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Posts for category: Medications

Cough and cold medicines are not recommended for respiratory illnesses in children under four years of age.

Research has shown these products offer little benefit to young children and can have potentially serious side effects. 

Many cough and cold products for children have more than one ingredient, increasing the chance of accidental overdose if combined with another product.

Cough and cold medicines should not be used under age 4, and should be used from age 4 to 6 only if recommended by the child’s doctor. View a video clip here.

There are comfort measures that can be offered to parents of young patients, including plenty of fluids; saline nose drops or spray for stuffy noses; a cool mist humidifier; ibuprofen or acetaminophen to reduce fever. Talk to your child's doctor about how to use these products safely. 

For coughs, dark honey (Buckwheat Dark Honey, for example) may be given to children over 1 year of age. Giving honey to infants under a year old is dangerous. Talk to your pediatrician about amounts. 

Information for Parents:
Coughs and Colds: Medicines or Home Remedies?

September 21, 2017
Category: Medications
Tags: immunizations   Vaccines   pain control   EMLA   TegaDerm   shots   Lidocaine   Prilocaine  

Instructions to parent(s) to help minimize the pain of shotsPP_logo_largetag.jpg

Choose the shot spot according to the photos below and the age of your child. Clean the skin with soap and water (you do not need to use an alcohol swab), and pat dry. Apply EMLA cream available from your local pharmacy to the indicated area and cover with a Tegaderm Transparent Dressing, ideally for one hour before doctor’s appointment. You may need a prescription for EMLA; ask your pharmacist. Please call days before if you need an Rx.

EMLA Cream consists of a 1:1 mixture of lidocaine and prilocaine. EMLA prevents pain associated with topical skin procedures. Although EMLA Cream can be an OTC (Over The Counter) product, available in pharmacies, some pharmacies require a prescription. Please contact me if you need an Rx.

Nexcare Tegaderm Transparent Dressings 2-3/8 Inches X 2-3/4 Inches is a sterile dressings that covers & protects & is deal for abrasions, cuts, minor burns, blisters and post surgical incisions. It seals out water, dirt and germs to help prevent infection. Gentle on skin. Latex free materials. Waterproof transparent dressing. Ideal for covering and protecting wounds, such as abrasions, cuts, minor burns, blisters and post-surgical incisions & protecting reddened or fragile skin. Features: waterproof; can wear up to 7 day wear; stays on in bath and shower; flexes and moves with body for greater comfort; hypoallergenic. No. 1 hospital brand. Sterility guaranteed unless individual wrapper is opened or damaged. Please recycle. Packaging made from 100% recycled paperboard with a minimum of 35% post-consumer content by weight. Made in USA.

Where to Apply EMLA cream covered by TegaDerm

For children over age 1-2 yrs of age:Injection_intramuscular_deltoid_older_child_EQUIP_ILL_EN_300.jpg

Depending on sufficient flesh. This is the top, upper part of the arm. The non-dominant arm is generally preferred for 1 or 2 shots.

Cover the indicated area with EMLA cream, using a sufficient amount to leave skin surface wet and glistening; cover immediately with TegaDerm.

Do not wait for EMLA to dry before covering with patch.

For infants under age 12-18 months, use the thighs: The middle of the front outer side of the thigh. Do not use the inner thigh, side or back of the thigh. Divide the thigh into thirds; the injection site is in the middle third section

. Numbing Cream Patch Thigh Location.pngDoll_IM_Injection_Site.jpgInjection_site_baby_thigh.jpg


How To Use

Step 1

Peel away the printed liner from the paper-framed dressing, exposing the adhesive surface.


Step 2

Apply dressing over correct area covering EMLA cream where applied. See photos below. DO NOT STRETCH the dressing when applying.

Step 3

Remove the paper frame from the dressing while smoothing down the edges.



Apply the Tegaderm Patch over EMLA at least one hour before your appointment; The doctor will remove the patch on arrival.


How to make injections less painful for your child


Topical anesthetic agents, such as EMLA, lidocaine (Maxilene®), tetracaine (Ametop®) can be applied for one hour before giving the injection.  Follow the directions on the packet.


Sugar mixture (Oral sucrose 24%). You can make this at home by mixing one packet (1 tsp) of sugar to two tsp of water. Place a few drops of the mixture onto your baby’s tongue, a few minutes before the injection. Give a few drops right as you are giving the injection.This will make it less painful for your baby. You do not need to give all of the sucrose mixture to the baby. This works in children up to 18 months of age.


How to make injections less painful for your child


Babies can be distracted with colourful mobiles and mirrors. Younger children can be distracted with blowing bubbles or party blowers, reading a favourite book, playing with a musical toy or with the use of virtual reality glasses. Older children can choose what they wish to be distracted with: a hand-held video game, for example.

Imagery and Relaxation

Ask your child to try to imagine a pleasant experience. As your child focuses on something other than the pain, ask them to describe it using all their senses. Your child can also pick an image that feels relaxing to them. You can also suggest other sensations such as sound, smell, taste and touch that go with the situation. You may suggest that as they breathe steadily in and out, they are blowing away the tension in their muscles.

More reduction of pain for babies and toddlers

Straddle Position can help steady your child for the shot & soothe at the same time.Injection_baby_straddle_how to hold.jpeg

Straddle your baby on your lap so that baby is  facing you and the limbs are on each side of you. This is similar to giving your child a ‘bear-hug'.This position is easy to do when there are two people present. The other person, the doctor, can inject on one of the injection sites that you have prepared as you securely hold your baby in place. Alternatively, you can swaddle your baby in a blanket, leaving the limb out for injection.  

Breastfeeding is a good time to give your baby an injection. This will make the injection less painful. This works when the doctor is available to give the injection while you are feeding. Or let your child suck on a pacifier during the injection. Many toddlers and babies find this soothing and feel less pain during the injection. You can also dip the pacifier in the sugar mixture (described above).

Please contact your doctor if you have any questions about preparation for immunization shots or need an Rx for EMLA (ask your pharmacist).  

September 04, 2017
Category: Medications

Auvi-Q is once again available for life-threatening allergic emergencies_anaphylaxis. This automatic systen delivers adrenalin (epinephrine) to reverse serious allergic reactions. This is a cool device and talks you through the steps of administration. It delivers one dose only. The most useful feature of this device is that it is easily carried in an adolescent's pocket or a parent's purse. 

Alternative adrenalin devices are the EpiPen and the generic Adrenaclick. All deliver adrenalin. Only Auvi-Q has an audio system of real-time instruction when needed and is easily pocket-portable. Price and insurance coverage are also factors in your choice of which to carry. 

Recommendations are for an individual to have access to two auto injectors, NOT just one, and after use, to seek emergency care quickly for further evaluation and treatment. All units require a doctor's prescription. 

Persons with serious life-threatening allergic reactions ALWAYS need to be prepared.

Dr. T

October 29, 2015
Category: Medications
Tags: Recall   Recalls   AuviQ   Auvi-Q   Anaphylaxis   Allergic Reaction  

Sanofi US Recalls All Auvi-Q Epinephrine Injection in 2015; 

Available Again in 2017!


Attribution | October 29, 2015

Sanofi US is voluntarily recalling all of its epinephrine injection (Auvi-Q) on the market because patients taking it for life-threatening anaphylaxis may receive an inaccurate and inadequate dose, the US Food and Drug Administration (FDA) announced today.

The company has received 26 unconfirmed reports of suspected device malfunction from patients in the United States and Canada as of October 26. No one died as a result, but patients continued to experience symptoms of underlying hypersensitivity reaction, the FDA said in a news release.

The agency said that patients using Auvi-Q should ask their physician to prescribe an alternate epinephrine autoinjector. If patients experience anaphylaxis, they should only use Auvi-Q if no other epinephrine autoinjector is available, and then seek emergency medical care.

Auvi-Q is distributed in packs that contain two active injectors, along with a training injector. There are roughly 490,000 packs of Auvi-Q on the market, all of them subject to the recall, Paul Chew, MD, Sanofi's global chief medical officer, told Medscape Medical News. Some packs contain epinephrine injection at 0.15 mg strength, and others at 0.3 mg strength.

The recall includes Auvi-Q packs in lots numbered 2299596 through 3037230, which expire March 2016 through December 2016.

Sanofi customers with questions about the voluntary recall, including how to return the product, can go to the Auvi-Q website or call 1-866-726-6340. More information about the recall is available on the FDA website.

To report any problems with Auvi-Q epinephrine injection, contact MedWatch, the FDA's safety information and adverse event reporting program, by telephone at 1-800-FDA-1088; by fax at 1-800-FDA-0178; online at; with postage-paid FDA form 3500, available at; or by mail to MedWatch, 5600 Fishers Lane, Rockville, Maryland 20852-9787.