World Health Organization: Consequences of the current status of the use of medicines in children (environmental aspects)
The consequences of the current status of the use of medicines in children include the following:
- Wrong dosage causes short-term toxicity or treatment failure.
- Non-availability of appropriate paediatric formulations forces health care providers to resort to administering crushed tablets, dissolving tablets in solvents or administering the powder contained inside the capsule. Consequently, these formulations are administered without any data regarding their bio-availability, efficacy and toxicity.
- Formulations of strengths suitable for administration to neonates, infants and young children are not always available. Adult formulations therefore need to be diluted or administered in miniscule volumes over a period of time. This leads to administration errors (intravenous drips running fast, errors in dosage calculation and dilution), especially in circumstances that require urgent action (as in emergency units, premature units and paediatric and neonatal intensive care units).
- Inappropriate packages and lack of awareness among parents and caregivers about the methods to be used for prevention of injuries, accidents and poisoning lead to accidental poisoning in infants and small children.
- Medicines can interact with traditional and herbal medicines.
- Medicines may have long-term safety problems. For example, etanercept may increase susceptibility to tuberculosis, or long-term use of inhaled corticosteroids in early infancy may increase the risk of growth retardation and/or osteoporosis.
- In public health programmes in resource-poor countries, co-morbidity or malnutrition may exacerbate the toxicity. Dehydration is frequently associated with ibuprofen-induced renal failure and malnutrition with paracetamol hepatotoxicity.