ࡱ> monM(j( / 0DTimes New Roman2|d0|Wo 0DArialNew Roman2|d0|Wo 0 DWingdingsRoman2|d0|Wo 0 ` .  @n?" dd@  @@``  9~ !     !  "#  0e0e A@A5%8c8c     ?1d0u0@Ty2 NP'p<'p@A)BCD|E?@8'(uʚ;2Nʚ;g4?d?d0pppp@ <4!d!d 0,t3<4dddd 0,t3 bZ___PPT9<z(  ? %D4Medications & Their Side Effects in Children & Teens:Erin Dobbs, PharmD Walgreens Pharmacy Manager Johnston, IAOver-the-counter MedicationsPain relievers/analgesics Heartburn/reflux medications Cough & cold preparations Decongestants Antihistamines Cough suppressants/expectorants 2Q= Q>O-T-C Pain Relievers/analgesics"Tylenol (acetaminophen): used for pain/fever  should have little to no effect on behavior  maybe drowsiness if anything Advil/Motrin (ibuprofen), Aleve (naproxen): used for pain/inflammation /fever  should have little to no effect on behavior  may cause upset stomach@dmO-T-C Heartburn/reflux/diarrheaPepto Bismol (bismuth subsalicylate): avoid in aspirin allergy  no behavior effects Imodium (loperamide): treats diarrhea by slowing bowels  may cause drowsiness Zantac (ranitidine), Tagamet (cimetadine): reduce acid production  no behavioral effect Prilosec OTC (omeprazole): blocks acid production  no behavioral effectfJZ$2<11O-T-C DecongestantsSudafed (pseudoephedrine): used for relieving sinus & ear pressure  can cause hyperactivity because classified as a stimulant Sudafed PE (phenylepherine): also relieves sinus & ear pressure  fewer side effects.g;O-T-C AntihistaminesBenadryl (diphenhydramine): relieve allergy symptoms (runny nose, sneezing, itchy, watery eyes)  drowsiness is number one side effect (paradoxical in young children), dry mouth, dry eyes Chlor-Trimeton (chlorpheniramine), Tavist (clemastine fumarate), Claritin/Alavert (loratidine): less drowsiness than diphenhydramine Zyrtec (cetirizine): some drowsinessxi!( O-T-C Cough Suppressants~Delsym (dextromethoraphan): stops cough  can cause drowsiness@& O-T-C ExpectorantsRobitussin/Mucinex (guaifenesin): helps to produce cough to clear chest congestion  little to no side effects expectedy Y  O-T-C CombinationsCombination products with two or more medications are likely to have additive effects based on their ingredients  sometimes the effects can be canceled by each other (decongestant vs. antihistamine = no hyperactivity or drowsiness) Prescription MedicationsjStimulants Antidepressants Pain relievers Muscle Relaxers Asthma Blood pressure (used in ADD/ADHD) Allergy aSleep aids Epilepsy Antipsychotics Antibiotics Antianxiety Corticosteroids Hormones AntidiabeticsT   Prescription StimulantsRitalin/Concerta/Metadate/Methylin/Focalin/Focalin XR (metylphenidate preps.), Adderall/Adderall XR/Dexedrine/Dextrostat (amphetamine preps.): used to treat ADD/ADHD  should cause child to focus  could cause jitteriness, agitation, nervousness, loss of appetiteXy##>y# Prescription AntidepressantsProzac (fluoxetine), Paxil (paroxetine), Wellbutrin (bupropion), Effexor (venlafaxine), Celexa (citalopram), Lexapro (escitalopram), Zoloft (sertraline), Remeron (mirtazapine), used to treat depression/bi-polar (never alone = mania) cause flat affect (no highs or lows), nausea, headache, anxiety, nervousness, agitation, jitteriness, dry mouth, constipation, diarrhea, drowsiness, insomnia -Z Prescription Antidepressants& !!5Elavil (amitriptyline), Pamelor (nortriptyline), Norpramin (desipramine), Tofranil (imipramine), Desyrel (trazodone): usually used for anxiety or insomnia either alone or due to side effect of other antidepressant cause dry mouth, drowsiness, constipation, trouble urinating, blurred vision, impaired thinkingv Prescription Pain RelieversVicodin/Lortab/Norco (hydrocodone/acetaminophen): Darvocet (propoxyphene/acetaminophen): drowsiness, nausea, constipation Motrin (ibuprofen), Naprosyn/Anaprox (naproxen), Relafen (nabumetone): may cause stomach upsetY!G0%!#Prescription Muscle Relaxers<Flexeril (cyclobenzaprine), Skelaxin (metaxalone), Robaxin (methocarbamol): relax muscles/ease muscle spasms  not specific to painful muscle cause drowsinessTLSSl    VPrescription Asthma Medications,Proair/Proventil/Ventolin (albuterol): helps to open up lungs for easier breathing  may cause jitteriness, nervousness Singulair (montulekast): works on asthma/allergy pathway to block chemical that leads to inflammation  aids in breathing  should have no affect on behavior.%S8Prescription Blood Pressure Medications Used in ADD/ADHD9"Catapres (clonidine), Tenex (guanfacine): not FDA approved but widely accepted help with hyperactivity but probably not distractibility may cause drowsiness, dry mouth, decreased blood pressure/heart rateB* Prescription Allergy MedicationsAllegra (fexofenadine): - antihistamine less drowsiness than diphenhydramine Flonase (fluticasone), Nasonex (mometasone), Nasacort (triamcinolone): steroid nasal sprays used to treat inflammation may lead to nose bleeds)%GH%HPrescription Sleep AidsAmbien/Ambien CR (zolpidem), Lunesta (eszopiclone): help to fall asleep/stay asleep  may experience  hang-over effect if not given at least 8 hours to sleep Rozerem (ramelteon): used to help fall asleep  not much known yet  patient may be drowsy, nauseous, or have headache These medications are generally not used in children.BNZn!Prescription Epilepsy Medications""":Tegretol (carbamazepine), Trileptal (oxcarbamazepine), Lamictal (lamotrigine), Topamax (topiramate), Depakote (valproic acid), Dilantin (phenytoin), Neurontin (gabapentin), Gabitril (tiagabine): used to control seizures  most common side effect among all antiepileptics is drowsiness]Prescription Antipsychotics$atypicals are more commonly seen today Risperdal (risperidone), Seroquel (quetiapine), Zyprexa (olanzapine), Abilify (aripiprazole), Geodon (ziprasidone), Invega (paliperidone): used in bi-polar disorder and other psychotic disorders  many other uses and many side effects~'c  Prescription Antibioticsfrom Amoxil (amoxicillin) to Zithromax (azithromycin): too many to list  used for anything from infections to acne to preventative for dental work side effects most commonly include nausea and diarrhea, but may range as far as vivid dreams6P   Prescription AnxiolyticsAtivan (lorazepam), Klonopin (clonazepam), Valium (diazepam), Xanax (alprazolam): used to treat anxiety, also commonly used for sleep most common side effect is drowsinessfRZZPrescription Corticosteroids*prednisone, dexamethasone, prednisolone: used to treat inflammation in the body, due to injury, asthma, or illness cause stomach to produce acid leading to stomach upset as number one side effect, can also cause insomnia, frequent urination prolonged use can affect immune system, cause weight gainT)   Prescription Hormonesfemale hormones include birth control pills (too many to list) and hormone replacement (not commonly seen in children) used for acne, to regulate menstruation, & as birth control cause periods to become more regular and less severe and stop ovulation can cause stomach upset, promiscuity&ww8Prescription Hormones Cont dmale hormones include testosterone or anabolic steroids used as hormone replacement, but more commonly as performance enhancers side effects include agitation, acne, and the body stops producing its own testosterone&88 !Prescription Diabetic Medications"""insulins including Humulins, Humalogs, Novolins, Novologs, Lantus, Apidra, are, for now the most common diabetic medications seen in children used to treat insulin dependent diabetes mellitus (IDDM) also called Type 1 diabetes if too much insulin is present, child may go in to shock or become disoriented  treat with glucose, juice, sugar, etc.ZZFT!!Prescription Diabetic Medications"""Glucophage (metformin), Diabeta (glyburide), Glucotrol (glipizide): not commonly seen in children used to treat non-insulin dependent diabetes mellitus (NIDDM) or Type 2 diabetes metformin causes upset stomach, diarrhea glyburide & glipizide can cause hypoglycemia if patients don t eat after taking  treat once again with glucose, juice, sugar, etc. many others  not generally used in childrenbc+!+"Conclusion/Questions(brief overview  not complete list of all medications didn t go into illicit drugs  you probably have more training than I do If you ever have any questions about a child s medications, please feel free to call us at Walgreens in Johnston 331-0497. 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