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Have you ever used the dive bomber, the air-o-plane, or the choo-choo train technique when attempting to give medicine to a child? Being creative can make all the difference in successfully getting a full dose of medicine in that little mouth!! Even more important for the parent is giving the medicine at the right time and watching out for any potential side effects or interactions from the drug. Dispensing the medicine properly to children is important whether we are giving OTC or prescription drugs. If given incorrectly, drugs may be ineffective or even harmful.

  
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"The most important thing for parents to know is what the drug is, how to use it, and what reactions to look for," says Paula Botstein, MD, pediatrician and acting director of the Food and Drug Administration's (FDA) Office of Drug Evaluation III. Questions for parents to ask the doctor or the pharmacist include the following:

 

* What is the drug and what is it for?

 

* Will there be a problem with other drugs my child is taking?

 

* How often and for how long does my child need to take it?

 

* What if my child misses a dose?

 

* What side effects does it have and how soon will it start working?

 

 

Reading the label thoroughly is extremely important, cautions Debra Bowen, MD, an internist and director of FDA's medical review staff in the Office of OTC Drugs. "There are many warnings on there, and they were written for a reason. Don't use the product until you understand what's on the label." Make sure that the label contains a pediatric dose and do not assume that it is safe for anyone under 12 years of age.

 

Caution should be noted when giving cold medications to children because they are more sensitive than adults. Two common ingredients in cold medications such as antihistamines and alcohol can have adverse effects on young patients, causing excitability or excessive drowsiness. There are some drugs, such as aspirin, which can cause serious illness or even death of children with chickenpox or flu symptoms.

 

Children under 2 years of age should not be given any OTC drug without a doctor's consent. Prescription drugs can work differently in children than in adults. Take barbiturates, for example-they usually make adults feel sluggish; when given to a child, they become hyperactive. Amphetamines, which stimulate adults, can calm children.

 

Before giving OTC, make sure that they are truly necessary. A study published in the Journal of the American Medical Association found that more than half of all the mothers surveyed had given their 3-year-olds an OTC medication in the previous month. Keep in mind that not every cold needs medicine. Common viruses run their course for 7-10 days with or without medication. Antibiotics, available by prescription, are ineffective against cold viruses.

 

Failing to measure the medicine correctly can cause a reaction or overdose. Giving children several different kinds of medicine with duplicate ingredients will also cause an overdose. Pediatric liquid medicines can be given using a variety of dosing instruments. Plastic medicine cups, hypodermic syringes without needles, oral syringes, oral droppers, and cylindrical dosing spoons can all be used to measure out the correct dose. Some products come with their own measuring devices. Use caution when reading these dosing instruments.

 

Tips for Using Common Dosing Instruments

 

Syringes: Use with infants who cannot drink from a cup and can be used to draw up, and store a dose for later use.

 

Droppers: Safe with infants and children too young to drink from a cup. Use caution and measure at eye level, and administer quickly because they have a tendency to drip.

 

Cylindrical dosing spoons: Convenient for children who can drink from a cup but may spill the contents.

 

The FDA is currently working to change labels of OTC medications to make them more eye-catching, easier to read, and consumer-friendly. The FDA is also taking additional measures to provide more information to healthcare providers about the use of products in children. If you want to see a listing of Pediatric Exclusivity Label changes since July 1998, check out the FDA's site at http://www.fda.gov/cder/pediatric/labelchange.htm#New%20listings.

 

A tabular listing of label changes to include the date granted, the product, the indications for use, and the label changes can be found here.

 

Information contained in this article originally appeared in the January to February 1996 FDA Consumer and was written by Rebecca D. Williams. Information was revised in May 1996 and reprinted by the Food and Drug Administration (http://www.fda.gov/fdac/features/196_kid.html).