Keeping Your Child Safe: Pediatric Polypharmacy
Parents and caregivers want to provide the best life for all their children. Healthcare issues can make care more complicated. Monitoring medications is a challenge as multiple drugs have interactions with the entire medication or just components. Adding in over the counter, other nonprescription medications, or even dietary preferences and restrictions further complicates the issue.
Often one of the issues is polypharmacy, which is taking multiple medications, often for the same condition. In pediatrics, this can range from taking two or more medications for one day or over 31 days. A review of pediatric polypharmacy is here.
Multiple medications include many forms. Medication lists should include all forms such as oral, rectal, tube inserted, inhaled, lotions, drops, injections, patches, implants, and others. Individuals often overlook over the counter, recreational, or supplements including dietary.
How polypharmacy occurs is usually due to in-the-moment health needs. An example is most frequently seen in bowel care. A child may use a suppository, later stool softener is added, and even later flax seed. The suppository may be prescription, the stool softener over the counter, and flax seed a dietary supplement. All may be needed for the child’s successful bowel program, but it is the use of several products which makes this program polypharmacy.
Other common examples of the occurrence of polypharmacy include the treatment of tone (spasticity), behavior concerns, and respiratory issues. However, any condition can be subject to polypharmacy.
There are also secondhand effects of medications. For example, direct sunlight can affect some antibiotics. Smoking, vaping, or other inhalant use by adults can affect the child.
Polypharmacy, when required, is not necessarily a bad thing. However, not reexamining the need for all products over time can be a concern. Perhaps the need may change and some of the products are no longer necessary as your child develops.
As children are growing and developing their bodies, their healthcare needs change. Providing treatments today may not be what the child needs next month or next year. The long-term effects of some medications into adulthood are not clearly understood. Testing of medications and interactions is not always available for the specialized care of a child. Therefore, keeping on top of drug interactions with other medications, supplements, and foods is imperative.
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You may not have access to information about drug interactions, but your healthcare providers and pharmacists do. Keeping a list of all medications both prescribed and otherwise as well as doses and how given is essential to your healthcare provider to assess for interactions and polypharmacy. Today’s healthcare systems and the electronic medical record have reduced the number of drug interactions. However, not everyone is in a healthcare system and sometimes you may have to go outside of your usual system for the special needs of your child.
Prescriptions outside of the child’s healthcare system or items that you have purchased yourself will not be on the medication list unless you disclose this. Therefore, it is essential that you disclose this information. You should not feel ashamed or embarrassed that you tried something to help your child.
To keep your child safe, there are some actions that you can take:
- Keep a complete record of all medications, supplements, and other medications your child takes.
- Report additions, stopping, or changes in medications, side effects, or intolerances.
- Be sure you review all medications at each healthcare interaction.
- Check with your healthcare professional or pharmacist for interactions before starting any new medication, supplement, or other medication.
- Read medication product package inserts for interactions with other medications, foods, or environmental issues.
- Be mindful of your own medication or self-medicating for effects on your child both from an environmental or role modeling point of view.