Q: At what point should you give a child Tylenol or ibuprofen to bring down a fever? When I was a young mother and took my child to the emergency room to find out why his temperature was high, the doctor berated me for not loading him up with aspirin.
A: There is no single temperature that necessitates treatment in a young child. According to Dr. Tieraona Low Dog, author of “Healthy at Home,” it makes more sense to assess the child’s overall behavior. A child who is listless and not eating, even if the fever is only 99 or 100, may need prompt medical attention. A child with a fever of 102 who is active, eating and drinking probably doesn’t need a fever reducer.
Aspirin is no longer given to children with viral infections because it could lead to Reye’s syndrome. But even acetaminophen and ibuprofen don’t speed recovery from a cold or flu.
In fact, a recent study suggests that taking fever reducers during a bout of the flu increases viral replication and may help spread the flu to other people (Proceedings of the Royal Society B).
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Q: Do you have any information you can share about older people being overmedicated? I am concerned about the number of pills my in-laws are taking.
Mom is on Detrol LA for her bladder, atorvastatin to control cholesterol, lisinopril for blood pressure and sertraline for mood improvement. Dad is taking twice as many pills. They both are showing signs of cognitive impairment. The checkbook is a mess, they forget appointments, and the house is topsy-turvy.
A: Your in-laws should have a neurological assessment that includes the cognitive effects of all their medications. Tolterodine (Detrol) and similar medicines for overactive bladder can contribute to confusion and memory problems.
The prescribing information for atorvastatin (Lipitor) notes that the drug may be linked to cognitive impairment (memory loss, forgetfulness, amnesia, memory impairment, confusion). Other statins may have similar side effects.
Q: I’ve been using Selsun Blue for a month for my rosacea. To my amazement, it really works.
I was so self-conscious about my complexion. There still are some faint red pimples, but my skin looks better. I’m not red as a tomato anymore.
I had tried other treatments, and Selsun Blue has made a difference. I use it every other day for about two minutes and wash it off with warm water.
A: Rosacea is a skin condition characterized by red cheeks, chin, nose or forehead, often with small bumps that resemble pimples. Sometimes the eyes or eyelids are involved.
The cause of rosacea is unknown, although some hypotheses point to small-intestine bacterial overgrowth and others to large numbers of skin mites (Demodex).
Treatment often involves antibiotics or topical prescriptions such as Finacea. You are not the first to describe benefit from using a selenium-sulfide shampoo to wash the face gently.
In their column, Joe and Teresa Graedon answer letters from readers. Write to them c/o King Features Syndicate, 300 W. 57th St., 15th floor, New York, NY 10019, or via their website: www.peoplespharmacy.org