The baby has a headache and a fever. Some parents try to save the trouble and give the baby medicine based on experience.
Data shows [1] that 24.87% of parents often go to pharmacies to buy medicines for their babies.
At the same time, the incidence of medication errors in children in my country is three times higher than in adults; the incidence of adverse drug reactions is twice that in adults.
Tragedies may be hidden in luck.
(Source: [email protected])
Which medicines are commonly used at home that children must not use, or should be used with extreme caution?
Parents, remember these 6 medicines! If you have it at home, don’t use it again.
(The article is a bit long, but it is worth reading and collecting for every parent!)
1. Analgin
This once “magic anti-fever medicine” was recently cancelled by the State Drug Administration.
As early as March 10, 2020, the State Food and Drug Administration has cancelled the dosage forms of Analgin injection [2].
(Source: State Drug Administration official website)
Analgin may cause serious adverse reactions in the blood system, such as thrombocytopenic purpura, aplastic anemia, etc.; and may also cause severe allergic reactions, such as severe drug eruption, anaphylactic shock, etc.
Therefore, it is prohibited for children under the age of 18[3].
2. Aspirin
Use in children may affect liver and brain function, so use with caution under 16 years of age[4,5].
Aspirin is not completely useless, for example, it is very effective in the treatment of Kawasaki disease in children. The key is that parents don’t use it indiscriminately, and must use it under the guidance of a doctor.
3. Lysine, Benoate
They both release aspirin in the body, use with caution in children.
4. Nimesulide
It was once commonly used to reduce fever in children.
But it may cause gastrointestinal adverse reactions, liver and kidney damage, coagulation dysfunction, central nervous system damage, etc. In severe cases, it may lead to permanent organ damage and even death [6].
In 2011, the State Food and Drug Administration issued a document prohibiting the use of nimesulide in children under 12 years old[7].
(Source: State Drug Administration official website)
Tips
There are two types of fever-reducing medicines currently available for children: acetaminophen and ibuprofen[8].
(Source: Guidelines for Primary Care of Acute Upper Respiratory Infections (2018))
1. Codeine
Has analgesic and cough-relieving effects, long-term abuse can cause dependence and addiction, and even life-threatening.
The State Drug Administration stipulates that children under the age of 18 are banned[9].
2. Dextromethorphan
It is also an antitussive drug. The adverse reactions are headache, drowsiness, irritability, nausea, skin irritation, etc. Overdose can cause confusion, bronchospasm, and respiratory depression[10].
Not recommended by the American Academy of Pediatrics for children under 6 years of age[11].
3. Volcodine
By inhibiting the central nervous system, the purpose of antitussive is achieved.
The British Pharmaceutical Council does not recommend the use of phloxidine-containing antitussives in children under the age of 6 [12].
Image source: Zhanku Hailuo
Tips
Cough is a symptom, not a disease.
Coughing can remove foreign bodies and secretions from the respiratory tract and play a protective role in the human body. If you blindly use antitussives to your baby, it will cover up the condition.
It is recommended that parents first understand the reason behind their child’s cough, whether it is a cough caused by a cold, infection or allergy, and then it is more reliable to take medication for the cause. The best way is to see a doctor.
1. Guaifenesin
May have adverse reactions such as nausea, dizziness, drowsiness, allergies, not recommended for children under 6 years old[13].
2. Ambroterol Oral Liquid
Combination of ambroxol hydrochloride and clenbuterol hydrochloride.
Among them, clenbuterol is a bronchodilator and the main component of clenbuterol, which can relieve asthma symptoms. Excessive use can easily lead to adverse reactions such as palpitations, tremors, excitement, insomnia, etc. [ 13].
If the child does not have symptoms such as wheezing, but just has a lot of phlegm, a single-ingredient preparation is recommended for safety.
Image source: Zhanku Hailuo
Tips
All expectorants don’t make phlegm disappear out of thin air, but reduce the viscosity of phlegm, making it easier to expectorate or swallow into the digestive tract.
Sometimes, expectorants can increase the secretion of sputum, which may block the trachea and need to be used under the guidance of a doctor.
1. Pediatric Pseudomephene Drops
The main ingredients are pseudoephedrine hydrochloride and dexamethasone hydrobromidemethorphan.
Among them, the adverse reactions of pseudoephedrine include tachycardia, anxiety, headache, insomnia, rash, etc. [14].
In 2005, the US Food and Drug Administration (FDA) stipulated that cold medicines containing pseudoephedrine should be used with caution in children under 2 years of age [15].
The State Drug Administration (2018 No. 28) has cancelled this drug[16].
2. Methionine solution
Similar to Pediatric Pseudoephedrine Drops, it is composed of pseudoephedrine hydrochloride, dextromethorphan hydrobromide and chlorpheniramine maleate.
Always consult a doctor before use in children.
3. Pediatric Paracetamol Huang Namin Granules
It is a compound preparation of acetaminophen, chlorpheniramine maleate and artificial bezoar.
acetaminophen is used to reduce fever and pain;
Chlorpheniramine maleate is used to relieve symptoms such as sneezing and runny nose;
Artificial bezoar has the functions of clearing heat and detoxifying.
If the child does not have the above three symptoms at the same time, it is unnecessary to use the corresponding drug ingredients, which also increases the risk of drug safety.
Image source: Zhanku Hailuo
Tips
Cold medicines with the words “ammonia”, “phenol”, “min”, “ma”, “mei” are usually compound cold medicines and should be used sparingly or not , not to use several drugs at the same time.
If you’re not sure, it’s always a good idea to ask your doctor or pharmacist. (Not a clerk in a pharmacy)
1. Aminoglycosides
Including streptomycin, kanamycin, gentamicin, etc.
These antibiotics have the potential to cause deafness, therefore, children under 6 years old are contraindicated[17], and they should be used with caution over 6 years old.
2. Quinolones
Including norfloxacin, ofloxacin, ciprofloxacin, levofloxacin, moxifloxacin, etc.
The use of these drugs in children may cause symptoms such as rashes, nausea, headaches, and may also cause cartilage development disorders, affecting growth and development. Generally not for children and adolescents under the age of 18 /strong>[18].
Image source: Zhanku Hailuo
Tips
Antibiotics (many people call them “anti-inflammatory drugs”) can’t be taken lightly!
Antibiotics may be needed only when infections such as bacteria, mycoplasma, etc. are identified, or mixed infections, and antibiotics must be used under the guidance of a doctor!
The principle of using antibiotics is that you don’t need them if you can, and when you need them, you need to use them in a sufficient amount and for a full course of treatment.
Otherwise, pathogens are prone to resurgence, superinfection, antibiotic resistance, etc., making subsequent treatment more difficult.
1. Ribavirin
Also called ribavirin. Adverse reactions include anemia, headache, nausea and vomiting, insomnia, and red blood cells, white blood cells, and hemoglobinWhite drops etc.
This medicine currently does not recommend a safe oral dose for children under 6 years old, and it must be used with caution under the guidance of a doctor[19].
2. Acyclovir
Common medications used to treat herpes simplex virus infection.
In 2009, the State Drug Administration notified that acyclovir should be used with caution in children [20].
Image source: Zhanku Hailuo
Tips
Many viral infections are self-limiting. In other words, in the vast majority of cases, you can recover by relying on your own immunity.
If the condition is severe, see a doctor and do not self-medicate.
As a final reminder, we can see the words “Adverse Reactions: Not Known” in many drug inserts.
“Unknown” means that the adverse effect is indeterminate, not that there is no adverse effect.
Children’s medication is no trivial matter. If parents are not sure, don’t be too troublesome. You can go to the pediatric department of a community hospital, pediatric hospital or general hospital to consult a doctor .
Contributing Author
Li Shihua| Attending Physician, Pediatrics, Beijing Muslim Hospital
Reviewer
Bao Huiling| Deputy Chief Physician of Pediatrics, Peking University Third Hospital
Hu Qin | Pharmacist in charge of the Department of Pharmacy, Xiangya Hospital, Central South University
References
[1] Zhao Minmin, Tong Xiuqin. Research progress on factors related to ovarian corpus luteum rupture. World Latest Medicine Information (Electronic Version) 2019 Vo1.19 No.06.10.19613/j.cnki.1671 -3141.2019.06.051
[2]Ho Wen-Kuang,Wang Ya-Fen,Wu Hsin-Hung,et al. Ruptured corpus luteum with hemoperitoneum: case characteristics and demographic changes over time[J]. Taiwanese Journal of Obstetrics and Gynecology, 2009, 48(2).
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