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Drug: The Double Edged Knife (Part 27)
By: Mohamed H. Dahir, Chairman Pharmaceutical Association of Somaliland, Email: mayakharaj@hotmail.com
Drugs from pregnancy through childhood (continued)
If a doctor will not take extra precautions to prevent pregnant woman from receiving dangerous prescription products, then women themselves will have to take on the responsibilities for protecting their unborn children from the potential dangers of drug-induced birth defects. Unless the withholding of a particular drug would endanger the mother or baby, no woman should receive any medication during the nine-month gestation period. While some of the adverse reactions are not serious, others may be extremely dangerous.
Drugs and the Nursing Mother
The newborn baby is not safe from dangerous side effects after delivery. Many drugs can be transmitted from a lactating mother to her baby through breast milk. Picture the following situation. A woman bears her fourth child and decides that she does not want any more kids. After two or three months she begins taking birth control pills on the recommendation of her gynecologist. She never bothers to ask her pediatrician whether her oral contraceptive might be dangerous to her nursing baby. This is just one example, but it is equally true for many other commonly prescribed medications and even lots of non-prescription drugs.
Babies may also be susceptible to the hazards of special antibacterial bathing soaps or dusting powders. There is no longer any doubt that hexachlorophene can be absorbed directly through the skin and poses a definite threat of brain damage. Once a newborn baby has managed to survive all the pitfalls and dangers of the first few months of life, you would think that the worst would be over. Such is not the case.
The infant is very vulnerable to drugs and even worse, the administration of drugs. Because it is virtually impossible to get a young child to swallow a pill doctors often resort to injections to get medicine into kids. One of the favorite shots is something called an IM, intramuscular injection. This involves the placement of drug between the layers of muscle. Because muscle tissue is liberally supplied with small capillaries, the medicine reaches the blood stream very quickly and reliably. Unfortunately, extra caution must be used for this kind of shot since the possibility of hitting a nerve or blood vessel is always present. “Drop foot” is a limp caused by nerve damage resulting from improperly administered medicine. Children, especially infants, should never receive an injection in the buttocks.
In the first few years of life a child’s bottom just does not have enough muscle to protect the sciatic nerve from possible destruction. In the past, deformities or limps were often attributed to polio while in reality an improper buttock injection was responsible of majority of these cases. The proper place for an intramuscular shot is the triceps muscle of the arm or the outer surface of the thigh muscle, where it is much safer and less painful. Writing about long-acting penicillin preparation, one doctor has gone so far as to state that “all such preparations should be injected into the midlateral aspect of the thigh in both adults and children”. And yet I will bet that most adults and a great many young people regularly get stuck in the butt. Although most pediatricians no longer give intramuscular injections into buttocks, many general practitioners do. But doctors are not t0 blame. Well-meaning parents are also guilty of administering incorrect or dangerous medicines to their children.
Medicine can be a valuable tool in the fight against childhood illness. It can also be dangerous when used casually or without proper precautions. Parents should be particularly careful about leaving drugs around the house. Millions of children under the age of five suffer from accidental drug poisoning all over the world every year.
Aspirin alone probably accounts for many of those cases. Kid-proof containers can be difficult to get open, but they are worth the extra effort if they help prevent accidents. Even with special bottles, children manage to get into drugs that are dangerous. Parents should always be prepared for any emergency.
Treatment of poisoning involves certain basic principles. If the poison that has been swallowed is not corrosive or irritating and the patient is still conscious, vomiting should be induced immediately. If a finger down the throat does not do the trick, an emetic (a chemical that causes vomiting) should be used.
Kids are people too. Unfortunately, they are at the mercy of parents, doctors, and drug companies that are not responsive to their special problems. Although little is known about the way in which medications affect children, hardly anything is being done to correct the situation. While drug treatment can be of value, or even crucial, for many childhood illnesses, the casual use of potent chemicals for disorders that might respond to other techniques is to be condemned.
To be continued
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