Download When You Have a Sick Child

When You Have
a Sick Child
NON-COMPLIANCE
LEADS TO
• Persistent symptoms
• Need for additional doctor visits
or even hospitalizations
• Worsening of condition
• Need for additional medications
• Increased healthcare costs
It's not uncommon for a visit to your
• Development of drug-resistant
doctor's office to end with a written
organisms in cases of infectious
prescription for medications. Those lit-
diseases
tle pieces of paper are extremely
important for you, your child and your
HOW IMPORTANT IS
pharmacist. They provide the exact
medication directions for the pharma-
IT FOR YOUR CHILD
TO TAKE ALL THE
MEDICINE?
cist to dispense, and for you to administer, in order to properly treat your
child's signs and symptoms. The
speedy control of disease requires that
Skipping doses or forgetting to take
your child take all the doses at the
medications or ending a drug regi-
proper intervals of time. This requires
men early are serious matters. In
the child's compliance which you
fact, not finishing a complete treat-
know is NOT an easy thing. Yet for
ment program or not following
your child, being almost 100% compli-
directions from your pediatrician
ant is almost as critical as the medi-
and/or pharmacist can be harmful
cine itself.
to your child's health.
3
COMPLIANCE
Compliance means taking the
right amount of a drug at the
right time for the total length of
days of treatment.
In order for a drug to be effective it
dren is as low as 53%, meaning that
must circulate in the blood system
children frequently fail to take med-
to the ailing tissues. Some drugs
ications properly. Therefore drugs
require only one dose per day and
are not made available in the body
persist in the body for 24 hours.
to combat the disease.
Others, however, are destroyed or
When getting a prescription it is
excreted by the body, and require
important to know if it is going to
more frequent dosing. For children
taste bad. Ask your doctor if other
taking liquid medications, compli-
children experience problems tak-
ance can be particularly difficult to
ing the medicine. He or she might
achieve when medications are bit-
recommend taking the prescribed
ter, sour or foul-smelling. In fact,
medication with food or drink, but
The American Academy of Pediatrics
this too can have its consequences.
estimates that compliance in chil4
MIXING FOOD
WITH MEDICINE
FACTS & STATS
One common trick to hiding the
• Non-compliance causes
taste of medicine is mixing the
125,000 deaths annually in
medication with food or a drink.
the US and is the cause of up
But did you know that many
to 1/4 of hospital admissions.
medications interact negatively
• About 50% of the 2 billion
with food and/or drink?
prescriptions filled each year
are not taken correctly.
Most recently, this concern was
• On average, 1/3 of patients
documented by Pharmacy Times in
an issue related to food & drug
take all their medicine, 1/3
interaction. There are many ways
take some and 1/3 never even
that food and drink can affect a
get their prescription filled.
• If a child experiences negative
drug's activity on the body. Such
nutritional mixtures can interfere
effects from a drug (nausea,
with medication absorption in the
vomiting, diarrhea, poor
gastrointestinal tract and result in
taste), they are less likely to
lower drug concentrations in the
take the drug and their par-
blood system.
ents/caregivers are less likely
to administer it.
5
On the other hand, some of these
Interactions Table for some impor-
interactions can increase drug
tant guidelines to keep in mind.
absorption and interfere with the
Remember, having too much or not
body's breakdown of the medication
enough of a drug’s effects is NEVER
causing inappropriately high blood
a good thing.
concentrations of medication. These
Unless specifically directed by the doc-
last two can increase blood concen-
tor, medicines should be taken with
trations of the drug in the body
water and not with other possibly
sometimes as much as 2-3 times!
interfering liquids.
See our Negative Food & Drug
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MEDICATION
NOT ENOUGH DRUG ACTIVITY
Ï
NEGATIVE FOOD &
DRUG INTERACTIONS
TOO MUCH DRUG ACTIVITY
Ï
FOODS TO AVOID
Acidic liquids and dairy prodDRUGS:
ucts. E.g. grapefruit juice,
penicillin, amoxicilllin/potassium clavu-
orange juice, tomato juice,
lanate, methenamine, tetracycline, lev-
lemonade, milk, cheese,
ofloxacin (Augmentin, Hiprex, Sumycin,
yogurt, ice cream.
ANTIBIOTICS & ACID-LABILE
Mandelamine)
Ï
RESULT:
Foods high in vitamin K. E.g.
broccoli, spinach, kale, turnip
ANTICOAGULANTS:
greens, cauliflower and
warfarin (Coumadin, Sofarin)
brussel sprouts.
BRONCHODILATORS:
theophylline, albuterol and epinephrine
(Accubron, Duraphyl, Theovent, Proventil,
Ï
RESULT:
Food and beverages that
contain caffeine. E.g. chocolate, colas, coffee and tea.
Ventolin, EpiPen, Susphrine)
RESULT: Ï
DIURETICS:
bananas, oranges, green leafy
furosemide, triamterene, hydrochloroth-
vegetables.
Potassium-rich foods. E.g.
iazide (Lasix, Dyrenium, Dyazide, Maxzide)
RESULT: Ï
ANTIFUNGALS:
Dairy products. E.g. milk,
fluconazole, griseofulvin, ketoconazole, itra-
cheese, yogurt, ice cream.
conazole (Diflucan, Fulvicin, Gris-PEG,
RESULT:
Ï
Grisactin, Nizoral, Sporanox)
Iron rich foods and dairy prod-
QUINOLONES:
ucts. E.g. milk, cheese, yogurt,
ciprofloxacin, levofloxacin, ofloxacin,
ice cream, certain vitamins &
trovafloxacin (Cipro, Levaquin, Floxin,
minerals.
Trovan)
Ï
RESULT:
THE PSYCHOLOGY
AND PHYSIOLOGY
OF MEDICINE TIME
Until a child is around 8 years old,
swallowing pills can be challenging.
This is often due to the smaller
structure of a child's esophagus.
Therefore, children under the age of
8 are typically prescribed liquid
medications. While liquids are easier to administer, getting the child to
swallow it is a whole different story.
Struggling with or forcing a child to
The leading reasons for this are:
take a medication adds additional
Children have a much greater num-
strain to the already unpleasant
ber of taste buds than adults. These
state of feeling sick. It can also pre-
taste buds regenerate every two
dispose children to believe that all
weeks. As with many of the senses,
medications, regardless of taste or
taste becomes altered as a function
smell, are unpleasant, giving them
of aging process, which explains
a negative impression of their
why most children find certain fla-
treatment. Like most of us, children
vors to be too 'strong' when adults
will resist unpleasant experiences.
do not. Children, and infants in particular, are most sensitive to bitter
Not surprisingly, children embrace
and sweet tastes, making them less
pleasant experiences including
likely to swallow bitter-tasting med-
pleasant tastes. Studies have shown
ications and also more prone to lik-
that allowing a child to play an
ing sweeter, fruity flavors.
active role in choosing the flavor of
their medication makes him/her
The active ingredients in medica-
more compliant to drug regimens.
tions often taste bitter and/or have
Showing a child that they have the
a pungent smell. Masking the taste
capability to modify the flavor of a
of medication can often be difficult
medication to a flavor of their lik-
simply because the innate flavor is
ing grants them some authority in
so overpowering.
their treatment.
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YUCKY 21
Certain medications just taste
worse than others. Many of them
have extremely strong, pungent
smells, bitter tastes and sour aftertastes. These can be particularly
difficult to administer to children,
so be sure to consult your physician or pharmacist on the best
ways to administer these medications.Here are some of the most
difficult medications:
1
Airet, Proventil, Ventolin, Volmax (Liquid Albuterol)
2
Augmentin Suspension (Amoxicillin Clavulanate)
3
Bactrim Suspension (Trimethoprim/Sulfamethoxazole)
4
Biaxin Suspension (Clarithomycin)
5
Ceftin (Kefurox, Zinacef) Suspension (Cefuroxime)
6
C-Lexin, Cefanex, Keflex, Keftab Suspension (Cephalexin)
7
Claritin Syrup (Loratadine)
8
Cleocin Suspension (Clindamycin)
9
Eryzole, Ilosone Sulfa, Sulfimycin Liquid (Erythromycin)
10
Furadantin Suspension (Nitrofurantoin)
11
Fulvicin, Grifulvin, Gris-PEG, Grisactin Suspension (Griseofulvin)
12
Any Iron Liquid
13
Pediazole Suspension (Erythromycin)
14
Barbita, Luminal, Solfoton Elixir (Phenobarbital)
15
Prelone Syrup (Prednisolone)
16
Robitussin (or any product containing guaifenesin)
17
Tylenol with Codeine Elixir (Acetaminophen with Codeine Phosphate)
18
Any Liquid Vitamin
19
Vantin Suspension (Cefpodoxime Proxetil)
20
Zantac (Ranitidine)
21
Zithromax Suspension (Azithromycin)
BUT IT SAYS,
“TASTES GREAT”
Sometimes the pharmacist will tell
you that the medication is already
flavored. Believe it or not, he or she
is correct. All medications DO
come flavored, however many manufacturers fail to completely mask
bitter tastes. You should ask your
pediatrician if taste could pose a
problem for your child, or ask your
pharmacist if your child can taste
BAD-TASTING
MEDICINE? THERE
IS A SOLUTION!
the medicine. If your child does not
like the existing taste, have it flavored at your pharmacy. Keep in
mind that you and your pharmacist
Unpleasant tasting medications
don't have as keen a sense of taste
can result in particularly poor com-
as your little one.
pliance in children. The addition of
a safe pharmaceutical flavoring to
food or drink, FLAVORx flavoring
medicine can greatly improve your
available at the pharmacy will not
child's sensations of taste and
adversely affect a medicine's prop-
smell, leading to acceptance and
erties at all. Studies show:
therefore compliance. In fact, studFor children, taste may be the only
ies show that proper flavoring can
motivation to take a medication
increase compliance in children
and complete a full treatment pro-
from 53% to over 90%. Simply ask
gram. Improved taste of a medica-
your pharmacist to "FLAVORx" your
tion can improve therapy adher-
child's medication. The process is
ence, leading to improved clinical
scientifically-proven, safe and
and economic outcomes (medica-
effective. Unlike the addition of
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IS
IT TIME TO CALL
THE DOCTOR?
tions taken because of flavoring are
far less expensive than continued
disease processes or hospitalization).
As a parent, you know that anytime
Oftentimes a parent's frustration
your child has even the slightest
with giving a bad tasting medica-
signs or symptoms suggestive of
tion will cause them to stop treat-
disease you're alarmed. So when are
ment as soon as the symptoms go
you being too cautious, and when is
away, thus not giving the full
it time to call the doctor?
course. This can result in resistant
micro-organisms in infectious dis-
9 SYMPTOMS YOU
SHOULDN’T IGNORE
eases and may cause the child to
become sick again.
The addition of flavoring has been
1. Vomiting
shown to save money by reducing
2. Dehydration
the number of wasted/spit out
3. Fever (higher than 100.4 F)
doses and increasing compliance.
4. Abdominal Pain
On average, the patient 'quality of
5. Difficulty Breathing
life' score improves from 3.5 to 8
6. Bloody Stool
after the addition of flavoring.
7. Abnormally Tired or Confused
8. Limping
9. Stiff neck
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COMMON CHILDHOOD ILLNESSES
Most parents can't help but feel anxious when their child is sick. It may
be comforting to realize that many common ailments, while persistent,
are easily treated with a combination of medicine and rest.
ILLNESS
STOMACH VIRUS &
ABDOMINAL INFECTIONS
EAR INFECTION
SYMPTOMS
Upset stomach, stomach
cramps and pains, vomiting,
diarrhea.
TREATMENT
Plenty of fluids to prevent
dehydration. Antibiotics
and/or antispasmodics may
be prescribed.
Mild to severe- earache,
Visit the doctor to assess
hearing difficulties, fever,
symptoms. Antibiotics may
nausea, vomiting, dizziness.
be prescribed.
Plenty of fluids, vaporizer to
BRONCHITIS
Deep cough (may cough up
add fluid to the air, rest and
mucus), wheezing, headache,
possible use of over-the-
chills, fever, tightness of the
counter medications.
chest, difficulty breathing.
Antibiotics may be prescribed.
If fever reaches over 100 F
Fever, headache, aches and
COLDS & FLU
pains, runny nose, sneezing,
cough, exhaustion, chest discomfort.
(as with the flu), contact your
pediatrician. Use of over-thecounter medications (cough
suppressants, fever-reducing
medications and decongestants) to treat symptoms.
Visit the doctor to assess
Yellow or green nasal dis-
STREP THROAT
symptoms. More than likely a
charge, fever, difficulty swal- throat culture will be taken
lowing, swollen glands.
and an antibiotic will be prescribed.
It is important to remember to take all the medicine as prescribed. You can
improve treatment adherence by having medicine flavored at your local
pharmacy. This will result in improved outcomes, less treatment failure and
recurring symptoms, and inevitably leads to better economic outcomes by
decreasing office visits, avoiding time missed from work, and decreasing
overall healthcare costs.
HOW DO I KNOW IF I HAVE A COLD OR THE FLU?
FEVER OR CHILLS
HEADACHE
ACHES AND PAINS
TIRED OR WEAK
RUNNY, STUFFY NOSE
SNEEZING
SORE THROAT
COUGH
EXTREME EXHAUSTION
CHEST DISCOMFORT
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FLU
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Usual and Severe
Frequent, may become severe
Moderate
Mild
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COLD
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