News from the School Nurse
Meagan Imsand, BSN, RN
Welcome!
In The News
Children's Guaifenesin Recall
Children's Guaifenesin Grape Liquid and Guaifenesin DM Cherry Liquid by Perrigo Company: Recall - Potential Defect with Dosage Cup
Including store brands:
- Sunmark
- Rite-Aid
- Topcare
- Kroger
- GoodSense
- Dollar General
- Care One
- CVS
AUDIENCE: Consumer
ISSUE: Perrigo Company announced that, following the recent recall of certain dosing cups by its supplier, it has initiated a voluntary product recall in the US to the retail level of 2 batches of its children's guaifenesin grape liquid (100mg/5 mL) and 3 batches of its children's guaifenesin DM cherry liquid (100mg guaifenesin and 5mg dextromethorphan HBr/ 5 ml) sold in 4 oz. bottles with dosage cup in a box under multiple store brand product names. Some packages contain an oral dosing cup with incorrect dose markings. See the press release for affected label and lot numbers.
At risk populations such as those who are poor metabolizers of dextromethorphan may experience an overdose by a factor of 3, if incorrect measuring levels are used.
Consumers should be aware that an overdose of Guaifenesin DM may cause hyper excitability, rapid eye movements, changes in muscle reflexes, ataxia, dystonia, hallucinations, stupor, and coma. Other effects have included nausea, vomiting, tachycardia, irregular heartbeat, seizures, respiratory depression, and death. Small children who are poor metabolizers of dextromethorphan and use the product regularly over a period of several days at the mistaken dose, may develop cumulative toxicity. Moreover, adverse reactions to guaifenesin when given in high or excessive dosage may include nausea/vomiting, diarrhea, and/or abdominal pain. Therefore, an extreme overdose in an at risk population may need medical intervention, but in most cases adverse health consequences are temporary and reversible.
BACKGROUND: These recalled products are sold by distributors nationwide and distributed through retail stores.
RECOMMENDATION: Gastric decontamination is recommended after acute ingestion of greater than 10 mg/kg, if administered soon after ingestion.
Consumers that have product with the corresponding labels and batch numbers listed in the Press Release should discard the dosing device and product and may call Perrigo, toll free, Monday through Friday from 8:00 AM to 10:00 PM EST, at1-888-345-0479, or visit mucusreliefrecall.com. Consumers should contact their physician or healthcare provider if they have any questions, or if they or their children experience any problem that could possibly be related to this drug product.
Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:
- Complete and submit the report Online: www.fda.gov/MedWatch/report
- Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178
Read the MedWatch safety alert, including a link to the press release, at:
You are encouraged to report all serious adverse events and product quality problems to FDA MedWatch at www.fda.gov/medwatch/report.htm
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Is It a Cold or the Flu?
Head Lice - What You Need To Know
1. Avoid head-to-head (hair-to-hair) contact.
- Kids will be kids, but tell them to avoid head-to-head contact while playing with other children, whether at school, on a playground, or during sports activities. Since head lice also can't fly, hop, or jump, they'll pass on to your children only through direct contact.
2. Say "no" to sleepovers until 48 hours after treatment and no living lice visualized
- If there's a head lice outbreak in your child's school, put sleepover parties on hold for a while, since head lice can live in bedding, pillows, and carpets that have recently been used by someone with head lice.
3. Don't share what's on your hair.
- Tell kids not to share combs, brushes, hats, scarves, bandanas, hair bands, ribbons, barrettes, or towels — basically, anything that goes on kids' heads.
- Disinfest combs and brushes used by an infested person by soaking them in hot water (at least 130°F) for 5–10 minutes .
4. Think wisely when it comes to your house.
- Extreme environmental clean-up does not appear to lessen the spread of lice. However, washing pillow cases may be useful. Spending excessive time and money on housecleaning activities is not necessary to avoid re-infestation by lice or nits that may have fallen off the head or crawled onto furniture or clothing.
- Common sense should guide you if you wish to do anything more.
- You may avoid lying on beds, couches, pillows, carpets, or stuffed animals that have been in immediate contact with an untreated, infested person.
- You may choose to machine wash and dry clothing, bed linens, and other items that an untreated, infested person wore or used during the 2 days before treatment using the hot water (130°F) laundry cycle and the high heat drying cycle. Clothing and items that are not washable can be dry-cleaned OR sealed in a plastic bag and stored for 2 weeks.
- You may vacuum the floor and furniture, particularly where the untreated, infested person sat or lay.
5. Be sure other members of the household including dual households and yourself are examined and treated for head lice if needed.
6. Do not use pest sprays and fogs in the house.
- They are not necessary to control head lice and can be harmful if they are inhaled or get into the skin, especially on young children.
Source: American Academy of Pediatrics www.aap.org
Health Information to Know and Share
Parent Notifications
Parents will be notified for all head injuries, severe cuts/scrapes or contusions, fever above 100, and suspected communicable diseases. Parents are not routinely notified for minor injuries or visits to the nurse. You will be asked to pick up your child if he or she has a fever greater than 100, or is having vomiting or diarrhea. Students must be free from fever, vomiting, and diarrhea for 24 hours without the help of medication before returning to school.
Medications at School
If your child requires medication at school, the physician must complete a Provider/Parent Authorization form, as well as a School Management Plan for chronic health conditions. These forms must be signed by the parent as well as the physician in order for the nurse to administer medication. You can obtain both forms from the school nurse or see the links at the bottom of this page. Parents must bring the medication to the school along with the completed paperwork. Prescription medication needs to be in an original pharmacy labeled container and over-the-counter medications need to be in an unopened bottle. Please check the expiration date. Students may carry emergency medications (i.e. inhalers, EpiPens, etc.) if authorized by their physician. Paperwork must be completed each year.
Disease Prevention
Good hand washing is the best defense against the spread of illness. Make sure your child washes his/her hands frequently with soap and water and does not share food or drink with other students. If your child has a fever or is experiencing vomiting or diarrhea, please keep them home! Students should remain at home for a full 24 hours after symptoms subside, without the use of medication.