Ask a CHOC Doc: Is it OK to Cut Pills, or Crush Them into Foods?

Question:

Is it OK to cut pills in half, or crush them to mix into my child’s foods? -Anonymous

Answer:

Yes and no. Some medications can be cut or crushed, but some should be given whole. This is due to specific formulations of medications and how they work in the body. Most of the no-crush medications are sustained release, extended release, or enteric coated. The reason these medications can’t be crushed or chewed is because the tablet is formulated to release a specific amount of medication over a certain time period. Cutting or crushing the tablet usually results in the medication not being released into the body properly. Some medications shouldn’t be crushed or chewed because they have an unpleasant taste.

If you feel like your child won’t be able to swallow their medication whole, ask the pharmacist if it can be chewed or cut, or talk to your child’s doctor about prescribing a liquid formulation.

-Whitney Pittman, clinical pharmacy resident at CHOC Children’s

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Whitney Pittman, clinical pharmacy resident at CHOC Children’s
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Ask a CHOC Doc: What Medications Should I Have on Hand for my Child with Asthma?

Question: 

What medications should I always keep on hand for my child with asthma? -Anonymous

Answer:

All inhaled medication in children using a meter dose inhaler will require a valved holding chamber, as well a mask for children less than 6 years. This is not required for dry powder inhalers. The child should have access to a reliever medication such as albuterol both at home and school. For preventative measures, those who suffer from asthma must have a controller medication such as an inhaled corticosteroid or an oral medication such as montelukast. These need to be taken on a daily basis for several months as directed by your provider to be effective. At every visit, your provider should give you an asthma action plan so that you know when to take controllers and relievers, depending on how well your child is doing, as well as advice on when to seek medical help. A peak flow meter, an easy-to-use breathing test for home use, can also tell you how well your child is doing, and is part of the asthma action plan.

-Dr. Stanley Galant, pediatric allergist at CHOC Children’s and medical director of CHOC’s Breathmobile

dr-stanley-galant-asthma
Dr. Stanley Galant, a pediatric allergist at CHOC Children’s, specializing in asthma.
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Ask a CHOC Doc: How Can I Avoid Seasonal Asthma Triggers?

Question:

What are seasonal asthma triggers that I should be aware of? How can I avoid them, or treat symptoms of them? -Anonymous

Answer:

While seasonal allergies occur typically in the spring and fall, and are difficult to avoid, it is important to avoid playing outside when pollen counts are high, such as after the grass is freshly cut. Again, the flu vaccine can reduce flu-related asthma symptoms in the fall and winter months. Keep in mind also that the avoidance of indoor allergens, such as house dust mites, by using pillow and mattress impermeable covers, can reduce the effect of outdoor allergens, and non-allergic triggers.

-Dr. Stanley Galant, pediatric allergist at CHOC Children’s and medical director of CHOC’s Breathmobile

dr-stanley-galant-asthma
Dr. Stanley Galant, a pediatric allergist at CHOC Children’s, specializing in asthma.
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Ask a CHOC Doc: How Can I Help Manage My Child’s Asthma Year-Round?

Question: 

How can I help manage my child’s asthma year-round? -Anonymous

Answer: 

In the CHOC Children’s Breathmobile program, we strongly emphasize the importance of taking measures to avoid potential indoor allergens such as house dust mites, cat and dog dander, cockroaches and mold. We also recommend avoiding non-allergic triggers such as environmental tobacco smoke, and high levels of air pollution. Respiratory viral infections such as influenza can also be a trigger, so getting the flu vaccine in the early fall is a must for all people who suffer from asthma.

dr-stanley-galant-asthma
Dr. Stanley Galant, a pediatric allergist at CHOC Children’s, specializing in asthma.

The appropriate use of medication also plays a major role in managing asthma. This includes the use of a medication such as albuterol for asthma symptom relief and for preventing exercise induced asthma if given 15 minutes beforehand. In patients with more ongoing chronic asthma symptoms or severe asthma exacerbations, referred to as persistent asthma, a preventive approach, which will require daily controller medication for months as determined by your provider, is necessary.

Dr. Stanley Galant, pediatric allergist at CHOC Children’s and medical director of CHOC’s Breathmobile

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Ask a CHOC Doc: How can my athlete daughter learn vital nutrition?

Question: 

Mine is an interest. I’m looking to learn more about how my teenager, dealing with orthorexia eating disorder, can continue to play high school sports and learn vital nutrition techniques, like how to refuel the calories that have been burned. -Anonymous

Answer: 

Health care providers always support teens and families focusing on healthy nutrition choices such as a balance of fruits and vegetables, whole grains and lean proteins. Sometimes, however, a nutrition plan overly focused on the ideals of healthy eating can actually result in significant nutritional lapses with both short term and long-term consequences to your health – this is what is commonly referred to as orthorexia. Persistent fatigue, prolonged muscle aches, dizziness, mood changes, and loss of periods are all signs that your teen should be evaluated by their pediatrician as soon as possible, and with the right interventions hopefully we can prevent nutritional imbalances and medical complications.

In order for your teen to perform in their sport at their most optimal level, they need the right balance of carbohydrates, protein, and fat in addition to supportive vitamins and minerals, and adequate fluids.

  • Carbohydrates are the body’s primary fuel source and should be a significant part of all meals and snacks. All athletes need energy!
  • Protein is important for muscle growth, and repair of muscle breakdown after exercise. Athletes should consume a protein and carb snack within 30 minutes after exercise to help refuel their body’s and aid in recovery. Pairing protein and carbohydrates actually lets the body use the protein better. It is important to note that the body can only utilize 30grams of protein at any one time.
  • Fats are the body’s “reserve tank” for fuel, and are especially important in any type of endurance sport.
  • Vitamins and minerals help unlock the energy stored in food, and Calcium and vitamin D are essential for bone health.

Checking with your doctor is always important to make sure there are no early signs of an eating disorder or complications from imbalanced nutrition. Seeing a sports nutritionist can help identify the exact nutritional components your teen needs, and the best choices to meet those needs. Great websites for additional information and resources include eatright.org and scandpg.org (sports, cardiovascular, and wellness nutrition section of the Academy of Nutrition and Dietetics).

-Dr. Alexandra Roche, pediatrician specializing in adolescent medicine and Amanda Czerwin, nutritionist at CHOC Children’s

Learn more about adolescent medicine at CHOC.