Drug utilization in children is of great concern worldwide. Many drugs for this group of population are used in outpatient settings.
Parents generally give drugs to treat their child’s sickness. The trend of using drugs on their own that is self-medication has been increasing in developing countries as well as in developed countries in recent years.
This has increased concerns about the dangers of self-medication. Primary responsibility for the use of self-medication products comes not only to the individual but also on all people involved in self-medication.
Therefore, all people must be aware of the benefits and risks associated with the self-use of medicines.
- What is the self-medication?
- Some Statistics on Self- Medication
- Types of Self medication
- What every parent should know about self-medication?
- When should you self-medicate?
- Dangers of self-medication?
- Causes for Over Dosage
- Notes and Tips to Parents
What is self-medication?
According to World Health Organization self-medication is the use and selection of medicines by individuals to treat self-recognized illnesses or symptoms.
The International Pharmaceutical Federation (IPF) has defined self-medication as non-prescription drugs use by individuals on their own initiative or on the guidance or insistence of non-medical person.
Self-medication is a widespread practice among individuals and an important part of the healthcare system. But, the practice of self-medication has detrimental effects due to its inappropriate use.
Therefore, everyone must be aware of the benefits and risks associated with the self-use of medicines.
Some Statistics on Self- Medication
(According to research on Prevalence of self-medication practices among the residents of urban slums located near govt. medical college, Jabalpur, published in International Journal of Community Medicine and Public Health, Jan 2018, and few more studies)
- Self-medication in developing countries varies from 12% to as high as 73% in different communities
- Among the total 412 participants, 176 (42.7%) practiced self-medication.
- More than 30% of the child outpatients are due to effects of self-medication.
- Self-medication is more common in older children. Esp. children in their tweens and teens.
- More than 50% of the children were found not having adequate knowledge on self-medication and its effects.
- Males were more likely to use self-medication than Females.
- Highest prevalence was found among 18-40 years of age group,
- Almost 70% of the sample population how self-medicate are literates.
- Major reason for self-medication is that the underlying disease is simple.
- More than 70% of the population has self-medicated occasionally.
- The most common go to person who suggest drugs for self-medication were Pharmacists.
- Almost over 81% of self-medication drugs are got through OTC.
- Most widely used drugs were Analgesics
- The main symptoms for self-medication were headache, body ache and other pains (25.2%).
- Easy availability of over the counter (OTC) drugs is a major factor responsible for irrational drug use.
- South America followed by the United states are led the self-medication journey.
Types of Self medication
Self-medication is not just over the counter drugs that we take and pop in to deal with the headquarter body ache or other pains
There are different types of self-medication some of them or outline below.
Substance abuse. (common ones being alcohol and Drugs)
Substance abuse is a common form of self-medication. Of which alcohol and drugs are the common once. The common recent for this type of self-medication is to cope with stress, and depression.
Food: There are different forms of self-medication that are taken by way of food. Example drinking a cup of coffee for a headache to stop. Binge eating on comfort food to relieve stress. Taking sugar or sugary items for mood enhancement. Or even the good old natural medication that is taken in the form of food is considered a self-medication.
Psychostimulants: Stimulant such as cocaine and amphetamines are often used by people to cope up with depression and other mental health related conditions. There also used too short circuit their systems to create an illusion of wellbeing.
Cannabis: Use of Cannabis is legal in some places. It is also medically used to treat people with depression. However, most of the times than not usage of cannabis in the form of self-medication only lets prediction and further complications. Same goes for Opioids with heroin being one of the opioids.
What is listed above are the forms of self-medication. Our blog focuses on self-medication for children. So, most of what is listed above apart from ‘food’ may not be relevant to our case here.
What every parent should know about self-medication?
Unlike adults, children are in constant growth, this means the pharmacokinetics (what the body does to the drug) and the pharmacodynamics (what the drug does to the body) may vary from child to child.
Therefore, the deposition or the way the drug reacts can be different from child to child. This can be dangerous in the case of self-medication because some drugs have a narrow therapeutic index (the difference between the maximum amount of drug that can be ingested without it being toxic and the minimum amount of drug that is needed to cause an effect in the body).
This also can differ when from children to children. A small change in dose at such conditions will bring severe consequences.
Factors that influence drug intake quantity.
There are many factors that influences the quantity of drug a child can be given in a span of time. Some of them are.
- organ development
- surface area
- enzyme development
- binding of the drug to plasma and tissue
- functional and physiological development
When should you self medicate?
When children become sick the first response by most of the parents is to self-medicate them. Majority of the parents in both developed and developing countries prefer to treat their child’s common ailments like fever, cough/cold, and diarrhea without consulting a physician.
Analgesics, antipyretics, anti-inflammatory agents, cough, and cold preparations are amongst the commonly practiced self-medication besides vitamin and mineral supplements are also used.
In short, the answer to the question when should you self-medicate? The answer is preferably never. However, Generally, OTC medicine or Over the Counter (OTC) drugs are the safest to be used on your child. These drugs mostly have a wide therapeutic index and lesser adverse effects compared to the drugs that require a prescription from a doctor.
And remember when you self-treat with OTC drugs Diagnose your health problem carefully, Read the label carefully and follow dosage instructions and Follow any label warnings.
What are the risks of self-medication?
Self-medication associated risks include
- inappropriate diagnosis
- drug interactions
- drug resistance
- adverse drug reactions
- inappropriate drug choice.
- inadequate dosage
- excessive prolonged drug use
- Accidental overdose: Overdose can happen due to many reasons one such is double medication. This happens when individual took the same composition of drug with another brand name which may lead to serious consequences.
Few side effects of commonly used OTC medicines
Though OTC medicines are safe and can relieve your child’s symptoms, some products can cause serious effects.
- Overdose on paracetamol can cause liver damage and liver failure.
The liver of children has not attained their functional maturity. Most drugs are being eliminated with the help of the liver if the dosage is too much for the liver, the liver goes into overdrive and damage itself. Symptoms of paracetamol overdose include, nausea, being sick, and pain near the liver area.
- Cough and Cold medicine can cause seizures and side effects
The most common OTC drug used for cough and cold is diphenhydramine. This is also used to cause sedation and sleep. This is an antihistamine, particularly a first-generation antihistamine. The first-generation antihistamines can penetrate the Central Nervous System; thus, it can cause many nervous system-related side effects.
Listed below are some of them
- Blurred vision
- Pain killers such as Non-Steroidal Anti-Inflammatory Drugs can cause stomach bleeding.
Non-Steroidal Anti-Inflammatory Drugs or NSAIDS are commonly used as pain killers. They bring about their effects by blocking the production of Prostaglandins, a chemical responsible for many functions in the body. Protecting the stomach layer is also a function of Prostaglandins, so by blocking them the stomach layer will be damaged by its acid secretion.
Causes for Over Dosage
Drug overdose in children is a serious public health problem that can lead to fatal consequences.
In the USA alone 70000 children under 18 are treated for accidental or intentional drug overdose annually. Out of the 81% are under the age of 6.
Taking all ages into consideration, analgesics (Paracetamol) are the most common poisoning.
Some of the main caused of overdose are …
- Incorrect measurement of dosage
- Assumption of dosages without professional help.
- Giving multiple medicines at a time (Polypharmacy)
- Mixing up drugs that look the same.
- Young children may swallow drugs assuming they are sweets.
In any case if your child shows the following symptoms or reactions, seek medical help as soon as possible.
- Losing conscience
- Breathing trouble
- Dizziness or severe headache
Tip to Parent: Should an unfortunate incident happens, and you need to rush you child to the hospital. It is advice to take along with you the medication you had administered to your child along with the measuring cup.
This will give the doctor a quick info on what has been indigested, and he/she can quickly resort to the right treatment there by saving valuable time.
Notes and Tips to Parents
- Know the exact height and weight of your child.
- Read all the instructions and labels that come with the drug, if it is unclear ask the pharmacist for clear instructions
- Use a cup or dropper that comes with the drug to give the medicine, if you do not have one you can ask the pharmacist.
- Did you know that in 86% of cases, children taken to the E.R. for medicine poisoning got into medicine that belonged to an adult. Often, kids found the medicines in purses, bags, and briefcases, or in easy-to-reach places like nightstands. Have a medicine cabinet so that it is easy to access by adult and the same kept out of reach of children.
- Do have a note pad with a working pen always in your cabinets so that any use of medicine can be recorded with time. This will prevent accidental overdose. E.g. one spouse has administered paracetamol to the infant but forgot to communicate the same and the other spouse also administers a certain dosage.
- Keep the medicine away from children’s reach and in a sealed or locked box.
- It is better to keep the medicine in their respective packages, if not use separate containers and name them to avoid confusion.
- You should follow certain precautions when your self-treat with OTCs.
- Many OTC medicines for children come in liquid form. The best way to measure the dose is use the dosage cup that is given if you do not have always have a special dosing spoon in your medicine cabinet. So, you are sure of the dosage you give your child not some random kitchen table or teaspoon. In case of emergency take the dosing spoon with you so the medical practitioner can ascertain the exact dosage administered.
- It is still advice NOT to self-medicate your kid. However, should you have to do that. Always look for one that treats the main symptom. Not a generic one that treats an array of symptoms. Multi-symptom medicines expose you to medicines you do not need. This increases the risk for side effects. Ask the pharmacist for help in choosing the safest and most effective OTC medicine for your symptoms.
Self-medication has its advantages and disadvantages. Knowing the basics of self-medication can save you a lot of time and money. But, most of the time the disadvantages outweigh its benefits. It is always recommended to get professional advice rather than googling it.
Did we miss out on any precautions to be taken when we self – medicate our kids? We like to hear about it. Leave in your comments below.