MONDAY, Aug. 27, 2018 (HealthDay News) — Everyone worries about drug abuse among children, but a hidden danger for some kids rests in prescription medicines intended to help them, a new study warns.
Some children and teenagers who are prescribed multiple medications are at risk of drug interactions that could literally stop their heart, according to the report.
“We found that about 1 in 12 kids using two or more medications together were potentially at risk for a major drug interaction,” said lead researcher Dima Qato, an assistant professor with the University of Illinois at Chicago’s College of Pharmacy.
Most of the potential drug interactions detected in the study can create dangerous heart rhythms called arrhythmias, which might lead to sudden cardiac death, Qato explained.
Teenage girls were most at risk for these interactions, which most often involved the combination of a long-term antidepressant and a shorter-term medication like a nonopioid pain reliever, an antibiotic or an anti-nausea drug, Qato said.
She noted that the problem is probably even larger than observed in the study, since the researchers relied on data regarding prescription medication use.
“We actually likely underestimate the prevalence of this problem because it’s limited to prescription drugs. Many short-term medications like naproxen [such as Aleve] are available over the counter,” Qato said.
For the study, researchers reviewed federal survey data regarding prescription medication use by more than 23,000 children aged 19 and younger.
The investigators found that nearly 1 in 5 kids uses prescription medications. The use of prescription medications was highest among teen girls (28 percent), and boys aged 6 to 12 (26.5 percent).
The most commonly prescribed drugs were asthma medications, antidepressants and stimulants used to treat attention deficit hyperactivity disorder (ADHD).
About 7.5 percent of kids reported using two or more prescription medications at the same time.
Qato and her colleagues then referred to a prescription drug database to check whether the medications prescribed to kids could potentially create dangerous drug interactions.
About 8 percent of kids taking multiple prescription medications are at risk for a dangerous drug interaction, the researchers concluded.
Teenage girls were nearly three times as likely as boys to be taking a dangerous combination of drugs, 18 percent versus less than 7 percent.
The difference was largely due to the use of antidepressants in combination with prescription NSAIDs, anti-nausea drugs and asthma medication, researchers found.
Most dangerous interactions could cause fast and chaotic heart rhythms that might trigger fainting spells or seizures, Qato said. In the worst cases, these rhythms could cause the heart to stop beating altogether.
The findings were published online Aug. 27 in the journal Pediatrics.
“Extrapolating these data to the population at large, the message is that nearly 1 of every 100 children in the U.S. is potentially exposed to dangerous combinations of prescription drugs,” said Dr. David Katz, director of the Yale University Prevention Research Center in New Haven, Conn. He was not involved with the study.
It can be tough to get a handle on the short-term and long-term medications a kid has been prescribed, Qato added.
“The way these kids use health care, they often go to retail clinics sometimes or emergency rooms. Their primary care doctor may not be aware of all the medications they’re on, particularly if they’re on them for a week or two,” Qato said.
Katz said that better systems are needed to track kids’ prescriptions and check them for potential drug interactions.
“But the bigger problem is almost certainly our highly medicalized culture, and use of medication when other options are preferable,” Katz continued. “As the opioid crisis so vividly indicates, our society relies routinely on potentially dangerous drugs for many conditions — mental and physical — better treated by other means.”
Expanded use of EKG and heart health screening among school-age kids also could help, “especially with asthmatics and athletes who are more vulnerable to sudden cardiac death,” Qato said. “We want to make sure drugs are not increasing that risk, particularly drug combinations.”
The American Heart Association has more about abnormal heart rhythms in children.
TUESDAY, May 15, 2018 (HealthDay News) — American kids are taking fewer prescription medications these days — but certain drugs are being prescribed more than ever, a new government study finds.
Researchers found that between 1999 and 2014, the percentage of children and teenagers who’d been given a prescription in the past 30 days dipped — from almost 25 percent, to just under 22 percent.
But the trends varied, based on the type of drug. Prescriptions for antibiotics, antihistamines and cold medicines fell, while a growing number of kids received prescriptions for asthma, heartburn and attention deficit hyperactivity disorder (ADHD).
Experts said it’s hard to tell from the figures alone whether the patterns are positive or negative.
But in at least one case, the shift might reflect improved treatment, said Dr. Gary Freed, a professor of pediatrics at the University of Michigan.
He pointed to antibiotics prescriptions, which fell by close to one-half. During the study period, health experts increasingly warned of inappropriate antibiotic use — for viral infections like colds, for instance — and the growing problem of antibiotic resistance.
“So the trend in antibiotic prescriptions is probably a good thing,” said Freed, who wrote an editorial accompanying the study. Both were published May 15 in the Journal of the American Medical Association.
Lead study researcher Dr. Craig Hales agreed.
“In the case of antibiotics, there was a campaign to reduce inappropriate use,” said Hales, a medical epidemiologist with the U.S. Centers for Disease Control and Prevention.
Most other changes, though, are hard to interpret, both Hales and Freed said.
For example, the drop in prescriptions for antihistamines and cold-and-cough remedies looks good on the surface. Past studies had shown that those drugs were being overused, and guidelines now say that kids younger than 18 should not take cold medications containing the ingredient codeine.
But, Hales’ team said, since 1999 some of those medications have become available over-the-counter — and it’s not clear how many kids are using those.
Freed made the same point. “All we know is, fewer prescriptions are being written. We don’t know if over-the-counter use has increased.”
Similarly, the increases in certain prescriptions are difficult to decipher.
By 2014, more kids aged 6 to 11 had prescriptions for ADHD medications, compared to 12 to 15 years earlier. Specifically, prescriptions for amphetamines, such as Adderall, nearly doubled: Just over 2 percent of 6- to 11-year-olds had a prescription for those drugs in recent years.
“On one hand, you could say, ‘That’s concerning,'” Freed said. “On the other, maybe we’re getting better at diagnosing ADHD and treating appropriately.
“The bottom line,” he said, “is that these findings are interesting, but not conclusive.”
The study results are based on more than 38,000 children and teens whose families took part in an ongoing government health study.
Overall, the percentage of kids who’d taken a prescription medication in the past month dipped between the first survey — done between 1999 and 2002 — and the most recent one (done between 2011 and 2014).
However, prescriptions for eight medication types rose.
They included contraceptives: Just under 9 percent of teenage girls had a prescription in recent years — up from less than 5 percent in 1999-2002. Similarly, the percentage of kids with asthma drug prescriptions rose from roughly 4 percent to just over 6 percent.
But it’s not clear, Freed said, whether that means asthma diagnosis and treatment has improved.
Hales agreed. “We do know there was an increase in asthma prevalence during the study period,” he said, and that could be a factor in the upward shift.
More research, Hales said, is needed to dig into the reasons for the changes seen in this study.
But regardless of national prescribing patterns, Hales said, treatment decisions for any child have to be individualized.
Freed agreed. “It has to be a one-on-one discussion between parents and their health care provider,” he said.
The U.S. National Library of Medicine has more on children and medications.
MONDAY, Dec. 4, 2017 (HealthDay News) — Pairing medication with an ingestible sensor can help clinicians track how often and when patients actually take their prescription drugs, according to a small new investigational study.
The findings come on the heels of the U.S. Food and Drug Administration’s decision last month to approve the first digital pill for use with the antipsychotic drug Abilify, often prescribed to treat schizophrenia, bipolar disorder and depression.
The new research involved just 15 patients, all of whom had been prescribed the opioid pain drug oxycodone (OxyContin) after sustaining a fracture.
However, the study participants were given a special configuration of oxycodone. The pain med was packaged together with a so-called “digital pill.” This meant that each time a patient took the pain med, they ingested a gelatin capsule that contained the oxycodone as well as a radiofrequency emitter.
The emitter was automatically activated when the capsule was swallowed. It sent signals to a sticky patch placed on the person’s abdomen. That, in turn, conveyed basic pill-taking information to an iPod-sized reader.
The system enabled researchers to track how many pills the 15 patients actually took, rather than the number of pills they’d been given.
On average, the patients took just six pills total — even though they had been provided a supply of 21 pills, according to the report.
“As an investigational tool, the digital pill provides a direct measure of opioid ingestion and changes in medication-taking behavior,” senior author Dr. Edward Boyer said in a news release from Brigham and Women’s Hospital in Boston.
“This technology may also make it possible for physicians to monitor adherence, identify escalating opioid use patterns that may suggest the development of tolerance or addiction, and intervene for a specific medical condition or patient population,” he added.
Boyer is with the medical toxicology division within the hospital’s department of emergency medicine.
Boyer and his colleagues published their findings in the December issue of the journal Anesthesia & Analgesia.
The U.S. Food and Drug Administration has more on digital pills.