How to administer medicine to children and infants

The following are questions that are often asked by parents of children and babies in Panti Rapih Hospital Pharmacy:


What do doctors pay attention to when giving medicine to babies or children?

When prescribing medicines for babies and children, the doctor will see:

  1.     Diagnosis of disease based on physical and laboratory examinations (if needed).
  2.     Baby age. The smaller the baby's age, the more drugs that may not be given.
  3.     Baby weight. The dosage of the drug is given based on the weight of the baby so that weighing the body is very important.

 

What if your baby's medicine is still left over, can it be given back if one day he experiences the same disease?
Depending on the type of drug, if:

  1. Antibiotics. Don't give it! Whatever the shape is either syrup or powder. Antibiotics should be spent or according to doctor's instructions.
  2. Concoction. Both syrup and powder should not be given, it is feared there are types of drugs that cannot be consumed again.
  3. Syrup medicine. May be given, for example febrifuge, cough, runny nose, and others.
  4. Powdery, such as seizure medication or other emergency drugs, can be given as long as the drug condition does not change, either color or texture (clumping / not). As well, the weight or age of the baby is not much different when the drug is given.


How long can the syrup medicine last after the packaging is opened?
Actually there is no definite time. The mother should check the condition and expiration date of the drug again.

What is the best method for storing residual syrup?

  1. Close the medicine bottle tightly, wash / wipe with warm water to remove the remaining drugs outside the bottle.   
  2. Place it in the place indicated on the medicine package. If requested in a refrigerator, preferably not in the freezer, place it in a separate closed container so that it is not contaminated with vegetables or other ingredients in the refrigerator.
  3. Store in a room temperature that is maintained (26-27 degrees Celsius) and avoid direct sunlight.

Can your child be given medicine belonging to another baby or child?
See the little one's condition. The principle may be, limited drugs for first aid, such as fever, provided the age or weight between one baby to another is not much different, can use the same usage rules. But if you are different in weight or age, ask your pharmacist. For drugs other than febrifuge, it is recommended to see a doctor so that the treatment is in accordance with the conditions and dosage needed.

Which is better, a febrifuge drug in the paracetamol or ibuprofen group?
Both are the same, but sometimes some feel more suitable using paracetamol than ibuprofen or vice versa.
But usually for children who have a history of convulsions or heat that is difficult to go down, the doctor may combine 2 types of febrifuge drugs that are given alternately.
For cases of suspected dengue hemorrhagic fever, administration of paracetamol is a choice. Due to the administration of ibuprofen it is thought that it can lead to a decrease in platelet counts.

When can a re-fever lowering medication be given after the first administration?
Giving was repeated 4-6 hours after administration of the drug beforehand. If the heat is difficult to fall, the mother can give the baby to drink more and compress the body with warm water.

Which is better, a fever-lowering drug through the mouth or anus?
It's the same, but the drugs given through the anus react faster. But the gift is adjusted also with the complaints of the child. If the baby is vomiting, the drug will be administered through the anus. But if the baby has diarrhea, it will be more effective if the drug is given by mouth.

Can you stop giving antibiotics prematurely?
It may not be because it can cause resistance / resistance to germs. Mothers also cannot change their drinking rules, for example: 4x1 becomes 3x1 because each antibiotic has its own working period. If your child missed 1x while taking antibiotics, Mother still gave it according to the instructions for use with a shorter interval, for example: the baby should take medicine at 9 but accelerated to 6 o'clock.

Is it true that giving antibiotics to babies can result in yellow teeth when a child is big?
When Mother is still small, there is a type of Tetracycline antibiotic. Well, this type can cause yellow teeth when the little one is big. But don't worry because it's rarely used now.

Is patent medicine better than generic drugs?
Between patents and generics have the same quality. Because it has the same content. Patent drugs are usually far more expensive than generic drugs due to additional ingredients, packaging costs and promotional costs. But sometimes doctors prescribe patent drugs because there are several types of drugs that are not yet generic.

Is it possible for an allergic reaction to occur in a baby during administration? If yes, how are the characteristics?
Allergic reactions due to drug administration are very possible.

The characteristics that arise depend on what system is affected, for example:

  1.     Digestion, marked by babies experiencing nausea, vomiting until diarrhea.
  2.     Breathing, marked by the sound of grok-grok due to the production of excess mucus. You can even get short of breath.
  3.     Skin, red spots appear, itchy to blister.

This allergic reaction can arise immediately after the drug is given or even a few days later. So, mothers are advised to keep copies of recipes and receipts for your child's medication to find out which drugs cause allergic reactions. With any drug data that has been used, the mother can find out the medical history of your child as well.

What are the parents' actions if the baby has a drug allergic reaction?
The first thing to do is to stop using the drug to avoid more reaction.
Actions that can be done depend on complaints that arise, if:

  1. Light, limited to itchy and red-red, you can simply stop giving the drug and give topical medication to the affected area.
  2. Severe, such as vomiting, diarrhea to tightness, stop giving the drug immediately and take it to the nearest health center.

Can you increase / decrease drug dosage independently by parents?
We recommend that you consult a doctor, do not reduce / increase the dose independently. If overdose, can cause liver and kidney disorders in the long term. However, if the dosage is lacking, the drug cannot work optimally.

What if the baby vomits medicine?
If the medicine given is immediately vomited, you can give it again at the same dose. But if your little one vomits after 30 minutes, you don't need to repeat, because the intestine will absorb most of the medicine at 30-45 minutes after administration.

Contact your pediatrician if your child is vomiting back and forth. Giving a dose of medication that is too often can cause vomiting or diarrhea, especially in some types of antibiotics. If you have this, giving antibiotics can be done by injection.

Can you mix drugs, for example syrup mixed with powder?
You can, but you have to pay attention to the time of giving. Do not combine drugs that should be taken before meals with medication after meals.

Which is better, syrup or powder medicine?
It's the same, but if there are a lot of prescription drugs, for the sake of practicality, doctors usually prescribe concoction so that your child doesn't need to take many drugs.

Can you give medicine to babies by mixing with honey?
Children are often uncomfortable with the mostly bitter taste of the drug. To improve the taste, you should be able to give sugar water or pure honey. But sometimes it is feared that circulating honey is not necessarily good, high sugar levels can also cause coughing. If you have to give a bitter quail, you can ask for additional flavor neutralizers at the nearest pharmacy.

Can the baby drink milk immediately after taking medicine?
Depending on the type of drug. There are those who can, but there are also those who wait 30 minutes after administration of the drug, because there are certain drugs that are soluble in milk.

There are several drugs that can be given along with milk. For example, Lactobacillus powder preparations (which are commonly used to treat diarrhea in children). However, all milk must be taken so that the medication your child receives is in accordance with the dosage.

Easy tips for giving medicine to babies?

  1. Create a relaxed atmosphere, if your child likes to hear music then play music. Divert attention so that he doesn't know he will be given medicine.
  2. Avoid using loud sounds when giving medicine. Use soft tones and the mother relaxes.
  3. Position the baby with the head higher so that the drug does not enter the lungs. Generally, giving medicine to babies is more difficult, because he likes to rebel. So, the position of his body must be right. How? Your little one's lap, then arrange for her position to be half seated.

Note: Do not stretch the baby, because the drug can enter the lungs. Especially for babies, the liquid medicine should be given with a pipette. The baby can't swallow from a spoon! There is a trick so that the drug was really swallowed by the little one. For example, place the pipette in the corner of the baby's mouth, then slowly remove the drug. Place the tip of the pipette on the lower lip of the child, let the drug flow into the mouth.

Dysmenorrhea and Management

Dysmenorrhea (dysmenorrhea) comes from the ancient Greek word "dys" meaning difficult / painful, "meno" means month, "rrhea" means flow / flow. Then dysmenorrhea is defined as pain that occurs during menstruation. There are two types of dysmenorrhea, namely primary dysmenorrhea (menstrual pain without pelvic abnormalities) and secondary dysmenorrhea (menstrual pain accompanied by pelvic abnormalities).

Risk factors for dysmenorrhea include heavy menstruation, irregular menstrual cycles, age less than 30 years, sexual violence, first menstruation at <12 years of age, malnutrition, obesity, family history, and smoking.

Primary dysmenorrhea can occur due to excessive production of prostaglandin by the endometrium. The production of prostaglandin is affected by progesterone levels, which increase during or immediately after menstruation begins. This prostaglandin causes uterine contractions so that pain is felt during menstruation. Secondary dysmenorrhea can occur due to endometriosis, adenomyosis, polyps, tumors, infections, and attachments.

Dysmenorrhea occurs 6-12 months from the first menstruation, during the menstrual cycle, and lasts for 8 - 72 hours. Complaints related to dysmenorrhea are back and thigh pain, headaches, diarrhea, nausea and vomiting. There are also other complaints such as pain during intercourse, too much menstrual blood, bleeding after intercourse, and bleeding between menstrual schedules that should be.

The doctor will diagnose dysmenorrhea by asking about the characteristics of menstrual pain, history of infection or vaginal discharge, and family history; the doctor will also examine the pelvis and genital organs; if necessary, the doctor will perform transvaginal ultrasonography.

Other useful tests include a pregnancy test for human chorionic gonadotropin in the urine; vaginal and cervical swabs, complete blood count, erythrocyte sedimentation rate in urine, and urinalysis. Cervical cytology can also be done to get rid of malignancy. MRI can be used as a second-line diagnostic choice

The main therapy is non-steroidal anti-inflammatory drugs such as mefenamic acid and ibuprofen. Treatment must be carried out one to two days before the onset of menstruation and continue with a fixed schedule for two to three days. In addition, hormonal contraception can also be used as a treatment for dysmenorrhea. Other therapies other than medicines are exercise and warm compresses.

Reference
1. Obstetrics and gynecology. 3th. Baltimore, MD: Lippincott Williams & Wilkins; 2016
2. aafp.org/ Diagnosis and initial management of dysmenorrhea
3. PNPK. Management of Menstrual Pain in Endometriosis. 2013