Complementary and Alternative Medicine Products . Table 5 summarizes the herbal preparations that may be effective in adults. 10 , 14 , 18 , 20 , 35 – 38 An herbal solution containing P. sidoides was shown to reduce the duration and severity of 10 different cold symptoms in a randomized controlled trial. 37 Another randomized controlled trial demonstrated the benefit of Andrographis paniculata (Kalmcold) in improving symptom scores. 35 A systematic review also indicated that A. paniculata , alone or in combination with Acanthopanax senticosus , may be more effective for symptom relief than placebo. 36
The adverse effects of corticosteroids in pediatric patients are similar to those in adults (see ADVERSE REACTIONS ). Like adults, pediatric patients should be carefully observed with frequent measurements of blood pressure, weight, height, intraocular pressure, and clinical evaluation for the presence of infection, psychosocial disturbances, thromboembolism, peptic ulcers, cataracts, and osteoporosis. Pediatric patients who are treated with corticosteroids by any route, including systemically administered corticosteroids, may experience a decrease in their growth velocity. This negative impact of corticosteroids on growth has been observed at low systemic doses and in the absence of laboratory evidence of HPA axis suppression (., cosyntropen stimulation and basal cortisol plasma levels). Growth velocity may therefore be a more sensitive indicator of systemic corticosteroid exposure in pediatric patients treated with corticosteroids should be monitored, and the potential growth effects of prolonged treatment should be weighed against clinical benefits obtained and the availability of treatment alternatives. In order to minimize the potential growth effects of corticosteroids, pediatric patients should be titrated to the lowest effective dose.