Childhood Diseases

Question
Posted by: ILSEO | 2009/09/01

Q.

COUGHING WHILE ON SINGULAIR

MY 3YEAR OLD HAS BEEN SUFFERING FROM SINUSITUS FOR THE PAST 3 WEEKS. DOC GAVE HER DESELEX TO USE AND SHE IS ON SINGULAIR CHEWTABS FOR THE PAST 8 DAYS BUT STILL COUGHS A LOT. TOOK HER TO MY GP AND HE GAVE BETANOID TO USE FOR 5 DAYS AS WELL AS SINUMAX TO CLEAR THE POSTNASAL DRIP. SHE USES THE SINGULAIR AT NIGHT BUT STILL COUGHS A LOT DURING THE DAY. CAN I GIVE HER SOME COUGHMEDS LIKE FLEMEZE/BRONCHOPED DURING THE DAY?

Expert's Reply

A.

Paediatrician

Singulair is a medicine used to treat asthma. It is not used to treat sinusitis.Deselex is an antihistamine used to treat nasal allergy and will not help with sinusitis.Betanoid is powerful cortisone which does not help for sinusitis. Sinumax contains pseudoephedrine and an old fashioned antihistamine which will make your child unhappy and may cause her to have bad dreams.All in all not a good list of medicines to be on. Now we come to another important issue: Children of 3 years very seldom have any sinuses formed yet so a diagnosis of sinusitis is unlikely.
It is likely that your daughter has an adenoidal infection possibly associated with tonsillitis which is causing her to have a post nasal drip.The post nasal drip is causing her to cough.Use Salex nose drops twice to three times daily to clear her nose. If this does not work after 3 days,she may need to get an antibiotic to clear her nasal infection.You can give her Flemeze as this will help to thin down the mucous from her post nasal drip.

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user comments

C.

Posted by: desire | 2009/09/13

My 8 yr 7 mth old daughter (weight: 40.3kg, height: 1.40m) has a 1 year history of severe abdominal pain and foecal impaction (the latter confirmed by ultrasound). Despite chronic use of Pegicol (2 sachets per day, as well as the acute regime for impaction), together with a high fibre diet and use of Pro-B5 (1 cap bd), there has been little if not no improvement  resulting in two admissions (last being on 2 July 2009), wherein she was administered et al, fleet enemas. Scopex and Buscopan provide no relief of her pain. At times, although she sits on the loo for extended durations, up to 45 minutes, she does not have a bowel movement even though she feels like going. There have also been intermittent episodes of reflux, which she describes as chest pain. Vee was admitted again five days ago and CT scan of the abdomen with contrast, revealed nil of note except for mild oecal impaction. Today, she underwent a colonoscopy, which was indicative of spastic colon (ibs). Consultation was also held with a dietician, who noted the need for very little change in my daughter' s diet, except perhaps to substitute cow' s milk with soya milk (she is not allergic to cow' s milk). Blood and stool cultures revealed nil of note. I have been advised by Vee' s paed to continue with the Pegicol, Buscopan/Scopex (when necessary) and Pro-B5, as well as use of Altosec (1 cap daily).

Regarding the epilepsy, there is a five month history of headaches, located to the frontal region and forehead  which are unresponsive to Ponstel caps and Panado tabs. At times, she is also pyrexial (rise in temp of +- 1 degree to about 37.8 deg Celcius, her norm is 36.5). On administration of either Ponstel or Panado, her temp returns to normal, although rises again, requiring alternate use of the aforementioned, This is a pattern, in the absence of any other signs and symptoms. It must be noted that Vee has had eight bouts of URTI' s / pharyngitis this year, with use of antibiotics (oral, as well as ivi on two occasions), and her headaches were ascribed to the flu virene. However, there has been no remission and of recent, complaints of dizziness as well. This was investigated at her current admission by means of CT scan of the brain with contrast, as well as MRI scan  both of which revealed no abnormalities  however EEG studies have reportedly revealed " grand mal seizures without manifestation" . I watched the said EEG being performed and note that the spikes occurred during the 3 minute period that Vee was required to close her eyes, open her mouth and take deep short breaths. She has no history of any type of seizure, including nocturnal (although there has been more than one occasion where she wakes up with a headache) or febrile convulsions, nor is there any family history thereof. Vee has been commenced on Epilim (300mg bd), since three days ago, which I am given to understand, must continue for the next two years. She is to undergo repeat bloods in two weeks, with adjustment of the dosage by her paed thereafter if necessary. It must be noted that her doctor does not appear to be wholly convinced regarding the epilepsy, stating that he will be performing a repeat EEG in the near future.

Vee has allergic rhinitus, for which she is managed on Deselex (1 tab daily), Nasocor nasal spray (2 puffs per nostril bd) and Patonil eye drops (as required, owing to recurring cysts on her upper and lower eyelids, to which end, warm compresses and lid sccrubs are performed daily). I have read that a possible side effect of anti-histamines is seizures, alhough I am given to understand that Deselex does not cross the blood brain barrier.

Please advise. I am at my wits end. There are already changes in my daughter' s appetite (increased), as well as behavioural abnormalities (she appears clingy and subdued since being discharged this afternoon). I am not happy to continue with the Epilim.

Thank you.

Desire' 

Reply to desire

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