chapter 4 giving my child medicine - new york state … · 2014. 1. 16. · will help your...

Giving My Child Medicine 4–19/03

Giving MyChild Medicine

Contents Page

How important are medicines the doctor orders for my child? ........... 4-2

Should I give my child over-the-counter medicinesand therapies? ......................................................................................... 4-4

How do I choose a pharmacy or drugstore? .......................................... 4-5

What questions should I ask the doctor, nurse, or pharmacistbefore giving my child medicines? ........................................................ 4-6

How can I keep track of all my child’s medicines? ............................... 4-9

What can I do if my child cannot swallow pills? .................................. 4-11

What if my baby spits out the medicine? ............................................. 4-12

How can I help my toddler or young child take medicine? ............... 4-14

What if my child misses a dose of medicine? ...................................... 4-15

What if my child will not take the medicine? ...................................... 4-17

What if my child needs to take medicine at school? ........................... 4-19

Blank Medicine Schedule .................................................................... 4-20

CHAPTER 4

4–2 Giving My Child Medicine9/03

How important are medicines thedoctor orders for my child?

Most children with HIVneed to take medicines each day.

Your child’s doctor may order medicines for yourchild to:

■ help fight HIV.

■ prevent illnesses.

■ treat infections.

■ treat other medical problems.

Although it can be difficult, it is always importantfor your child to take the medicines his/her doctororders. This is especially true for the medicinesyour child takes to fight HIV. Depending on yourchild’s health, most doctors recommend thatchildren with HIV take 3 or more medicines to fightHIV. These medicines are called antiretroviral(an tï´ ret rö´ vï ral) medicines.

■ If your child takes every dose correctly and ontime, antiretroviral medicines will help lowerthe amount of HIV in your child’s blood. Thiswill help your child’s immune system getstronger, and he/she may have fewer illnesses.

■ If your child does not take every dose correctlyand on time, the HIV medicines may stopworking. This means HIV can grow stronger inyour child’s blood, your child’s immune systemcan get weaker, and your child may havemore illnesses.

Taking medicinesthe doctor ordersis very importantfor your child'shealth.


(See HIV: The Basics, How do medicines slowdown or stop HIV? page 1–11 and Why do HIVmedicines stop working? page 1–12.)

It is important for all of your child’s health careproviders to know the medicines he/she takes.

■ Keep a list of all the medicines your child istaking. For each medicine, write down:– the name.– dose (how much is taken).– how often is it taken.– if it is taken with or without food.

OR

If possible, take your child’s medicines intheir containers. You can show the doctorwhat your child takes and keep your childon his/her medicine schedule if doses areneeded during the visit or while traveling.

■ List or take all of your child’s vitamins,supplements, herbal therapies, over-the-counter medicines, or home remedies. Bringthe list or the medicines, vitamins, supplements,etc. with you every time you take your child tothe doctor, dentist, emergency room, or otherhealth care providers, such as a psychiatrist(sï kï´ a trist) and nutritionist (nü trish´ un ist).It is also a good idea to take the medicines orthe list when you see your child’s pharmacist(far´ ma sist). This will make sure all of yourchild’s health care providers know whatmedicines your child is taking.

(See Keeping My Child Healthy, How can Iprepare myself for my child’s doctor or clinic visits?page 2–13.)

Every time youtake your child toa health careprovider, list ortake all of yourchild's medicines,vitamins,supplements,herbal therapies,over-the-countermedicines, andhome remedies.


Should I give my childover-the-counter medicinesand therapies?

Always check with the doctor before giving yourchild any over-the-counter medicines or therapies.These are medicines or therapies you can getwithout a doctor’s order. You might get over-the-counter medicines or therapies from places like thegrocery store, drug store, or health food store. Theyinclude things such as: home remedies, coughsyrup, acetaminophen (as ët´ a min ö fen), ordietary supplements like vitamins, minerals, andherbal therapies.

It is important that the medicines ordered by yourchild’s doctor work properly. Some foods, drinks,vitamins, minerals, or herbs can make themedicines ordered by the doctor:

■ stop working.

■ work too much.

This is called a drug interaction. Drug interactionscan be very harmful to your child. If your child’sHIV medicines stop working, they cannot controlthe HIV. If your child’s HIV medicines work toomuch (overdose), the medicines can cause harmfulside effects. Your child’s doctor can tell you if anymedicines or supplements you want to give yourchild will interact with his/her ordered medicines.

(See Eating Healthy Foods, Should I give my childa vitamin or mineral supplement? page 3–10, andCan I give my child herbal therapies? page 3–11.)

Check with thedoctor beforegiving your childany medicine thatis not ordered byyour child'sdoctor – evenacetaminophen orcough medicine.


How do I choose a pharmacyor drugstore?

■ Ask your nurse or doctor for suggestedpharmacies or drug stores.

■ Try to find a pharmacy where the pharmacist isfriendly and helpful.

■ Find out if the pharmacy takes Medicaid,ADAP, or your health insurance plan.

■ Find out if the pharmacy is open on weekendsand nights, and if they will open for you inan emergency.

■ Ask if the pharmacy delivers medicines.

■ Make sure the pharmacy carries the medicinesyour child needs.

■ Ask if the pharmacy gives written information,in your language, about the drugs your childis taking.

■ Find out if the pharmacy can keep track of allyour child’s medicines and can tell if there arepossible drug interactions.

■ Once you decide on a pharmacy, be sure to fillall the medicines ordered by your child’sdoctors at the same pharmacy.

Getting apharmacy thatwill work withyou is important.

It is importantthat thepharmacist keepstrack of yourchild's medicines.Make sure to fillall the medicinesthat are orderedby your child'sdoctor at thesame pharmacy.


What questions should I ask thedoctor, nurse, or pharmacist beforegiving my child medicines?

How many times a day do I give the medicine?

Make sure you know when to give your childmedicine. Some medicines must be taken exactlythe same number of hours apart (such as every 6hours or every 12 hours) night and day. You mayneed to wake your child during the night to givethese medicines. Other medicines only need to begiven when your child is awake. Work with thedoctor or pharmacist to schedule the medicines atconvenient times. Most children will not have totake medicines at school. But if your child needs totake medicine in school, see Giving My ChildMedicine, What if my child needs to take medicinein school? page 4–19.

How much medicine do I give?

The medicine your child needs may come in tablet,capsule, powder, or liquid form. Be sure you knowhow much medicine is needed for each dose. Ifyou have to measure your child’s medicine, it isimportant that you measure it carefully. Forexample, if the directions say to give your child 1teaspoon, be sure to use a measuring teaspoon likethe ones used for cooking. Using a silverwareteaspoon may give your child too much (overdose)or not enough medicine. Or, ask your doctor orpharmacist to give you a medicine cup or oralsyringe. If tablets need to be cut in half, ask yourpharmacist for a tablet cutter. Make sure you askyour nurse or pharmacist how to use it correctly.

Make sure youknow how andwhen to give yourchild his/hermedicines.


Can I give my child more than 1medicine at a time?

Sometimes, when taken at the same time,medicines can act differently than if they weretaken alone. Medicines taken together may worktoo much or not work enough for your child. If yourchild is taking more than 1 medicine, always askthe doctor, nurse, or pharmacist if medicines canbe taken at the same time.

Do I give the medicine with food orwithout food?

Some medicines work better when taken on anempty stomach. (An “empty” stomach means 1hour before a meal or 2 hours after a meal). Othermedicines may upset your child’s stomach if notgiven with food. Be sure you know how togive each medicine.

Are there any side effects to this medicine?

Before your child starts to take a new medicine, askabout the medicine’s side effects. The doctor,nurse or pharmacist can tell you:

■ the medicine’s main side effects■ what to do if the side effects happen.

Diarrhea (dï´a rë´a) is a common side effect forsome medicine, especially when your child firststarts taking it. If possible, start a new medicine atthe beginning of a weekend so your child’s bodycan start to get use to it before he/she goes backto school.

Other side effects can be mild, such as being moresensitive to the sun.

Always ask thedoctor, nurse, orpharmacist if it issafe for your childto take morethan 1 medicineat a time.

Call your doctorright away if yourchild gets a badreaction to anymedicine.


Some side effects can be more harmful, such asrashes, or having trouble breathing.

Call the doctor right away if your child gets abad reaction. The doctor can suggest how totreat the side effects and find other medicinesthat may be better for your child.

Be sure to write down the:

■ medicine’s name.■ dose.■ how often it was taken.■ what kind of reaction your child had.

Where should I keep the medicine?

Ask the doctor, nurse, or pharmacist if themedicine needs to be kept in the refrigerator.Most medicines will be OK at room temperature.Do not keep medicine in:

■ damp places, like the bathroom.■ direct sunlight, like on a window sill.■ a hot place, like by the stove.

If you do not use a pill organizer, always keepmedicines in the containers they came in. Thesecontainers help keep moisture out.

Why should I talk with the doctor, nurse, orpharmacist about all the medicines my childtakes before a new medicine is given?

Sometimes the same medicine can have differentnames. This happens when there is a name brandmedicine and a generic (je när´ ik) medicine.

☞ WARNING

Keep all medicines,vitamins, supplements,herbal therapies, andhome remedies out of thereach of children, even ifthe bottles have child-proof caps. Remember,some of these look or tastelike candy. Keep thePoison Control Hotlinenumber by your telephoneor inside your medicinecabinet in case someonetakes the wrong medicineor takes too muchmedicine.


Examples of the same medicine with differentnames include:

■ d4T = Stavudine = Zerit■ Nevirapine = Viramune■ Saquinavir = Invirase = Fortovase

It is very important that your child not get too muchmedicine. By going over all the medicines yourchild is taking, the doctor, nurse, or pharmacist canmake sure your child will not take a name brandmedicine with the same generic medicine.

How do I keep track ofall my child’s medicines?

Keeping track of the directions for each medicinecan be confusing. A medicine chart can keepmedicine information easy to see and easy to taketo doctor or clinic visits. On page 4-10, a samplechart for an infant and a sample chart for anadolescent have been filled out. At the end ofGiving My Child Medicine, there is also a blankmedicine chart. Ask your doctor, nurse, orpharmacist to help you fill in the blank chart ormake another chart to show when to give eachmedicine, how to give it, and how much to give.

To take medicine on time, it may be best to link itwith one of your child’s routines. For example,medicine taken in the morning may be givenbefore or after your child’s breakfast, or before yourchild brushes his/her teeth. Medicine taken beforebedtime may be given before your child brusheshis/her teeth.

Ask your child'sdoctor, nurse, orpharmacist tohelp you make amedicine chart.


SAMPLE Medicine Schedules

When to Take

Medicine Strength Morning Afternoon Night How to Special CommonPurpose Dose 9:00 am 12:00 pm 9:00 pm Take Storage Side Effects Notes

Epivir 40 mg ✓ ✓ With or None Fever, tired, dizzyFight HIV 4 ml without upset stomach,

food vomiting, diarrhea

Zerit 9 mg ✓ ✓ With or None Tingling in handsFight HIV 9 ml without and feet, tired,

food pale, dizzy, coughfever, diarrhea

skin rash

Viracept 500 mg ✓ ✓ With a None Diarrhea,Fight HIV 2 pills light headache

crushed snack

Bactrim Pediatric ✓ At the None Skin rash, diarrheaPrevent 5 ml Monday beginning upset stomach,

PCP Tuesday of a vomitingWednesday feeding

INFANT

When to Take

Medicine Strength Morning Afternoon Night How to Special CommonPurpose Dose 9:00 am 12:00 pm 9:00 pm Take Storage Side Effects Notes

Combirvir 3TC ✓ ✓ With or None Headache, nauseaFight HIV 150 mg without tired, vomiting,

ZDV food diarrhea, anemia300 mg1 tablet

Sustiva 200 mg ✓ Do not None Skin rash, tired, Strange dreams3 take with upset stomach, or nightmares end

capsules high fat vomiting, diarrhea, in about 1 monthmeal trouble sleeping after starting the

and concentrating, medicinestrange dreamsor nightmares

ADOLESCENT


There are also some items you can get to help keepyour child’s medicines on schedule. Ask yourdoctor, nurse, or pharmacist for information onwhere to get these items, and if they are covered byyour insurance.

■ Pill boxes. There are many different kinds ofpill boxes. Some let you set up all themedicines your child needs to take during theday. Some can set up medicines for the week.If your child will not be home when medicineneeds to be taken, some pill boxes are smallenough to hold 1 dose.

■ Electronic alarms. Watches with alarms can beset to remind you of medicine time. There isalso a small electronic alarm that can be put onyour key chain or worn on a chain around yourneck. It will beep when it is time to give yourchild another dose of medicine.

What can I do if my childcannot swallow pills?

If your child cannot swallow tablets or capsules, askyour doctor, nurse, or pharmacist if there is a liquidform. If not, ask for advice. Here are some ideasthat work for some children.

Mix medicine with food or drink.

Always ask your doctor, nurse, or pharmacist if it isOK to mix a medicine with food or drink. If it isOK, mix the medicine in a little milk, juice, or food.Make sure your child drinks or eats everything you

Your doctor orpharmacist cansuggest ways tomake it easier foryour child toswallow pills.


give so he/she will get all the medicine. If themedicine tastes bad, try mixing it in jelly, icecream, applesauce, chocolate syrup, or anotherfood your child likes.

Crush tablets.

Ask your doctor, nurse, or pharmacist if it is OK tocrush a tablet and mix it with milk, juice, or foodyour child likes. If it is OK to crush the tablet, put itin a spoon and place another spoon on top of it.Then, squeeze the 2 spoons together. Be sure toget all the powder off the spoons so your child getsa full dose.

Open capsules.

Always ask your doctor, nurse, or pharmacist if it isOK to open capsules and mix the powder or beadsinto food or drink. If it is OK to open the capsules,ask the best way to do it.

What if my babyspits out the medicine?

It is hard for anyone to make a baby take medicinewhen he/she does not want it. Babies and toddlersdo not understand why they must take medicineand may spit it out if it tastes bad. Ask the doctor orpharmacist if you can change the taste of themedicine by mixing it with food or liquid. This maymake your baby more willing to take the medicinefrom a baby bottle or spoon. If the medicine can begiven with milk, juice, or food, make sure to give

It is best to giveyour babymedicine at thebeginning ofa feeding.


the medicine at the beginning of a feeding so yourbaby gets the full dose of medicine. Other tips togive medicine to children follow.

Giving medicine to babies

1. Prepare and measure the medicine. Use a softplastic dropper or a spoon for medicine.

2. If it is OK with the doctor, mix the medicinewith liquid or food.

3. Sit in a firm, comfortable chair.

4. Put a bib or towel on your baby.

5. If you are right handed, hold the baby in yourleft arm. Hold the baby’s left arm with your lefthand. Put the baby’s right arm under your leftarm and around your back.

6. Brace your baby’s head against your arm orchest so his/her head stays still. Tilt yourbaby’s head back a little.

7. Put the medicine into the corner of your baby’smouth, along the side of his/her tongue. Thismakes it harder for your baby to spit.

8. Give little amounts at a time so your baby doesnot choke.

9. Never yell or show anger. Speak softly and saykind words.

10. When all the medicine is finished, hold yourbaby sitting up for a few minutes and cuddleand comfort him/her.


How can I help my toddleror young child take medicine?

Some children do not want to take medicine. Donot threaten, punish, hit, or yell at your child ifhe/she has a hard time taking medicine. This willonly make it worse. Try to work as a partner withyour child to overcome the problem.

Giving medicine to young school-aged children

■ Never ask your child whether he/she wants, orwill take the medicine. Be firm and say he/sheneeds to take it.

■ If the medicine can be taken with food, trydifferent foods to cover up the taste of themedicine.

■ Offer your child choices.

– What kind of food or juice does he/she wantto take with the medicine?

– Does your child want to take the medicinestraight? If this is possible, does your childwant to take the medicine in a pill or in aliquid form? (Ask your pharmacist if themedicine your child takes is in both a pill orliquid form.)

■ Some children do best when they take a deepbreath and drink the medicine down fast.Others take their medicine a sip at a time witha drink of juice in between. Sometimes it helpsto count for your child while he/she takesthe medicine.

Never threaten orpunish your childfor not takingmedicine.


■ The bad taste of some medicine can becut by drinking juice or eating plaincrackers afterward.

■ Offer a reward such as a sticker or star whenyour child takes the medicine. Get other peoplewhom the child cares about to help encourageor reward your child.

Adapted from ”Your Child, Your Family, and HIV” published by theNational Pediatric & Family HIV Resource Center at the Universityof Medicine and Dentistry of New Jersey.

What if my child misses adose of medicine?

It is important to give your child all of the medicinethe doctor orders. But do not panic if your childmisses 1 dose. Just give the dose as soon as youremember, or if it is almost time for the next dose,continue with the regular schedule.

Taking medicine to treat HIV is very important foryour child’s health. If your child misses HIVmedicine doses because he/she is not feeling wellor throws up after taking the medicine, call thedoctor or nurse and ask what to do. If you arehaving trouble giving your child HIV medicine oryou forget to refill the HIV medicine before it runsout, call the doctor, nurse, or pharmacist. He/shecan give you some tips on what to do to keep yourchild’s HIV medicine on schedule. If you are amember of a caregiver support group, the othermembers may also have tips. No matter what the

☞ WARNING

Do not give 2 doses atthe same time.

Do not panic ifyour child missesa dose of medicine,but do your best tokeep him/her onschedule. Askthe doctor orpharmacist whatto do if your childmisses a dose.


reason for your child missing HIV medicine doses,let your doctor or nurse know how many doses weremissed. When doses of HIV medicine are missed,the medicine may stop working.

(See HIV: The Basics, How do medicines slowdown or stop HIV? page 1–11, and Why do HIVmedicines stop working? page 1–12.)

Be sure to keep enough medicine on hand.

■ Keep track of your child’s medicine to makesure you do not run out. Call your pharmacistfor a refill when you are getting low on amedicine. Remember that it may take time toget the medicine if it has to be special orderedby the pharmacist.

■ Plan ahead if you are going to take a trip.Count all the medicine your child will needwhile you are away. Ask for a refill if themedicine will run out before you get back home.Medicaid, ADAP, and insurance plans will letyou get a refill early if you are going away.


What if my childwill not take the medicine?

The first thing to do is try to find out why your childwill not take the medicine.

■ Does your child hate the taste of the medicine?

■ Is your child angry or depressed aboutbeing ill?

■ Does your child think the medicine is notneeded because he/she feels OK?

■ For an older child, has he/she talked tothe doctor to help make decisions aboutthe medicine?

■ Is your child angry about something that hasnothing to do with taking medicine?

Some children may try to use medicine-taking as away to control you or get things. As an example, ifyour child says, “I will not take my medicine untilyou get me a new toy.” Remember, you are theparent and you set the rules. Be firm, but do notyell. You might say something like, “You need totake your medicine to stay healthy. If you takeyour medicine on time for a week, we will talkabout getting something for you.”

If you also take medicine or a vitamin, take it at thesame time your child takes medicine. Try having acontest to see if your child can take his/hermedicine faster than you.

If your child hates the taste of the liquid medicine,ask your pharmacist if he/she can flavor it. Thereare over 60 flavors that can be added to liquidmedicine including strawberry, bubble gum,

It is important tofind out why yourchild will not takethe medicine.


chocolate, cinnamon, and root beer. Or, if it is OKwith the doctor, you can try giving your childmedicine with something else that has a strongflavor your child likes. Sucking on an ice pop or amint candy before and after taking the medicinemay also help.

As with all children who have a life-long healthcondition, sometimes they can become angry ordepressed. Sometimes they may think they do nothave a life-long health condition because they feelOK. These feelings need to be taken seriously anddiscussed with the doctor, social worker, or mentalhealth professional. It is very important for anolder child to understand the importance of takingmedicine to stay healthy. Most older children donot want to be different from their friends. Takingmedicine may make your child feel different.Older children also need to feel that they havesome control over their health and that theiropinions are respected. If you tell your child whatto do without listening to his/her fears, wishes, orconcerns, your child may be less likely to followhis/her treatment.

(See Helping My Adolescent Deal with HIV, Whatif my teen stops taking HIV medicines? page 8–29.)

Unless a cure is found, you are helpingyour child learn how to take medicine forthe rest of his/her life.

Listen to yourchild's concerns andfears and help yourchild deal withthem. The doctor,social worker ormental healthprofessional canhelp. Remember,unless a cure isfound, you arehelping your childlearn how to takemedicine for therest of his/her life.


What if my child needs totake medicine at school?

First, check with your doctor or pharmacist to see ifyour child’s medicine schedule can be changed soall medicines are given when your child is home.If medicines have to be taken while your child is atschool, check with the school nurse to find out ifyour child’s school will give medicine that hasbeen ordered by a doctor. Also, check to make surethe nurse is in your child’s school building whenyour child needs to take his/her medicine. If theschool nurse will give your child medicine duringthe school day, you will have to think about tellingthe nurse that your child has HIV. The nurse cangive medicines, arrange rest periods, offer yourchild support, and help arrange for home tutoringor other special help, if needed. By law, the schoolnurse must keep all HIV information private. It isnot appropriate for your child’s teacher to givemedicine.

(See Legal Issues, How does New York Stateprotect the privacy of my child with HIV? page10–2.)

If your childneeds medicineduring schoolhours, talk withthe school nurseto plan how thiswill happen. Ifmedicine cannotbe given duringschool hours, talkwith your doctor.

4–20G

iving M

y Ch

ild Medicin

e9/03

MEDICINE SCHEDULE

When to Take

Medicine Strength Morning Afternoon Night How to Special CommonPurpose Dose ________ ________ ________ Take Storage Side Effects Notes


Notes

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chapter 4 giving my child medicine - new york state … · 2014. 1. 16. · will help your...

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