This CE activity was originally published in The Rx Consultant. If you received credit for it previously, you cannot receive credit for it again.
Pediatric patients often suffer from viral upper respiratory infections (“the common cold”) with symptoms including congestion, rhinorrhea (runny nose), cough and, occasionally, fever. Children experience approximately 3 to 8 colds each year, about twice as many as adults. The annual cost of colds and cold-like illnesses in the US is an estimated $40 billion – due to lost work days for parents, medical appointments, and the cost of medications.3 Cough, a common symptom of several childhood illnesses, is the second most common reason for emergency department visits by children aged 15 years and younger. Another common symptom among children, fever, accounts for an estimated 6% of all office visits to pediatricians. Typically, colds and related symptoms of cough and fever are self-limiting, but nondrug measures and over-the-counter (OTC) medications may be used to relieve bothersome symptoms. Although many OTC medications are recognized as safe and effective through the FDA’s OTC monograph process, clinical trial evidence to support their use in children is limited.
In 2001, concern began to escalate about serious adverse effects and deaths related to cough and cold medication use in infants and young children. In addition, adverse events related to cough and cold medications were implicated as a common reason for emergency department visits, especially among young children. These reports led to a 2008 Public Health Advisory from the FDA recommending that cough and cold products not be used in infants and children under the age of 2 years. Following this recommendation, manufacturers voluntarily updated the cough and cold product labels to advise against use in children younger than 4 years.
Pharmacists and other easily accessible healthcare providers are key sources of information about the drug and nondrug options for treating colds, cough and fever in children. Placing emphasis on nondrug options is important to avoid unnecessary medication use and potential side effects. When OTC medication is recommended, caregivers need advice about identifying and measuring the correct dose (which can be quite confusing) as well as any contraindications or side effects of concern for the individual child. This issue focuses on OTC options for cold symptom management; prescription medications (eg, ipratropium nasal solution for rhinorrhea) are not included.
- This accredited program is targeted to pharmacy technicians.
CE activities for Pharmacists and Pharmacy Technicians:
This continuing education (CE) activity meets the requirements of all state boards of pharmacy for approved continuing education hours. CE credit is automatically reported to CPE Monitor.
The American Nurses Credentialing Center (ANCC) for formally approved continuing education (CE) hours, and CE hours of pharmacotherapeutics.
The American Academy of Nurse Practitioners Certification Program (AANPCP) for acceptable, accredited CE.
- The ANCC requires all advanced practice nursing certificants (CNSs and NPs) to complete 25 CE hours of pharmacotherapeutics as a portion of the required 75 continuing education hours.
- Pharmacology CE is recommended by the AANPCP and will be required for Certificants renewing certification starting January 2017.
- Most State Boards of Nursing require a minimum number of pharmacy contact hours to renew an advanced practice license.
Requirements for CE Credit
- Identify 1 common nonprescription (OTC) medication used for cold symptoms in children from each of the following classes: decongestants, antihistamines, cough suppressants and expectorants, and antipyretics. For each, provide the usual dose for 2-5 year olds and 6-11 year olds.
- List common side effects and potential drug interactions for oral decongestants, 1st generation antihistamines, codeine and dextromethorphan. Describe the regulatory policies and recommendations developed in response to patient safety and abuse concerns with pseudoephedrine and codeine.
- Describe 4 non-drug strategies for managing cold symptoms. Recognize 5 alternative or complementary products that parents may want to use for treatment of a child's cold symptoms
Courtney L. Bradley, PharmD
Brief Bio : Courtney L. Bradley, PharmD, is an Assistant Professor of Clinical Sciences and Applied Laboratory Coordinator at the High Point University School of Pharmacy, High Point, NC.
Disclosure : Dr. Bradley report no financial relationship with the manufacturer(s) or provider(s) of any commercial product(s) or service(s) that appears in this issue.
Kelly L. Scolaro, PharmD
Brief Bio : Kelly L. Scolaro is a Clinical Assistant Professor and Director of Pharmaceutical Care Labs, Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy at the University of North Carolina, Chapel Hill.
Disclosure : Dr. Scolaro reports no financial relationship with the manufacturer(s) or provider(s) of any commercial product(s) or service(s) that appears in this issue.