Over-the-counter (OTC) cough and cold medications are marketed widely for r
elief of common cold symptoms, and yet studies have failed to demonstrate a
benefit of these medications for young children. In addition, OTC medicati
ons can be associated with significant morbidity and even mortality in both
acute overdoses and when administered in correct doses for chronic periods
of time. Physicians often do not inquire about OTC medication use, and par
ents (or other caregivers) often do not perceive OTCs as medications. We pr
esent 3 cases of adverse outcomes over a 13-month period-including 1 death-
as a result of OTC cough and cold medication use. We explore the toxicities
of OTC cough and cold medications, discuss mechanisms of dosing errors, an
d suggest why physicians should be more vigilant in specifically inquiring
about OTCs when evaluating an ill child.