Establish a system and specific place for keeping your child's medical records, including detailed information about all medications, past and present.
About 1.5 million drug mishaps occur in the United States each year, and thousands result in fatalities. Managing medicines are a serious matter, but you can keep track of your child’s medications safely and effectively by utilizing a number of management techniques:
- Create a personal medication list. Write down all medicines that your child takes (prescription and over-the-counter) with times per day, dose, form (pill, liquid, injection, cream, drops), reason for use, and start/stop dates for each. Include any drug allergies, side effects, or sensitivities to which your child is prone.
- Recording forms can be printed from the AARP website. Or you can call 1-888-OUR-AARP (1-888-687-2277) and ask for stock number D18589.
- Keep a copy of the personal medical list for your reference, give a copy to your child to carry with him/her at all times, and keep a copy in your child’s medical records notebook.
- Provide a copy to both the doctor and pharmacist for their review. (Update the list any time there is a change, and ask them to check for possible drug interactions each time.
- If possible, have the instructions for all medications adjusted so they can be taken on the same schedule.
- Get to know the pharmacist and simplify record-keeping by using the same pharmacy to fill all prescriptions and to purchase over-the-counter medications and supplements. Pharmacists have more detailed information about medications than doctors do, and they can make helpful suggestions to both you and your doctor about alternative prescription possibilities and dosing. In addition, the pharmacy’s computer program can do a quick medicine interaction check.
- Carefully read any documentation that comes with each medication, especially directions and warning labels.
- Consider the use of a pill organizer. They are available in daily, weekly, and monthly configurations. Some even allow for multiple daily dose times − morning, mid-morning, noon, mid-afternoon, and evening. Keep the responsibility of filling the pill organizer and dispensing the medication yourself; this is too critical to risk with even the most responsible of children.
- Insist your child follows all medication instructions exactly.
- Insist your child eats a consistent, nutritious diet with a variety of foods to help alleviate drug-food interactions.
Basic Rules for All Medicines
- Never take medicines from another person.
- Don’t mix medications unless directed by your physician.
- Take medicine at the doses and times prescribed.
- Never take medicines past their expiration dates. (The drug’s chemical composition changes and no longer has the intended health effect.)
- Store medicines in a cool, dry, dark place to prevent the chemical composition from breaking down.
- Store medicines in a safe location where children and strangers have no access.
- Keep everyone’s medications in separate places so no one takes the wrong ones by mistake.
- Open medicine bottles over a flat surface, such as a countertop, to make a pill easier to find if it’s dropped.
- Remove the cotton plug, which attracts moisture, from medicine bottles.
- Keep oral and topical medications in separate places.
- Never throw expired or unused medicines in a wastebasket where pets or children have access.
Herbs and Homeopathic Medication
- Consider herbal products and other natural medicines the same as drugs because they can cause side effects and interact with each other or with traditional medicines.
- Remember that the Food and Drug Administration does not test herbal products like traditional medicines: there is no guarantee of the exact strength of the ingredients.
- Look on the label for the words “meets USP standards,” which indicates the product has been tested for quality and purity.
- Only choose products that clearly state the name, address, and phone number of the manufacturer or distributor on the label.
- The container should be fitted with tamper proof protection that has not been broken.
- Since herbal products such as ginkgo biloba, kava, or St. John’s Wort can interact with prescription medicine, learn as much as possible about the product before taking it.
- If your child has diabetes, high blood pressure, heart disease, an autoimmune disease, a blood clotting disorder, a psychiatric problem, or other serious medical condition, avoid herbal products unless under the supervision of a doctor.
At the Doctor’s Office
When the doctor is prescribing a new medication, ask:
- What are the alternatives? Anything besides medication?
- Why is this the best treatment for my child?
- Is the generic version okay?
- If this drug is new, is there a drug with a longer history that would work as well?
- Is there a drug with fewer side effects?
- Is this the lowest dose my child can begin with?
- Is there a drug that would be better for my child that’s not on his/her approved drug list? Can the doctor request it? (insurance appeal or pre-authorization)
- How will we know the medicine is working?
- How long will that take?
- How long will this medicine continue?
- When should we call back to discuss whether or not there has been an improvement?
To aid in double-checking the accuracy of the prescription, have the doctor write on the prescription:
- The reason for the medication
- Both the brand and generic names of the medication
At the Pharmacy
When filling the prescription, ask the pharmacist:
- To make the label with large print
- To include what condition it treats (the reason for the medication) on the label
When picking up the prescription, the pharmacy staff will have you sign a statement certifying that counsel about the medication was declined. Even if you already signed this, you can still speak with the pharmacist.
Try to be there when the drugstore isn’t busy so you can ask as many questions as you want. During the consultation, ask for:
- A review of the updated personal medication record
- A thorough explanation of dosing for the new prescription
Some possible questions for clarification about the new prescription include:
- When to take it? How many times a day? At what hours of the day?
- Okay to take at the same time as other medications?
- With or without food or drink?
- How long before eating or after eating?
- Okay to split the pill or crush it into food if difficult to swallow?
- Does this medication have special storage requirements? (refrigeration, etc)
- If a dose is missed, should it be made up? If so, when?
- Should any activities be avoided?
- What side effects are more likely for younger people?
- What, if any, side effects might be dangerous and warrant emergency attention?
- How many refills?
- What if the prescription runs out?
If There’s a Negative Reaction
Since young bodies absorb and excrete drugs differently, it’s important to know how your child normally reacts to drugs in order to detect something unusual that might need medical attention.
If your child experiences an alarming side effect or drug interaction, call the doctor or pharmacist immediately. Possible symptoms that need reporting include:
- Blurry vision
- Ringing in the ears
- Coordination problems
- Skin rashes
- Memory problems
If symptoms indicate something life threatening, call 911.
Be prepared to provide important information:
- What symptoms were experienced and when? How are these different than he/she normally experiences?
- What information is on the drug container label? (Have the drug container with you for the call.)
- When was the medication taken?
- Could anything else have caused the symptoms?
Monitor How Drugs are Working
Note any changes in how your child feels when taking the medication, write them down, and remember to tell the doctor or pharmacist. If no changes are noticed, ask the doctor when you should report back to discuss whether or not your child has noticed any improvement.
Insist on a medication review at least once a year. For each medication on the list, ask the doctor, “Is this still needed?”
If a medicine has been added to treat the side effects of another medicine, this is called prescription “cascading.” Instead of piling on more medicine, ask the doctor if the first drug could be adjusted or replaced to alleviate the problem.
If tests are necessary to monitor ways the medication may affect a person’s body (internal organs, for instance), make sure you and your child don’t miss or postpone these appointments: They are key to avoiding dangerous side effects.
Also, write down the results of the tests. If more than one health professional is involved in treating your child, let each of them know the results of the monitoring tests.
An abundance of information is available to educate yourself about prescription drugs. But heed a word of caution: Don’t rely on online drug research without taking into consideration your child’s individual circumstances and medical history. Read the available material about safety, effectiveness, and price comparison; then consult the doctor, pharmacist, or other health provider before making changes.
The FDA Drug Safety website provides helpful drug-safety information, such as new drug warnings, drug label changes, shortages of medically-necessary drug products, and recall alerts.
AARP’s Drug Research guide summarizes what current medical research says about particular prescription drugs.
AARP also provides a Drug Directory to help you decipher drug labels, compare drug effectiveness and costs, check for food and drug internactions, and provide over-the-counter drug safety tips. The website includes a drug-search tool.
For other medicine management questions, you can call AARP at 1-888-OUR-AARP (1-888-687-2277).
The National Council on Patient Information and Education (NCPIE) offers some great ideas on medication safety and questions to ask medical professionals. Visit website or call 301-656-8565.
Consumer Reports (CR) offers a site to recommend particular drugs for different medical conditions. They tell which ones they consider to be a best buy and why. Other CR documents are linked to expand on the drugs’ safety, cost, and effectiveness. New drug reports appear each month.