Amidst the pediatric drug shortages, doctors are advising parents to avoid giving their sick children expired medications, and to talk to trusted health professionals about how to manage the illnesses as well as their concerns.
They also stress that families should not buy medication to panic and realize that there are plenty of options to help children, such as stocking when there’s no sick person taking medication off the shelves for people who need it.
“When we noticed a shortage, there was clearly a growing concern from parents that they might not be able to access medications at pharmacies,” said Dr. Justin Cohen-Silver, a pediatrician with the Women and Child Health Program in St. Joseph Health Center and St. Michael’s Hospital in Toronto, told CTVNews.ca.
She explained that there are ways to alleviate these concerns including over-the-counter alternative medication options, adding that parents can follow advice on other means of managing fever symptoms in children and infants at home.
Cohen Silver does not recommend the use of expired medications and several doctors have spoken to CTV, where they said there is a lot of uncertainty about efficacy and personal safety.
Health Canada first confirmed in mid-August that there was a nationwide shortage of pediatric pain relief medications, which include children’s liquid Tylenol and acetaminophen chewable tablets.
According to Daniel Pace, chief pharmacy officer of the Canadian Pharmacists Guild, the shortages are caused by increased demand, similar to other demand-driven supply challenges that have affected the availability of other drugs and personal protective equipment throughout the pandemic.
“To our knowledge, production levels remain above normal, supply continues to come in sporadically, but demand is already outpacing it,” she told CTVNews.ca.
“There are a lot of viruses circulating in the community, it’s back in the school season,” she said.
This week, CTVNews.ca asked families to share their experiences with drug shortages and how to manage them. Dozens reached out to say they ran out of painkillers for their children and combed drugstores and online stores with no luck.
Many of them said their young children became ill within weeks of starting school or daycare, and it was alarming to leave them without easy access to marketed medications.
How to manage a fever and why expired medications are not recommended
Cohen said that with schools and nurseries returning to sessions without mandatory public health measures like wearing masks, and cold weather potentially meaning more spread of COVID-19 along with illnesses like the flu, families fear having to deal with illness without adequate treatment options. -silver.
When parents come to her for guidance on how to treat their child if they have a fever, Cohen Silver says she’s been giving some simple advice.
“In general, we think a fever is a good thing, it’s our bodies’ response to trying to help fight infection,” she said. She said there are options other than medication, including wearing lighter clothing, applying a cold cloth to the skin, and monitoring to see if pain relievers are necessary. She explained that if the child is still active and alert, painkillers may not be necessary, and consulting a doctor can help with the decision-making process.
I’ve also told families that there are options, including asking the pharmacist about over-the-counter and over-the-counter medications. She explained that, for example, a pharmacist could make versions of medicines that would be tolerated for children.
When it comes to using expired medications, Cohen Silver recommends not doing so, as it can be difficult to be sure what happens to medications after they expire.
Dr. Doug Campbell, deputy chief of pediatrics at St. Michael’s Hospital at Unity Health Network in Toronto, said doctors would never recommend expired medications to children because the drug’s efficacy could not be guaranteed.
He said he advises families about the types of medications to take and whether medications are necessary. “I try to talk to families ahead of time so they know why they need these kinds of medications, rather than just going out and buying them anytime,” he said.
“Many families go and use these medications probably when they don’t really need them, so it creates some anxiety,” he said. “She’s also working frankly with the pharmacist, because doctors need to work more closely with pharmacists to have better conversations…to see what products are available and if they can make a different formulation than what’s on the shelves,” he explained.
He said families should not stockpile medicines or buy pain relievers when their child is not sick. He added that if they had a sick child at home, it would be helpful to talk to their family doctor or pharmacist about medication options.
“You should keep those kinds of points in mind, rather than using expired medications or rather than rushing in in an emergency,” he said.
When it comes to fever, Campbell said that any temperature higher than 38 degrees in an infant three months old or younger needs to be evaluated “urgently by a doctor,” and would likely be a reason to go to the emergency department, he said.
For older children, if the fever is one-off and the child is active, awake and eating, Campbell said parents may be able to wait to see a family doctor or clinic doctor.
Pace says that community pharmacists are a “key resource and strongest ally when it comes to drug management.”
“This is an unfortunate situation, but we try to do our best to support families and caregivers, and to see that there is a reliable source of medication advice available to you in your community,” she said.
Health Canada recognizes supply barriers
In a statement to CTVNews.ca, Health Canada said companies continue to inform the agency that they face ongoing supply restrictions due to demand along with “supply chain issues.”
The supply of these products has been restricted since earlier this year with some products having intermittent outages. As supply remains limited locally, Health Canada is working closely with industry, provinces and territories as well as stakeholders across the supply chain to facilitate information sharing, assessment of supply status and identification of potential mitigation strategies.
The agency also said it does not recommend the use of expired medications as the expiration date is determined by multiple factors including the drug’s efficacy and stability. She recommends that parents and caregivers talk to health professionals to get alternative medication if needed.
Preparing for the fall of the disease
Dr Anna Banerjee, a pediatrician and infectious disease specialist at the hospital, said that COVID-19 is not over yet, and it would be best to encourage children to use masks during the period of increased spread of the virus, especially in school environments where ventilation may not be sufficient. Termerty College of Medicine and Dalla Lana School of Public Health at the University of Toronto.
Without the county tracking daily COVID-19 numbers and a lack of PCR testing, she said, it’s hard to know the levels of illness in the community. Banerjee recommends families focus on getting their booster and flu shots to help combat anxiety about illness, especially in the midst of a drug shortage.
She said that fever is not common among children when it comes to viral infections. “But if a child is very lethargic, or has trouble breathing, and is breathing rapidly, these are indications that he is dehydrated and should go to the emergency department,” she said.
“But most other viral infections will pass and are usually relatively mild,” she said.
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