welcome to ASA do I'm Kathy Bill and today we're going to be doing a deep dive into the ever evolving world of pediatric medications from antibiotics and probiotics to over-the-counter and prescription meds Dr meline Kaho Chief Pharmacy officer for Baptist Health and Dr Marie rosique a pediatric clinical manager for Baptist Health are standing by and ready to answer your questions on this episode of ask the dog send in your questions to questions allhealth tv.com or allhealth go on Facebook or YouTube or visit the askthe dooc page on our website allhealth tv.com welcome to as the do the show where we encourage our viewers to send in their health questions so let's kick things off with a question from one of our viewers and today's first question comes to us through our website all Health tv.com and it's from Evelyn and Evelyn's question is hey Doc my 15-year-old son just had his four wisdom teeth removed the oral surgeon prescribed per cassette for severe pain my boy's complaining about about the pain but I'm hesitant to give him the medication for fear of him getting addicted to it what should I do so Dr Kaho what's the deal should Evelyn be worried about her son getting addicted to painkillers so Evelyn that's a great question because unfortunately it's a typical one that we get asked all the time but addiction is rare when you're just managing postoperative pain for a period of less than seven days now perinet is in our otic and it's pain relieving medication that contains both acetaminophen and Oxycodone and it can be prescribed to kids after a surgical procedure to manage you know severe pain now the surgeon for this type of procedure should only have given you enough for three days that's make sure that that's only is the only thing that happens no more than that and my recommendation would be to start with just Tylenol first like 500 milligrams every six hours the first day to see how he's tolerating the pain if he's still complaining that the pain is severe then begin a one-time dose of the perco set and re-evaluate the pain in 30 minutes if it's better then the next dose then give him Tylenol again and re-eval pain only give peret when he's complaining of severe pain and after giving the Percoset if still no pain relief then call the doctor because there may be another issue that could be that could be Brewing so do that and then by day three he should not be comp uh complaining of any severe pain and now it's very important important to dispose of any leftover peret by soaking them in water and soak for a few minutes then mixing it with coffee grind's kitty litter and throw it in the garbage don't leave peret laying around the house this is how other teens come and kids who can take them and misuse them so that's one thing you always want to do is make sure you don't keep narcotics in any of your cabinets and hanging around that's a great Point Dr kameho thank you so much okay heads up doc we've got a YouTube question and this one is from Rama and Rama asks hey Dr Kaho my beautiful 8-year-old daughter has a sore throat and I was just about to give her aspirin but my equally beautiful wife was ready to kill me for even suggesting it why can suria have aspirin oh Rama that's a big no no right Dr kameho Dr rosique please tell Rama what oh yes Rama thanks for reaching out to us with your good question but I'm gonna let my good friend Marie repr man Rama but uh before I do let's check out this video from the mayor clinic so sore throats are very common especially amongst schoolage children uh some of the symptoms that a child might complain of are uh pain when swallowing uh difficulty swallowing refusal to eat or drink anything because it's uh painful they may complain of uh pain on the outside of their neck where their lymph glands are over 90% of sore throats are caused by viruses those are the most common cause of sore throats um a small percentage of s throats are caused by the uh group a strep uh or strep bacteria and those are the ones that uh require treatment with antibiotics uh all viral or throats will get better on their own and there's no benefit to taking antibiotics and in fact taking antibiotics for them could cause you or your child harm so we often recommend things like uh cool or warm drinks uh popsicles um lenes uh that the child can suck on if they're old enough to do that uh safely can help to numb the throat a bit using a humidifier to humidify the air can help because dry air can be quite irritating um and then using medications like ibuprofen or acetamin can also help to settle some of that pain until they get better yes so aspirin which falls into the class of medication known as solic late is not recommended in children less than 18 years of age due to the association with rice syndrome which can occur in children especially if they have a viral infection or illness rice syndrome is a very serious complication and condition that causes swelling of the liver and the brain and it's very important to note that aspirin and cicas may also be ingredients in some overthe counter medications like Pepto bismal so therefore it's important to review ingredients before giving your child any overthe counter medication and ask your pharmacist or doctor if you have any questions very important never give aspirin or solicit containing medications to your child for pain only give acetaminophen or Ibuprofen thank you Dr rosi so we got another allhealth tv.com question I love this it's from Lulu who asks hello Dr Kaho my seven-year-old son Wesley has a very bad cough that's not responsive to any of the over-the-counter cough meds should I call our pediatrician and ask her to prescribe cough syrup with coating which has helped us greatly in the past now what do you think doc a little cough syrup with coating cocktail for the kids is this okay so hi Lulu that's a good question uh and that you're asking and thanks for reaching out but the FDA has restricted the use of prescription cough and cold medications containing opioids like codin to adults only so um and the reason is is because children can experience severe side effects to Codine such as low or difficult breathing even at the most appropriate doses so try to give robotos and DM first if the cough has not responded to over-the-counter then talk to your pharmacist to see what they would recommend maybe the cough syrup you're giving doesn't contain dexa aoran which usually helps for cough and if that doesn't work always call your pediatrician for advice thank you Dr kameho now in case you missed it the first time here's my friendly and daily reminder another opportunity where you consent in your question is coming through check it out send in your questions to questions allhealth tv.com or allhealth go on Facebook or YouTube or visit the askthe do page on our website allhealth tv.com remember to send in those questions for ask the dog now we have one question from paita and she is our first Instagram question the dayao Bambina is teething and miserable I have origel at home can I rub a small amount on her gums or is there something else you can suggest we're getting some really great questions here this is another good one so can we do Orel for pil that's a good question paita but let's see what we could do to make Point P feel better and U Marie what would you recommend so origal product may contain a local anesthetic called called benzoin and the FDA issued a warning not to use in infants and children for teething pain since it can lead to a rare and serious condition caus called met hemoglobinemia that reduces the amount of oxygen in the bloodstream and can lead to even death similar warnings have also been issued for other topical anesthetics that may be applied to the gums like lidocaine therefore my recommendations for teething pain is to give your baby a chilled teething rate not frozen but chilled and to gently rub or massage the gum with your finger but never give origel or any other topical teething medication to your baby which may harm them thank you Dr rosique so we got another YouTube question this time it's from renie renie asks Dr Kaho I've got a question for you and Dr rosique why if my child has an ear infection my doctor won't prescribe antibiotics I was taking antibiotics almost every month when I was growing up so are all antibiotics on the no fly list right now Dr kameho and Dr rosique when can you give antibiotics so renie thanks for writing in and watching the show but just like we talked about with the sore throat many ear infections are caused by viruses not bacteria so you never want to treat a virus with an antibiotic and the majority of these ear infections will go away without the use of any antibiotics so give Tylenol or iuen for pain and it will go away one or two days the repeated use or misuse of antibiotics is really what leads to antibiotic resistance and uh failure to any future antibiotics working on on those bacteria so we try to not give antibiotics and is absolutely necessary and you have a bacteria infection thank you Dr kameho Dr R I have a followup to that which is when do you give antibiotics uh for children is it only for certain infections so you give antibiotics when the doctor suspects after evaluating the patient that they might have a bacterial infection so you want to give antibiotics when you either suspect or you have a positive culture that says that you have an infection like a strep or flu or something of that nature correct so you can do your your child may go to the pediatrician's office and they might actually do a swab a rapid test and it comes back as it's positive to strep so you're G to start the antibiotics because you have a positive culture now sometimes when you do a strep culture if it comes back negative let's say you do a a strep test a rapid test test and it comes back negative the doctor will do a culture to confirm because sometimes the rapid strep test can come out negative but the culture comes back positive so if the doctor feels at that point that it's highly suspicious even though your strep test came back negative they actually may actually start the antibiotic and wait for your culture come back sometimes the culture will come back positive that's exactly that exact scenario is what happened with one of my children as a parent this this question is extremely helpful we have another question so let's get to that it's from Trent and he wants to know hi Dr C what are the potential side effects of giving antibiotics to children and can you minimize some of these Side Effects by giving probiotics my wife recently got me on probiotics and kombucha and it's definitely been helping with my digestive system so doc one and two your respective thoughts on probiotics especially for children so Trent I love this question and but I'm going to hand this one back to Dr rosique this is definitely up your alley okay so the common side effects of antibiotics which can occur in about 20% of children that go on antibiotics usually um consist of like nausea diarrhea stomach upsets and rashes and sometimes some more concerning reactions like allergic reactions Pro biotics can help with the stomach upsets and diarrhea by restoring the healthy gut Flora that antibiotics can wipe out do not use probiotic supplements that are sold in pharmacies because they are not FDA approved and you don't know what's in them okay and they can sometimes lead to side effects but instead what I recommend is to give your child something like yogurt which also contains healthy probiotics and can be added to their diet while they're taking the antibiotic and I usually recommend to um continue the the yogurt for about two weeks after your child has completed the antibiotic to make sure that that healthy Flora is maintained Dr rosique what about the the probiotic gummies for kids I don't recommend any probiotic um sub supplements or gummies for children because they're not FDA approved and with children you have to be very careful because sometimes they might have ingredients in there that can cause side effects or that can lead to allergic reactions especially there's so many kids nowadays that have allergies to foods and you never know what you can get in those products that are not FDA approved thank you very helpful Dr kameho looks like we got another question from the gr and it's time it's from viva is there a l between vaccines and autism especially those flu vaccines that have oh my gosh Dr kameho thos Sol as the preservative okay I didn't know that they were still allowed to use therasol in vaccines and please tell me I said that semi correctly Dr kameho diasol diasol there you go so Kathy you're mostly right there are some flu vaccines that still use it but I'll get to that in a minute and great great question Vivian thanks for writing in but first there is no evidence that vaccines really cause autism the cause of autism is still not fully understood and in 2001 thimerosol which is a Mercury containing uh preservative which was removed from all childhood vaccines so however it it is still contained in some of the multi-dose files of influenza vaccines and as a parent when you go get your child vaccinated for the flu ask and request for single dose syringes when you're vaccinating because they don't contain any thimerosol thank you Dr gameo now if you got questions we got answers you know the drill and in case you missed it in the first couple of times here's yet another chance to find out where to send in those questions send in your questions to questions allhealth tv.com or all Health go on Facebook or YouTube or visit the ask the do page on our website allhealth tv.com all right this question is from Quenton who reached out to us on allhealth tv.com you should really check the website out when you get a chance because it's really chalk full of great information we have fantastic medical experts like Dr kameho and Dr rosi here to answer anything any questions that you might have so let's see what qu what quenon wants to know he says our son silus is severely allergic to peanuts and almonds if he has an allergic reaction when should I use the EpiPen and are there any harmful side effects associated with using the the EpiPen so doct does the EpiPen have any harmful side effects that uh quincon or those who have allergies need to be uh worried about so excellent question Quinton and we appreciate you writing it in but before I answer that question let's check out this video from the good Folks at the Mayo Clinic does your child have a food allergy how does food allergy happen is the first question Dr a Joi says one theory has to do with babies who have the skin condition eczema the food gets introduced through the skin and that causes an aberant immune response so instead of the food being tolerant you start recognizing the food as an allergen when that food is introduced into diets later the babies have already developed antibodies against that food kids start having itching and throat closure if large amount of consumed they can have vomiting they can have head tuto hives breathing difficulty and anaphylaxis anaphylaxis happens when your immune system identifies a substance such as peanuts as foreign this triggers cells called mast cells to release chemicals that cause many symptoms including dilated blood vessels constricted Airways intestinal problems and even death for the Mayo Clinic News Network I'm Vivien Williams so epinephrine should be used immediately in a severe anaphylactic reaction that's the most important thing do not be afraid of using this life saving medication even if you're in doubt so side effects that could be expected should be like palpitation Tremors nausea vomiting but those are minimal compared to the to giving the medication and experience an anaphylactic reaction which could be life-threatening so after you give the EpiPen you can also give an antihistamine like a Benadryl or a zerx help with the reaction as well thank you Dr gaho now this question comes from ANA who reached out to us via Facebook our 10-year-old daughter Faith was just diagnosed with ADHD and we have some concerns about potential side effects we've heard about such as mood swings weight loss and Disturbed sleep and are there any cardiac issues that can result from children using ADHD medications fi I've heard some of the same things about these potential side effects with ADHD meds so let's go to Dr rosique for a little bit more info okay so stimulant medications like methyl fenal state which is Rin or amphetamines like adderal are first line treatments for ADHD in children six years of age and greater and should be used in combination with behavior management for most kids stimulant are safe and effective in treating ADHD symptoms stimulant medications do have side effects some of which can affect sleeping um they can decrease appetite and cause weight loss they can cause irritability and anxiousness or social withdrawal in some kids and may even cause some nausea and vomiting however it's important to know that the majority of these symptoms occur early in treatment and are usually mild and shortlived and they can also be managed by changing either the dose of the medication or switching to a different formulation like either going from an immediate release formulation to a long acting or even as simple as taking the medication on a full stomach after meals which will relieve the nausea and vomiting that can occur stimulant also can increase the heart rate and blood pressure and this is important in children that might have an underlining condition of the heart so prior to starting treatment with these medications it is important that your child or adolescent has a thorough cardiac evaluation and usually your doctor make send your child to a Cardiologist to do this whole review and it is important after you start these medications to monitor your child's heart rate um blood pressure um throughout the time that your your your child is on these medications thank you so much Dr RI we have time for some more questions and this one comes to us via Facebook from Gage hi Dr rosique can you overload the immune system by giving multiple vaccines at the same time great question Dr rosique so children's immune systems are not overwhelmed by vaccines there are millions of Childrens that have safely received multiple vaccine shots at the same time the recommended CDC immunization schedule is designed to work best with a child's immune system at certain ages so time with vac without vaccination is time without protection against these vaccine preventable diseases so it's important that you do not try to delay the immunization or the vaccines that are scheduled at a certain age for your child I'm going to put you on the spot here Dr rosique how many vaccines should children be be having throughout uh their early years so if you follow there is the CDC has an immuniz ation schedule that has multiple um vaccines that are given to Children according to their age there are some new ones that the vaccine schedule is was just updated it's usually updated every year at the beginning of the year and we added now a new vaccine um which is for RSB prevention so the number of of vaccines that you get a year can change according to's age and according if there's any changes in the CDC immunization sched super helpful thank you Dr oi we have time for one more question and this one comes to us from Jasmine she ask Dr kameho will anti anti-convulsants affect my child's growth development and learning so Jasmine thank you for reaching out now some anti-convulsive medications can affect bone growth the concern is especially important for children who need to take certain anti-seizure medications for many years so it really is important to have that conversation with your with your doctor um if your child needs an anti-c convulsion medication for more than one or two years um make sure you have that conversation with your physician as well as to see what else can be given uh calcium or think to help with improve that bone health generation so uh similarly anti compulsin is can affect thinking remembering things paying attention as well uh have that conversation with the pharmacist to see which one would have be the most important one that has less side effects um and it's just about how your child reacts to medication everybody is different so I can't prescribe one thing or the other it all depends on how your child's going to react to the medication all right doc 60 seconds here let's do a little Express recap on the importance of pediatric vaccines and anything that we have covered today what did you want to add let's start with Dr gjo so I think the most important thing is do get your kids vaccinated um I think it's really important uh there are so many folks that are not vaccinating their kids and we're getting we're starting to see a lot of of uh diseases that are really starting to uh creep up especially menitis other things that we should be vaccinating we all got vaccines when we were kids so I think that's really an important lessons follow the CDC guidelines for vaccinations uh especially for your kids and when they go to school remember they get exposed to a lot of things and if your child's not vaccinated they can be exposed to something that could eventually lead to a health risk later on in their development thank you Dr gumo 20 seconds Dr rosique anything you want to add I think in terms of the vaccines or just in general in general in general so in general I think it's important to always know what your the medications that your child is receiving what the side effects are what the appropriate Doses and if you have any question reach out to your kment we're available we love to answer questions and help your child and if we can't answer the question then we will ask you also to follow up with your physician thank you Dr Rosie we love to ask you questions now that's all the time that we have for today I'm Kathy buo thank you for joining us and I'll see you next time on ask the do send in your questions to questions allhealth tv.com or allhealth go on Facebook or YouTube or visit the askthe do page on our website allhealth tv.com