It is most important to be informed about the pain medicines your child is taking and to follow the instructions for administering them. If there is something you do not understand about the medications your child is taking, be sure to ask a health care professional. The following is a list of things you should know about each of the medications your child is taking:
Reason for taking the drug: For example, it will relieve pain. Name and type of drug: For example, you should know that your child is taking Tylenol, which is acetaminophen, and that it is a pain-relieving medicine. Dosage and frequency: For example, you should know that your child should be taking two pills every six hours and that the dosage should never exceed eight pills per day.
Route of administration: Taking medicines by mouth is the preferred route; however, there are other ways to take medicines, including by injection or as a suppository. Most medicines for children are available in liquid form, but your child may have to learn how to swallow pills in order to take the pain medicine. If the medicine your child has been prescribed is only available in pill form and your child has not yet learned to swallow pills, you should find out about other options. Some pills can be crushed or dissolved and given to the child in a small glass of water. However, please check with a health care professional before doing this. It is recommended that many medications be taken with food or milk. Others should be taken on an empty stomach. Find out the specifics of how to take and how not to take the medicine your child has been prescribed. Side effects and how to manage them: For example, if your child is taking an opioid mediciine such as morphine, you should know that constipation is a common side effect. You should also know that a change in diet to include more fluid, fruit, and fibre might act to counter this side effect and make your child’s digestive system more regular. Contraindications or reasons not to take the medicine: For example, some pain-relieving medicines such as NSAIDs can cause bleeding problems. If your child is about to go the hospital for surgery, you should check with your health care professional as to whether your child should continue to take existing medications or switch to another pain-relieving medicine.
Adherence or maintaining the medication schedule
Your child should not stop taking pain medicines suddenly without medical advice. This is because the body may react to not having the medicine any more. Please check with your health care professional before stopping any medicine.
You should make sure that you do not run out of the prescribed medicines. Make sure you are given the necessary prescriptions at each visit to, or following telephone discussions with, the health care team.
You should work with only one doctor in obtaining prescriptions for your child’s medicines. It is possible to get confused when too many doctors are involved in trying to manage your child’s pain. You are certainly entitled to a second opinion. But, if you choose to go to another doctor, it is important to take a list of medicines prescribed or the medicine containers with you.
Using multiple medications
Your child may need to take several different medications at the same time. If this is the case, you should take steps to ensure that no one gets confused about the pattern of taking them. The instructions regarding dosage and timing of the medication should be clearly labelled. With multiple medicines, some parents find weekly or daily pill containers helpful. One specific person should always fill these containers so that the risk of error is reduced, even if someone else is giving the child the medication.
Breakthrough pain
Your child may require constant pain medicine to control her pain. However, there may be times when she experiences more pain, or when the pain "breaks through" her otherwise controlled pain and becomes more intense. This extra pain may happen when, for example, she moves or coughs. If this source of pain is not treated, your child may refuse to move or cough because she knows that the pain will get worse. Your child’s doctor will order a "breakthrough" dose of her medicine which can be taken by mouth (pill or liquid) or given intravenously. This often consists of an additional but smaller dose of the same medicine your child is already using. It is important to encourage your child to use the extra dose if she needs it. She should be told not to hold out or wait until the pain gets worse because then the pain may be more difficult to bring under control.
Your health care professional may ask you to record how many "breakthrough" doses your child uses in each 24 hour period. Sometimes, the need for the extra doses means that the overall amount of medicine is not enough to control the pain and that her dosage may need to be changed.