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Headache, upset stomach, stuffy nose, bacterial infection — there is a medication to help treat, or at least relieve the symptoms, of almost every ailment. Medications have become such a routine part of life, we sometimes forget how powerful they are and how necessary it is they be taken with care. In order for medication to be healing rather than harmful, it must be taken correctly and only when needed. The problem — research shows medication is not given to children correctly up to half of the time!
With hundreds of thousands of over-the-counter medications, prescription medications, and herbal and vitamin supplements on the market — there is a potential for unwanted side effects and drug interactions (when medicine is made less effective, ineffective or dangerous due to one medication interacting with another medication taken at the same time, or a medication interacts with food with the same negative effect). On the upside, serious side effects are rare when medications are taken correctly, and when used appropriately overwhelmingly medications help rather than hurt. Reviewing safety guidelines and relying on your pharmacist and family physician or pediatrician for answers can help you avoid any problems.
Double-Dosing
Too much of any medication can cause serious problems. Even products that have been used safely for generations, such as acetaminophen (Tylenol®, Tempra®, Liquiprin®, Panadol®) and ibuprofen (Motrin®, Advil®), become dangerous in overdose. I'm not speaking of intentional overdoses, but of well-meaning parents misreading labels, incorrectly measuring liquids, or unknowingly giving more than one product with the same ingredients. It goes without saying that the old adage "if one is good, two is better" does NOT apply to medication! When my son became old enough to help himself to ibuprofen for his football-induced aches and pains, I found him one day with a handful. His back was hurting and as this was just "grocery store" medicine, he figured more was better than less! We had a long discussion about the potential for that medicine to damage his kidneys if he took too much.
Rules to keep in mind:
· First, adult medications are not the same as pediatric preparations. Do not use adult-strength over-the-counter medications for your child. Many brands come in several age-specific formulations, such as infant and junior; always follow dosing based on your child's age and weight. I have added links to dosing charts below.
· If your child has a new prescription, ask the pharmacist if it is safe for acetaminophen or ibuprofen to be taken with it.
· Never double-dose or take medicines longer than recommended in hopes that it will make your child better faster. It will not help your child, and it may do harm.
A quick reminder while we are talking about fever-reducers: The pink baby aspirin that so many of us have memories of taking (or adult aspirin for that matter) should not be given to a child. Aspirin use in children who have certain viruses, such as flu and chicken pox, has been linked to Reye Syndrome (a serious condition that can cause brain damage and even death). Reye Syndrome usually affects children age 4 to 12, but aspirin (or products containing it) also should not be given to infants or teenagers when they have a viral illness. Be on the safe side and always use acetaminophen or ibuprofen when your child needs a fever-reducer.
Avoid a Spoonful
While it is tempting and fast to grab a spoon from the drawer and to measure out a dosage, it's best to use the dropper or dosing spoon that comes with the product. If the product doesn't come with one, medication dispensers are available at any pharmacy.
Before each dose, check the label - twice! A common problem in incorrect dosages is a mix up between TBSP and TSP. TBSP = a tablespoon, while TSP = teaspoon. The difference between the two may not look like a lot, but a tablespoon is three times the amount of medicine of a teaspoon. My husband still shudders at the memory of a weekend when I was out of town - three children had the flu, and he gave cough syrup and medications for it. It was a narcotic cough syrup (perhaps not a good idea in the first place!), and he gave them tablespoons not teaspoons. The good news was they slept all weekend and were very little bother! The bad news was the potential for unconsciousness or even death from such a blunder!
Parents may be tempted to mix medicine with food, but it's not a good idea for several reasons. First, certain foods can interact with certain medicines. Second, the medicine might end up at the bottom of the bowl rather than in your child's mouth. Third, some medicines should not be crushed. Medicines are absorbed differently when taken with food, so always check with the pharmacist on whether a medicine needs to be taken on an empty stomach. If the taste of a medicine is a problem, ask if a few drops of juice can be mixed with it or inquire about new flavoring systems that pharmacies now use to make icky-tasting prescription medicines more palatable.
Herbal Remedies — Is Natural Safe?
Some parents have told me they have chosen to give their child herbal products because they are "natural." But the word "natural" shouldn't be confused with benign. The fact that a preparation is derived from a plant is not a reason to believe that it is safe. Case in point: many plants are poisonous. It is also not a reason to underestimate its potential power; many prescription drugs are derived from plants. Since herbal manufacturers are not required by the FDA to prove the safety of their product, many side effects are unknown - especially in the case of children. A research study found that the majority of parents who had given their child some form of alternative medicine were unaware of the potential for adverse events, but the potential is real. In addition, herbal products are not held to the same standards about exact formulations so the strength of the medicinal ingredient may vary significantly from one batch to the next making dosing very difficult to assure.
If you are giving your child an herbal remedy, one of the best ways to protect against interactions is to let both your child's doctor and pharmacist know what preparation is being given before giving your child a prescription or over-the-counter medication.
Another important safety tip is to avoid doubling on products used for the same condition. For instance, if your child is on an antidepressant, he or she should not be taking St. John's wort, since this could lead to increased levels of certain chemicals in the brain.
One of the most dangerous combinations of a prescription and herbal treatment is the use of the asthma medication albuterol in addition to ephedra preparations. It can be deadly. The FDA's ban on ephedra has gained much media attention in the last few months, but it can still be found on the market — and people may still have products at home. On its own, Ephedra is linked to seizures, heart attacks and death, so make sure to rid your cabinet of any products containing it.
A Final Note ...
Rather than a magic pill that treats everything, medicines are a precious resource. When needed, they can be life-saving. At other times, the best medicine may be no medication. When in doubt, even about using an over-the-counter medicine, ask your child's doctor. And when giving a medication, do what the nurses in hospitals do — check the dose once and then check it again before you give it.