Ask a CHOC Doc: Where Should I Store My Child’s Medications?

Question: Where should I store my child’s medications?  –Anonymous

Answer:

Contrary to its name, a medicine cabinet in the bathroom is not the best place to store medications. This is because the steam from showers can change the properties of the medication and it may lose some of its effectiveness. Storing medications in a cabinet near the stove is not ideal for the same reason. All medications should be stored in a cool, dry place away from light. Medications should be stored up and away out of reach of children. If possible, they should be stored in a locked cabinet.

Some medications require refrigeration. The bottle should say “refrigerate” on it. Liquid Augmentin® is a medication that must be kept in the refrigerator. Some medications, like liquid amoxicillin, don’t need to be refrigerated, but taste better if you refrigerate them. Others, like liquid azithromycin for bacterial infections, should not be refrigerated because it can get too thick and your child likely won’t want to take it.

-Whitney Pittman, clinical pharmacy resident at CHOC Children’s

whitney-pittman-choc-childrens-pharmacy-resident
Whitney Pittman, clinical pharmacy resident at CHOC Children’s

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Ask a CHOC Doc: How Important Is It To Finish An Entire Course of Antibiotics?

Question: Is it really that important for my child to finish their entire prescription of antibiotics?  -Anonymous

Answer:

Yes! Even if your child is feeling better, they should still finish the full course of their prescription as directed by their doctor. Even if, for example, they feel better on day five and their prescription is for 10 days of antibiotics, they need to finish the entire course as prescribed because the bacterial infection might still be present. To really beat the bacterial infection, it is important for your child to finish their entire course. Stopping short could cause your child to get sick again. If your child is experiencing a side effect, contact your pharmacist or pediatrician for more information on how to manage the side effect, such as taking the medication with food to help ease an upset stomach. If your child is having a side effect that they can’t tolerate or an allergic reaction, contact your child’s doctor immediately.

If the pharmacy gave you a full bottle of a liquid antibiotic, you might still have medication left in the bottle. If this is the case, you should always properly dispose of old medicine. It is not a good idea to keep the medication in the refrigerator or cabinet for the next time your child gets sick. Medications expire and they might not work properly or may cause your child to have an unexpected side effect. There is also the possibility that someone might accidentally take the medication.

-Whitney Pittman, clinical pharmacy resident at CHOC Children’s

whitney-pittman-choc-childrens-pharmacy-resident
Whitney Pittman, clinical pharmacy resident at CHOC Children’s

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Ask a CHOC Doc: How Can I Properly Dispose of Old Prescriptions?

Question: How can I safely dispose of old prescriptions my  family doesn’t need to take anymore? -Anonymous

Answer:

Expired or unused medications should be removed from the home as quickly as possible to help reduce the chance that someone may accidentally take them. There are several ways to get rid of old prescriptions.

  • Medicine take-back options – this is the preferred way to safely dispose of most types of unneeded medications. The US Drug Enforcement Administration (DEA) periodically hosts National Prescription Drug Take-Back events where temporary collection sites are set up in communities for safe disposal of prescription medications. Another option is to drop your medications off in a drop-box at a DEA-registered collector, which safely and securely collects and disposes of medications. For more information, visit National Prescription Drug Take-Back Day or DEA-registered collector to find an event or collection site near you.
  • Disposal in the household trash – If there are no specific instructions in the package insert, you can follow these simple steps to dispose of most medicines in the trash.
    • Pour unwanted or expired medications out of their original containers into a zip baggie.
    • Pour hot water (over 110OF – about as hot as a cup of coffee) into the baggie.
    • Insert kitty litter or another inedible product such as dirt or used coffee grounds into the baggie. Seal baggie. Place in trash bin.
    • Remove all personal information on the prescription label or empty pill bottles. Shred them or use a black marker to cross out label information.
  • Don’t throw unused or expired medications down the drain or toilet.

-Whitney Pittman, clinical pharmacy resident at CHOC Children’s

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Whitney Pittman, clinical pharmacy resident at CHOC Children’s

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Ask a CHOC Doc: Is it OK to Cut Pills, or Crush Them into Foods?

Question:

Is it OK to cut pills in half, or crush them to mix into my child’s foods? -Anonymous

Answer:

Yes and no. Some medications can be cut or crushed, but some should be given whole. This is due to specific formulations of medications and how they work in the body. Most of the no-crush medications are sustained release, extended release, or enteric coated. The reason these medications can’t be crushed or chewed is because the tablet is formulated to release a specific amount of medication over a certain time period. Cutting or crushing the tablet usually results in the medication not being released into the body properly. Some medications shouldn’t be crushed or chewed because they have an unpleasant taste.

If you feel like your child won’t be able to swallow their medication whole, ask the pharmacist if it can be chewed or cut, or talk to your child’s doctor about prescribing a liquid formulation.

-Whitney Pittman, clinical pharmacy resident at CHOC Children’s

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Whitney Pittman, clinical pharmacy resident at CHOC Children’s
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What is a Clinical Trial?

Children with life-threatening conditions are often candidates for clinical trials. If your child has a serious illness, your doctor might talk to you about enrolling your child in a clinical trial.

Carefully conducted clinical trials are performed in human participants to provide answers to questions such as:

  • Does a treatment work?
  • Does it work better than the standard existing therapy?
  • Does it have side effects?

“Through clinical trials, doctors find new ways to improve treatments and the quality of life for people with disease. They also give children with rare or difficult-to-treat conditions, such as certain forms of cancer, access to innovative treatments,” says Dr. Van Huynh, a pediatric oncologist at the Hyundai Cancer Institute at CHOC Children’s, and the CHOC principal investigator for the Therapeutic Advances in Childhood Leukemia/Lymphoma Consortium, a group of children’s hospitals and universities that work to quickly develop and carry out clinical trials. The consortium develops phase I and phase II clinical trials of new therapies and novel therapy combinations in recurrent childhood leukemia and lymphoma.

dr-van-huynh-choc-childrens-pediatric-oncologist
Dr. Van Huynh, a pediatric oncologist at CHOC Children’s.

Clinical trials are standard practice in cancer treatment for children, adolescents and young adults. In fact, a higher percentage of newly diagnosed children with cancer and their families participate in clinical trials, perhaps more than in any other field of medicine, according to Dr. Huyhn. All clinical trials are voluntary and information collected is confidential. Participants can withdraw from a trial at any time, for any reason.

“Some clinical trials evaluate how well new medications work and whether they are safe to use. Other clinical trials explore whether we can use medications in new combinations or at different doses to improve survival or reduce short-term side effects,” says Winnie Stockton, investigational pharmacist at CHOC Children’s. “There are trials that focus on finding the best ways to minimize long-term side effects of certain treatments, and other trials that aim to determine the best dose to give children for medications that have successfully treated cancer in adults.”

winnie-stockton-choc-childrens-investigational-pharmacist
Winnie Stockton, an investigational pharmacist at CHOC Children’s

Types of Clinical Trials

Clinical trials are categorized as Phase I to IV trials.

Phase I

Studies of a new drug are the first that involve people. Participants in these trials are usually the first to receive the new therapy. The drug is tested to evaluate the dosages of the treatment and how often the treatment can be administered. Drugs are given at gradually increasing dosages, and participants are monitored closely for side effects. The goal of a Phase I clinical trial is to find the dose that is best tolerated without causing severe side effects.

Phase II

Once a treatment is found to be safe in a Phase I clinical trial, it is then tested in a Phase II trial to determine if it works. The treatment targets the patients who responded most favorably in Phase I trials. In these trials, doctors may evaluate if the treatment works for a specific type of cancer or illness.

Phase III

Once a new therapy has been determined to be safe and effective, it is then moved to a Phase III clinical trial. These are the studies that most children with newly diagnosed illnesses or cancers will receive. These trials test whether the new therapy is better than the standard treatment.

Phase IV (also known as Post-Marketing Surveillance Trials)

Phase IV studies take place after the drug has received regulatory approval (market authorization) and are designed to provide broader effectiveness and safety information about the new medicine in large numbers of patients, and to compare or combine it with other available treatments. These studies are designed to evaluate the long-term effects of the drug.

When you take part in a clinical trial, you will only be in that one phase of the study. Treatments move through the phases, but patients do not.

“At CHOC, we believe it’s important to conduct research directly with children and adolescents in a facility that is devoted exclusively to the care, quality of life, rights and safety of children of all ages. If a parent is interested in having their child participate in a clinical trial, we currently have over 350 research studies in more than 30 specialties to provide children with the latest treatments,” says Dr. Huynh.

Learn more about research at CHOC

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