Medications generally provide much needed relief of symptoms for your children, a cure for most ailments and when our children are well we can all sleep better at night. However, there are inherent dangers in medications which apply to both over the counter (OTC) and prescription drugs if used inappropriately. Every medication has desired effects but also side effects that may result in serious illness and even death, especially if used incorrectly. Before giving medication we should ask ourselves the questions our children always ask us: who, what, when and how?

Who is this medication intended for?

Medications prescribed for adults should not be given to your children. Parents make the assumption that their child can get a half or a quarter of the dose that they take for a particular condition. A few points need to be borne in mind:

Medication dosing by weight is the mainstay of paediatric prescriptions.

Medications come in different concentrations. The half of a tablet that is given to an adult may far exceed the amount that a child can tolerate. For example, an adult tablet of paracetamol is about seven times the strength of a children's paracetamol tablet. A child who would require only one paracetamol tablet would get three times that dose if given half of the adult tablet.

Children's bodies process and react to drugs differently from adults and many medications have not been fully tested in children.

Medication prescribed for another child should not be given to your child because illnesses that appear to be the same may be quite different, the age and weight of the children are different and one child may react differently to the medication of another. Also, disclose all allergies and illnesses to your doctor as this will influence the choice of medication.

What is the medication for?

Cough and cold medications are generally not intended for children under six years, particularly children younger than two years. Apart from the fact that they may not have been tested in these age groups, these medications usually contain multiple drugs, some of which have a stimulant effect on the heart, causing an increase in the heart rate and blood pressure among other undesirable effects. In 2005 in the USA, three infants died and several were ill as a result of these OTC drugs administered by parents.

Aspirin should not be given for fever caused by colds, chicken pox or the flu. This is because Reye's Syndrome can result. This is a potentially fatal condition affecting the brain and liver. Aspirin is now prescribed by doctors for few, specific conditions.

The average Jamaican will not feel as if he/she went to the doctor if he/she does not get antibiotics, but antibiotics have specific uses and should not be given for viral illnesses. Doing so only contributes to antibiotic resistance in the long run.

Even if the medication is appropriate for the ailment, the dose is very important as relatively safe drugs such as paracetamol, commonly prescribed and used, may have harmful effects, especially on the liver, if given in high doses. Overdosing commonly occurs when caregivers misunderstand an instruction, for example, one dropper full vs one teaspoon full. Children have been known to self-administer drugs commonly given to them by their parents when they are not feeling well. However, instead of taking one tablet they may take the whole bottle!

All drugs should be kept out of reach of children.

When should the medication be given?

The timing of the dose is crucial. One should aim to give the medication as recommended as too frequent dosing can be toxic to the patient. Dosing that is too infrequent, for example, infrequent doses of medication for asthma, hypertension (yes, children get that too), can cause the drug to be ineffective.

How should the drug be given?

Medication should be given as recommended, for example, liquid vs tablet, with or without food (as instructed) as these may have an impact on the absorption of the drug by the body and the effectiveness of the drug.

The drug should not be given by different routes at the same time as there is the potential to overdose the medication.

One needs to be careful not to mix medications that are for similar uses. This is again true for OTC preparations that have more than one drug. You may inadvertently give large doses of one drug which may be present in both preparations. For example, paracetamol, also known as acetaminophen, is present in Panadol or Cetamol and in some multi-symptom cold formulas. Become familiar with the ingredients of your medications and always read the label and package insert.

Medication should never be given only for their sedative properties, like DPH just to make your child sleep, as this may lead to abuse of the drug by the caregiver, causing any number of adverse events.

If all your questions have been answered and you are still not sure, consult your doctor or pharmacist. Yes, it is medicine but it can hurt.

Dr Tamra Tomlinson is a paediatrician and president of the Paediatric Association of Jamaica..