What’s with the new cough and cold products?

One of my earliest lessons as a pharmacist working in the “real world” was that customers didn’t always act the way I expected. Parents of sick children frequently fell into this category — and the typical vignette went like this for me:

  1. Parent has determined that their child is sick, and needs some sort of over-the-counter medicine.
  2. Parent asks pharmacist for advice selecting a product from the dozens on the shelves.
  3. Pharmacist uses the opportunity to provide science-based advice, and assures parent that no drug therapy is necessary.
  4. Parent directly questions the validity of this advice, and may ask about the merits of a specific product they have already identified.
  5. Pharmacist explains efficacy and risk of the product, and provides general non-drug symptom management suggestions.
  6. Parent thanks pharmacist, selects product despite advice, and walks to the front of the store to pay.

In many ways, a pharmacy purchase mirrors the patient-physician interaction that ends with a prescription being written — it’s what feels like the logical end to the consultation, and without it, feels incomplete. It’s something that I’m observing more and more frequently when advising parents about cough and cold products for children.

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Hyland’s Teething Tablets: These sugar pills may be toxic

As has been repeatedly pointed out on this blog, homeopathy is an elaborate placebo system, with most remedies diluted so greatly that not a single molecule of the original material remains. The final product sold to consumers is quite literally, water – drops of which are dried on sucrose or lactose tablets. The fact that homeopathy has not been shown to be more effective than placebo should surprise no-one: it is a placebo, and the positive effects reported are placebo effects.

Because there are no medicinal ingredients, there is no way to take a typical homeopathic remedy and, by testing it, determine which remedy it’s supposed to be. All you would find would be sugar. That’s why Health Canada doesn’t require any post-manufacturing quality testing of the remedies it deems “safe and effective” – there’s nothing that can be objectively measured. So whether it’s lead, rabbit vagina (really), or the liver and heart of a duck, once they’re diluted enough, there’s nothing to distinguish one homeopathic remedy from another. Yet each approved product is granted a unique license number by Health Canada.

Homeopathy’s lack of active ingredients gives the products a reasonable safety profile. After all, a product can’t cause side effects, if it doesn’t cause any effects at all.  So you can take plutonium, dilute it enough, and you won’t get radiation poisoning.  But when a homeopathic remedy isn’t diluted enough, you can be exposed to the initial substance, which can be toxic. Enter Hyland’s Teething Tablets, and a recent warning from Health Canada: Continue reading

Canadian Flu Update 2010

We’re entering flu (influenza) season in North American and the annual vaccination campaigns have started. Here in Canada we’re fortunate to have a health system that covers the cost of immunizations for residents. In Ontario, where I’m located, the province funds a universal immunization program: everyone is eligible for a free flu shot. Here’s some background on influenza and some common questions (and answers) about the flu shot. This information is based on Canadian data and Canadian information with some general information pulled from the CDC. Apologies to SBP’s international readers, as much of this information will not be applicable outside Canada.

If you have any questions that aren’t answered here, please post them in the comments.

What is Influenza?

Influenza is a respiratory illness caused by influenza viruses. It typically appears 1-4 days after the initial infection, with fever, chills, muscle aches and fatigue common. Cough, sore throat and runny nose are also seen. In children, stomach complaints are frequent. On its own, the flu can be nasty. But it can complicate into viral pneumonia, or lead to a subsequent bacterial pneumonia. And if you have other chronic illnesses, like heart failure or asthma, it can cause significant worsening of these conditions. Continue reading