Medications

Medication Safety… an ounce of prevention is worth a pound of cure.

• Keep all prescription and over-the-counter medicines locked up, where children cannot see or reach them.
• Store medications in their original containers and use child-resistant lids. Weekly/daily pill planners may be convenient but they are not child-resistant and it may not be possible to identify the medications, doses, or directions for use if the original container is not readily available. Remember — nothing is child-proof! 
• Avoid expired medications. Discard any old, expired, or unused medications in accordance with local or state recommendations. Check the expiration date before you buy or use a medication. Expired medications may be less effective and some may undergo chemical changes that may make them dangerous. 
• Read the label and follow the directions on all medicines. Remember to turn on the lights! If you are taking or giving medication in the wee hours of the morning, make sure you can see…and think clearly. 
• Are children around? Take the product or medicine with you to answer the door or the phone.
• Is it medicine? Call it medicine…not candy. Take your medicines where children can’t watch because they learn by imitation 
• Measure with care. Always use a calibrated medicine spoon, dropper, or dosing cup to measure the correct dose. Do NOT use kitchen spoons which can vary in sizes and may lead to an underdosage or overdosage. Underdosing may render the medication ineffective while overdosing may result in toxicity and unwanted side effects. 
• Do not share prescription medications. What is safe and effective for your 5 year old may not be for your 2 year old. Also, your husband’s blood pressure medication may not be recommended and may actually be dangerous for your brother who is visiting and forgot his medication.

Over-The-Counter Products

When used appropriately, over-the-counter medications are safe and can help remedy many common and minor ailments. When used incorrectly or when accessed by children, there can be dangerous and unintended consequences. Regardless of the reason, our specialists of poison information are specially trained nurses, pharmacists, and physicians who are available to help answer your questions and concerns in English and Spanish at any time of day or night.

Some common examples of medications commonly reported to poison centers that can have dangerous effects include:

• Acetaminophen: Acetaminophen, the active ingredient most commonly found in Tylenol and many other over-the-counter and prescription medications, is one of the leading causes of liver failure and deaths reported to poison centers each year. When given in recommended doses it is a safe and effective analgesic and antipyretic for all age groups from infants to senior citizens, however in excessive amounts it may lead to potentially fatal liver failure. Common scenarios include children accessing a bottle from their diaper bag or the kitchen countertop, individuals inadvertently using different medications that contain acetaminophen at the same time without knowing, and unfortunately as intentional overdoses. Acetaminophen levels can be measured from a sample of blood and along with other labwork can help determine the need to provide an antidote that helps to protect the liver from damage due to acetaminophen. Our specialists of poison information can help guide you and provide treatment recommendations and toxicity information to your physician or hospital emergency department if someone may have ingested or may be at risk of ingesting acetaminophen in excess of recommended doses. 
• Cough and Cold Medications:  Although commonly available and long used to help relieve symptoms from coughs and colds such as runny noses, fevers, aches and coughs, these medications are no longer recommended to be used in children less than 4 years old. Cough and cold medicines often have more than one active ingredient, such as an antihistamine, a decongestant, a cough suppressant, an expectorant, or a pain reliever and fever reducer. These medications do not treat or cure the cold or cough and they have not been proven to be effective in young children. They do not shorten the length of time your child is sick. In addition there is the potential that the active ingredients in these medications when misused or overused may cause dangerous toxicities that may even include rapid heart beat, drowsiness, hallucinations and seizures. These medications should only be used under the guidance of your child’s pediatrician. Our specialists of poison information can help guide you and provide treatment recommendations and toxicity information for the various ingredients and formulations of cold and cough medications.

Prescription Medications

The use of prescription medications is at an all-time high and the trend is likely to continue due to our ever-aging population and new emerging therapies for chronic medical conditions. Some common examples of prescription medications commonly reported to poison centers that can have dangerous effects include:

• Diabetic Medications: The treatment of diabetes is aimed to help regulate and normalize blood sugar levels. Excessive amounts of sugar in the blood can lead to problems with circulation and is the leading cause of blindness, amputations, and kidney failure in the US. It also contributes to heart disease and is a risk factor for strokes and heart attacks. Depending on the type of diabetes and the patient’s glucose control there a several different types of medications that can be used including insulin, sulfonylureas (glipizide, glyburide, glimepiride), biguanides (metformin), thiazoladinediones (pioglitazone, rosiglitazone), DPP-4 enzyme inhibitors (sitagliptin, saxagliptin), and numerous other types of medications that all work by different mechanisms to help achieve glucose control. Depending on the patient’s age and medical condition and the specific medication and its mechanism of action, some cases may require an immediate referral to a health care facility for observation and treatment while others are considered essentially nontoxic. In case of an accident or emergency, the determination can by made by our experienced specialists of poison information. 
• High Blood Pressure Medications:  Hypertension or high blood pressure is another common malady whose treatment medications can be dangerous if taken incorrectly or by someone who doesn’t have high blood pressure such as a child. Numerous different types of medications are used to lower blood pressure such as beta blockers, calcium-channel blockers, ACE inhibitors, diuretics, and angiotensin receptor blockers are amongst the most commonly used. Depending on the type of medication, as little as a bite of a tablet may be dangerous to a toddler and require prolonged observation in a health care facility. 
• Other “Heart” Medications:  Antiarrythmics, nitrates, blood thinners, digoxin, and various other types of medications are commonly used. The safety from an accidental double dose will depend on the patient’s underlying medical condition and their stability on their prescribed dosage regimen. Likewise, a child accidentally getting into grandmother’s “heart” medicine can be extremely dangerous or may be minor, again, depending on the specific product and the child’s own health. In case of an accident or emergency, our nurse, pharmacist, or physician specialists of poison information are available to answer any questions and provide the appropriate treatment recommendations and toxicity information to the public and to other health care providers. 

Medication Abuse

The National Institute of Health reports that an estimated 20 percent of people in the United States have used prescription medications for non-medical purposes. Prescription drug abuse is a serious and growing problem. The increased availability of medications with more doctors prescribing more medications for more health problems than ever before and easy access to illegitimate internet pharmacies are compounding this issue.

Commonly abused prescription medications include analgesics for pain such as hydrocodone, oxycodone, or propoxyphene; stimulants used in the treatment of ADD-ADHD such as methylphenidate and amphetamines; sedatives and tranquilizers such as alprazolam, diazepam, and clonazepam; and muscle relaxants such as carisoprodol and cyclobenzaprine. If you suspect that someone you know may be abusing or misusing a prescription or over-the-counter medication, our nurse, pharmacist, or physician specialists of poison information are available to help answer questions you may have in regards to the risks and side-effects from specific medications.