld said.

Read more here:
http://easthamptonstar.com/?q=News/2012405/Whooping-Cough-Scare-Middle-School

ADHD and Stuff That's Like It

No doubt ADHD is real, but it can be confused with other conditions including sleep disorders.  SS

Think your child has ADHD? Think again …

“My child is having trouble at school. The teacher says I should ask about ADHD.”  Sound familiar to you? It should.
The diagnosis of ADHD is being made more frequently than ever before. In 2010, a whopping 10 million children were diagnosed with ADHD, which is a 66 percent increase from 10 years ago! What concerns me is that many are being incorrectly diagnosed with ADHD by busy pediatricians who don’t take the time to ask some important questions.
I once had a hyperactive 9-year-old patient with sleep apnea who snored so badly that he would stop breathing dozens of times each night. An operation by the ENT (Ear, Nose and Throat) surgeon cured his apnea and improved his behavior.
So what is ADHD? It stands for “Attention Deficit Hyperactivity Disorder.”  Children with ADHD can be impulsive and often have trouble waiting their turn. They are often forgetful, sloppy with schoolwork and chores, and have short attention spans. They are fidgety, squirmy and can be excessively talkative. Parents describe them as being so active that they seem to be “driven by a motor”.  I know what you’re thinking … don’t all children act like this? Yes, but children with ADHD have severe symptoms that impair the child’s functioning, specifically, their ability to do well in school, make friends and avoid injury due to reckless behavior.
While ADHD treatment is generally safe and very effective, it is important to make sure that we are treating the right condition. With that being said, here are some important questions to consider before visiting your pediatrician:
Does your child get a restful sleep every night? Unlike adults who become groggy and slow after a bad night of sleep, children can become hyperactive and rowdy. Inform your doctor of any sleep disturbances such as frequent nightmares, fidgetiness, bedwetting, trouble falling asleep or trouble staying asleep. Make sure your child gets at least 8-10 hours of sleep each night. 
Does your child behave violently? Do they do things just to spite you? Violent behavior is not a criteria for ADHD. The real question is where did your child learn this behavior? At least once a month I see a child for “ADHD” who lives in a home where one parent is emotionally or physically abusing the other. Children are like sponges that can easily pick up on violent tendencies from their parents, television, movies and video games. Other possibilities to explain violent behavior include oppositional defiant disorder and conduct disorder.
Is your child easily embarrassed? Does he or she have low self-esteem? Is your child a worrier? Again, these are not part of the ADHD criteria. Your child might have depression or anxiety. I know it sounds strange to think that a young child could have depression, but it is more common than you may think.
Does your child misbehave only in school? If so, are there specific teachers, students or situations that seem to elicit this behavior? Perhaps your child has a learning disability? Perhaps vision or hearing problems make it difficult for your child to concentrate in school? Maybe your child is being bullied? All of these can be terribly distracting for a young child and can contribute to poor behavior. School problems may warrant an evaluation by the child’s school for learning disabilities and a hearing and vision screening by your pediatrician.
Want to really impress your doctor? Fill out the “Vanderbilt” ADHD assessment tool. There is a parent form and a teacher form. Your doctor will score the sheet. This very simple tool can help determine whether your child has ADHD or something else.
Are you concerned about your child’s behavior? Has anyone told you that your child should be evaluated for ADHD? Please share your experiences.
Mario Cruz is is an assistant professor of pediatrics at Drexel University College of Medicine and an academic pediatrician at St. Christopher's Hospital for Children.

Posted by Mario Cruz, M.D. @ 6:53 AM 

http://www.philly.com/philly/health/Think-your-child-has-ADHD-Think-again-.html?cmpid=138896554

Read more: http://www.philly.com/philly/health/Think-your-child-has-ADHD-Think-again-.html?cmpid=138896554#ixzz1rG6nyNBK

What's in a Wheeze?

The search continues for the perfect home asthma test... the pediatric lung specialist is still the gold standard.  SS

iSonea begins recruiting for pediatric asthma trial

By: Brian Dolan | Mar 28, 2012   

iSonea, makers of the WheezoMeter, has begun recruiting for a post-market study of its asthma monitoring device for children under the age of 12 years old. The company aims to determine the device’s ability to accurately assess wheeze rate in a group of pediatric patients. The study is expected to include about 95 participants and will be based in Folsom, California,according to the clinical trial’s listing on clinicaltrials.gov.

iSonea’s core offering today is a medical device called the WheezoMeter, a point of care, handheld device that “analyzes 30 seconds of breath sounds using advanced signal processing algorithms to detect, quantify and objectively document the presence of wheeze and its extent,” according to iSonea’s website. The company is currently seeking an over-the-counter (OTC) status for the WheezoMeter from the FDA. Last month iSonea announced plans to leverage Qualcomm’s 2net platform for home health devices.

“Asthma impacts more than 7 million children in the United States, and the number of children expected to be diagnosed with this chronic condition continues to climb at alarming rates,” Dr. Jonathan Freudman, medical director for iSonea, stated in a company release. “This study is an important milestone for iSonea. In the pediatric asthma population, it is challenging to accurately monitor and manage asthma symptoms in patients using conventional techniques. The WheezoMeter has the potential to meet a critical unmet need for better, easy to use monitoring tools for young asthma patients.”

At the HIMSS event in February, iSonea demonstrated its device as part of the Qualcomm Life booth. While the company’s setup included an image of an iPhone app called Asthma Sense (pictured), the app is not yet available for download from Apple’s AppStore.

In the future, iSonea hopes to become hardware agnostic and create smartphone peripherals that work like its WheezoMeter today. Assuming the FDA grants the Wheezometer OTC status based on the bench validation study the company currently has underway, iSonea CEO Michael Thomas said the company plans to create smartphone-based versions of the medical device for iPhone, Android, and BlackBerry devices. Thomas told a journalist in Australia last year that since there were about half a billion smartphones sold the world over in the past year, and there are expected to be about 1 billion smartphones sold in 2015, the smartphone has become the most efficient way for iSonea to get its technology to the 300 million people worldwide who have asthma.

Read more below:

http://mobihealthnews.com/16797/isonea-begins-recruiting-for-pediatric-asthma-trial/

Sleep Disorders Increasing in Children

Sleep does not come easily for some children

By Paul Swiech pswiech@pantagraph.com 

Sleep disorders are more prevalent among children than most people realize, according to two Central Illinois sleep medicine specialists.

Sometimes, sleep disorder symptoms in kids are misdiagnosed and treated as other health conditions, including behavior disorders, meaning the underlying problem isn't addressed.

Sometimes, an untreated sleep disorder exacerbates symptoms of another medical condition, including attention deficit hyperactivity disorder.

"Thirty to 40 percent of kids 9 to 12 years old have difficulty falling asleep or staying asleep at least three days a week," said Dr. David Koh, a pulmonologist and critical care physician with Illinois Heart & Lung Associates, part of Advocate Medical Group. Koh figures the prevalence among children younger than 9 is similar.

While those children have sleep problems that should be addressed, not all have a diagnosable sleep disorder. Dr. Humam Farah of OSF Critical Care, Pulmonary and Sleep Medicine, said 4 percent of children have a sleep disorder.

Koh, medical director of the Midwest Center for Sleep Medicine, said the increasing numbers are partly because of improved diagnoses but he also thinks that more children have sleep disorders than a generation ago.

Farah, medical director of the Sleep Center of Central Illinois, said increased obesity is one reason for the increase. Obesity results in fat in the upper airways. Narrowed airways interrupt breathing and sleep and decrease oxygen to the brain.

Some children inherit a sleep disorder, such as restless leg syndrome (RLS) and periodic limb movement disorder.

RLS is a neurological condition characterized by the irresistible urge to move the legs, according to the RLS Foundation. The urge to move the legs is often accompanied by unpleasant sensations in the legs that worsen during periods of rest or inactivity and at night.

Periodic limb movement disorder is a rhythmic twitching of the legs after falling asleep, Koh said.

Both conditions prevent deep sleep and wake people up at night.

While RLS is generally associated with older adults, 2 percent of children have the condition. When either parent has RLS, the prevalence among children increases to 16 percent, Koh said.

In addition, many children with RLS or periodic limb movement disorder also have low iron levels, Koh said.

RLS is worsened by stimulants such as caffeine or chocolate.

When people are sleep-deprived and stressed, that increases the body's desire for fatty foods. Increased consumption of fatty foods prompts weight gain.

Sometimes, increased stress on the cardiovascular system prompts the kidneys to produce more urine, resulting in bed-wetting.

But many parents don't recognize their child has a sleep disorder. Instead, they focus on the daytime symptoms of lack of sleep: irritability, declining academic performance, weight gain and a wet bed.

Some children with a sleep disorder are assumed to have a behavior disorder. Others are diagnosed with ADHD.

Indeed, some have ADHD with a sleep disorder. Thirty percent of children treated for ADHD have a diagnosable sleep disorder, Koh said. When those 30 percent of children are treated successfully for their sleep disorder, about half of them are able to be weaned off their ADHD medicine.

Children who have trouble falling asleep and staying asleep should be taken to their pediatrician, Koh and Farah said. The pediatrician may refer them for a sleep study. The two sleep centers in Bloomington perform overnight sleep studies.

Some children are diagnosed with sleep apnea, a common disorder in which a person has pauses in breathing or shallow breathing while sleeping. Sleep is interrupted. Left untreated, sleep apnea increases long-term risk of heart disease and stroke.

For children, a common treatment for sleep apnea is removing enlarged tonsils or adenoids.

Some children are treated with continuous positive airway pressure masks, which supply a steady stream of air through the nose or mouth during sleep, Farah said.

Weight loss is a key for overweight children, Farah said.

For children diagnosed with RLS or periodic limb movement disorder, medicine such as Mirapex can lessen the symptoms and improve sleep, Koh said. Iron supplements can help boost iron levels.

Sleep tips

Newborns need 16 to 18 hours of sleep a day, toddlers 6 months to 1 year old need 14 hours of sleep a day, children ages 1 to 3 need 12 hours of sleep a day, preschoolers need 11 to 12 hours of sleep, school-age children ages 5 to 13 need 9 to 10 hours of sleep a day and teenagers need 9 hours of sleep a day. Many children and teens don't get that much sleep. Here are tips for children to get a better night's sleep:

-- Don't have caffeine and limit chocolate, which are stimulants.

-- Don't eat a meal or exercise at least two hours before bedtime.

-- Try to go to bed and get up about the same time each day.

-- No videos (television, video games, computer games) within two hours of bedtime.

-- No electronics (televisions, computers, cellphones) in children's rooms at night.

-- For young children who are older than 6 months, make sure they fall asleep in the same position in which they will wake up. In other words, don't let them fall asleep in your arms. Instead, go through your bedtime routine (bath, bedtime story, etc.), then put them to bed, wish them good night and leave their room. If they get up and come into your room, direct them back to their room politely but unemotionally. They should learn to fall asleep on their own.

-- For children who want some light, dim nightlights are OK.

-- For older children, don't tell them "Go to sleep." You can't force someone to go to sleep. Instead urge them to go to bed and relax.

 http://www.nwitimes.com/niche/get-healthy/newsletter-featured-fitness/sleep-does-not-come-easily-for-some-children/article_b756e3dc-fb42-523e-9cd4-10b64923abec.html

Read more: here

Can Children Outgrow Asthma?

Perhaps the most common question a parent asks me about asthma is whether the disease is life long.  This question is hard to answer and it is risky to assume that children may "outgrow" their condition.  SS

Patients can’t outgrow breathing illness

It’s not the news parents want to hear, especially those who have watched their children gasp for every breath.

   But the reality is that you can’t outgrow asthma.

   Sure, the symptoms might ease, especially during teenage years. And, yes, getting a handle on any triggers that might worsen the problem — mold, pollen, dust mites, smoke, pollution and strong odors chief among them — can help.

   Still, “Asthma is a chronic disease, not a temporary condition,” said Dr. Jonathan Parsons, a pulmonologist and associate director of the Asthma Center at Ohio State University’s Wexner Medical Center.

   “It’s like high blood pressure or diabetes. There’s waxing and waning of the symptoms, but you have to be aware that you have it, and you have to know how to manage it.”

   Doctors say that asthma is most often diagnosed in children, and of those, about 90 percent experience a recurrence of symptoms, Parsons said.

   Managing the condition becomes a way of life. Asthma occurs when airways are narrow and swollen, impeding the flow and speed of air intake.

   “That’s a wheeze,” Parsons said.

   But sufferers don’t have to huff and puff all the time to have the problem. Asthma can manifest itself as a cough or an uncomfortable feeling or tightness in the chest or can masquerade as a runny nose attributed to a sinus problem or allergies.

   The only way to really diagnosis it is to undergo pulmonary-function tests, which measure airflow.

   Parents often don’t want to accept the diagnosis, said Dr. Karen S. McCoy, chief of the Division of Pediatric Pulmonology at Nationwide Children’s Hospital.

   “An asthma diagnosis is perfect for making a parent as worried and apprehensive as they can be,” McCoy said. “They don’t want to think that their child would have something ongoing or chronic, and the potential for ongoing and long-term medications is a concern for them.”

   She said childhood asthmatics often get a respite during their teenage years mostly because teens aren’t as prone to viral infections, which trigger symptoms, and because a change in the size of the airways means that a little bit of swelling doesn’t affect breathing as much.

   But as those kids grow older, they must remember to watch for the signs again.

   Xandula Gaitor said she wishes her two sons were so lucky.

   Her boys, now ages 20 and 10, have long struggled with severe asthma. Her older son, Alwyn Burns, caught a break in his teen years, but that was largely because his condition was so severe that the family relocated to Phoenix for its drier climate, she said.

   To help her younger son, Isaiah Burns, manage his asthma, they relocated to Alabama for a time.

   Now they are back in Westerville to be closer to family, and Isaiah’s symptoms remain severe.

   Gaitor said that when Alwyn was 5 months old and doctors diagnosed his asthma, she was scared yet relieved to know why he suffered terrifying breathing episodes.

   “I just said, ‘OK. Tell me what we need to do and how we can get him better.’”

   Alwyn’s asthma is so severe that the smell of cleaning supplies can trigger an attack. So can a whiff of smoke. And his linens must be washed often in extra-hot water to kill dust mites.

   “It has altered our lifestyle in so many ways,” Gaitor said.

   Treating childhood or adult asthma is largely the same — a maintenance dose of inhaled steroids to reduce inflammation in the airways and a rescue inhaler or breathing machine (called a nebulizer) for serious episodes.

   While childhood patients typically don’t outgrow asthma, some adults end up developing the breathing disorder. It’s called adult-onset asthma, but Parsons said it’s virtually impossible to tell whether the inflammation is new or had always been there.

   Genetics and family history play a role, and exposure to mold or chemicals can make a difference. hzachariah@dispatch.com  


http://www.dispatch.com/content/stories/local/2012/03/25/health/Patients-cant-outgrow-breathing-illness.html

Too Many Soft Drinks May Be Associated with Respiratory Diseases

Too Many Soft Drinks May Be Associated With Respiratory Diseases

Chronic respiratory conditions like asthma seems to occur more frequently in people drinking large quantities of sugary soft drinks, inflammation may be the key.

Soda Linked to Lung Disease

By Kristina Fiore, Staff Writer, MedPage Today

Published: February 07, 2012

More bad news for soda lovers: in addition to obesity and heart disease, the sugary drinks may be tied to asthma and chronic obstructive pulmonary disease (COPD), Australian researchers found.

People who consumed at least a half a liter of soft drinks a day were more than twice as likely to develop either lung condition compared with those who didn't partake at all (OR 2.33, 95% CI 1.51 to 3.60), Zumin Shi, MD, of the University of Adelaide in Australia, and colleagues reported in Respirology.

The cross-sectional study, however, couldn't prove causality, and researchers not involved in the study suspect an overall unhealthy diet effect might be at play.

"High soda intake is a good marker for poor overall diet, and poor overall attention to health," David Katz, MD, director of the Prevention Research Center at Yale University in New Haven, Conn., said in an email to MedPage Today. "It likely suggests greater exposure to everything from tobacco smoke to air pollution."

Sugar-sweetened beverages have long been linked to a host of poor health outcomes, includingstroke and heart disease, but no study has yet assessed potential ties to asthma or COPD, the researchers said.

There are many potential explanations for the increased burden of asthma in Western countries -- less exposure to indoor allergens, improved hygiene, and use of antibiotics (the "hygiene hypothesis"), as well as poor diet and increased obesity -- but fewer noted risk factors for COPD.

Smoking, of course, is a major one, but up to 50% of airway obstruction can't be explained away by cigarette use, they wrote, thus the need to identify novel risk factors.

The group looked at data from the South Australian Monitoring and Surveillance System on 16,907 adults, mean age 46.7, who responded to phone interviews from March 2008 to June 2010.

The prevalence of asthma and COPD, based on self-reported doctor diagnosis, was 12.5% and 4.4%, respectively.

Though the vast majority (72%) said they didn't drink any soda at all, 11.4% reported taking down more than a half a liter of soft drinks every day. In addition to carbonated brand-name soft drinks, lemonade, flavored mineral water, and sports drinks were consumed.

Shi and colleagues found that folks who drank this level of soda had a higher prevalence of asthma and COPD than those who didn't drink any (14.7% versus 11.9% and 6% versus 4.2%, respectively).

In multivariate analyses adjusting for sociodemographic factors, intake of fruit and vegetables, and other life style factors, drinking half a liter of soda a day was associated with an odds ratio of 1.26 for asthma (95% CI 1.01 to 1.58) and an OR of 1.79 for COPD (95% CI 1.32 to 2.43) compared with never drinking soda.

The researchers also saw combined effects for drinking soda and smoking. Consuming more than half a liter a day and being a current smoker carried a 6.6-fold greater risk of COPD and a 1.5-fold higher risk of asthma than not smoking and drinking soda, they reported.

"The combined effect of soft drink consumption and smoking on asthma/COPD emphasizes the importance of lifestyle factor clustering in the etiology of asthma/COPD," they wrote. "Promoting a healthy lifestyle should be encouraged as one means of preventing asthma/COPD."

The mechanisms behind the relationships, however, are unclear. Both asthma and COPD are associated with inflammation, and it could be that foods promoting oxidative stress and inflammation could affect the pathogenesis of these diseases, they wrote.

Drinking soda has also been tied to a higher risk of obesity, which in turn leads to a greater likelihood of developing both lung diseases, they said.

And studies have shown that chemicals such as phthalates from plastic bottles, as well as allergies to preservatives such as nitrites and sulphites, may be linked to asthma.

In addition to not being able to prove causality, the study was limited by its reliance on self-reported data.

Still, Shi and colleagues concluded that "regardless of whether there is a cause-and-effect relationship, the public health implications of consumption of large volumes of soft drink are substantial."

http://www.medpagetoday.com/AllergyImmunology/COPD/31060

Can Tylenol Explain the Rise in Asthma?

Some asthma researchers are worried that the rise in asthma and Tylenol use is too coincidental.  Does this mean you should restrict acetaminophen use in your child?

Does Tylenol Worsen Asthma For Kids?

Parents and doctors around the world have been alarmed by the dramatic increase in childhood asthma.

One factor in the upswing is better detection by doctors, but at least one doctor thinks a common over-the-counter drug also has something to do with it.

Dr. John McBride sees lots of kids with asthma. He's a pediatric pulmonologist at Akron Children's Hospital in Ohio. He knew of studies that raised concern about the safety of acetaminophen — brand name Tylenol — to treat colds and fever in kids with asthma. So he decided to look more closely at the research.

"I was stunned," he says. All the studies he looked at showed a link between asthma and acetaminophen.

"The more acetaminophen somebody takes, the more likely it is that they have asthma," he says. "Also, there's an incredible consistency. Everybody around the world who's looked for this association has been able to find it."

In asthma, the airways of the lungs get blocked by mucous and narrow. That leads to wheezing and shortness of breath. The rise in asthma has closely paralleled the increased use of acetaminophen.

There are no scientific studies proving the medication causes asthma, but McBride says it may make asthma worse in kids who already have it.

Nine-month-old Martez coughs and wheezes as McBride examines him and talks with his mom, Ceasha Moorer, about his asthma. "He coughs. He wheezes. There are multiple symptoms," she says. "He works very hard to breathe. When he's excited from crawling or even laughing, then he breathes really hard."

In the past when Martez got a cold, Moorer gave him Tylenol. But that seemed to make his symptoms worse. At McBride's suggestion, she stopped using it. Then one day, her aunt was looking after Martez when he had a cold.

"I told her don't give him Tylenol," Moorer says. "I didn't specify that it was acetaminophen. She actually gave him a cold medicine, but it seemed to make him kind of worse. I looked at the active ingredients and acetaminophen was in the active ingredients."

In fact, acetaminophen is an ingredient in many cough and cold products — includingNyQuil, Robitussin and Theraflu. It might exacerbate the asthma because it decreases levels of a molecule called glutathione, which protects the lungs.

"So removing the beneficial effect of glutathione exactly at a time children's lungs are being irritated might end up being just one factor that contributes to the onset of an asthma attack," McBride says.

McBride's recommendation? Don't give acetaminophen to a child who has asthma. Other doctors say it's too soon for that advice.

Many other factors could play a role in the rise of asthma, according to Dr. Stanley Szefler, head of pediatric pharmacology at National Jewish Health in Denver. "Vitamin D insufficiency, dietary changes, air pollution or better control of infections are perhaps all related to the increasing prevalence of asthma," he says.

Johnson & Johnson, maker of Tylenol, said in a statement that the medicine has been used safely and effectively for more than 50 years. "There are no prospective, randomized controlled studies that show a causal link between acetaminophen, the active ingredient in Tylenol, and asthma," the company said.

It's important to control a child's fever, Szefler says. McBride agrees but says ibuprofen is a safer bet — at least until ongoing studies provide answers about the safety of acetaminophen for kids with asthma.

http://www.npr.org/blogs/health/2012/02/20/147002356/does-tylenol-worsen-asthma-for-kids

See a similar article from the New York Times...

http://www.nytimes.com/2011/12/20/health/evidence-mounts-linking-acetaminophen-and-asthma.html?_r=2