By Oge Okafor ([email protected])
Toluwani, seven-year-old son of Mr and Mrs Omoladun started running temperature in the middle of the night. This wasn’t the first time. As usual, his mother reached for a bottle of paracetamol which subdued the fever. This continued until the mother noticed that life was sneaking out of Tolu and she was forced to rush him to the hospital. With prompt medical attention, he was brought back to life.
A common adage says that too much of everything is bad. Drug abuse, especially of the common paracetamol, need not be dangerous in adults but can lead to serious complications, including liver failure, in children.
A number of children have been admitted to the intensive care unit, not for treatment of the primary illness but for paracetamol poisoning. These kids come in with multi-organ failure and while most of them could be saved, some couldn’t because it’s too late.
An overdose occurs when a toxic (poisonous) amount of a drug or medicine is taken. Substances that can cause harm when too much is taken include alcohol, prescription and over-the-counter medications, illegal drugs and some herbal remedies.
An overdose is a medical emergency that requires immediate attention. If it is suspected, call for help or visit a medical professional.
One common thing we do in our clime is that once we notice our children with temperature, we rush to give them paracetamol to beat down the temperature, because the mother presumes it is a fever. According to Dr Gabriel Omonaiye, a family physician, there is something wrong with that tendency because, at times, it may be a major sickness that is involved like septicemia, meningitis or even malaria that could make the child run temperature. So, the fever (high temperature) is just a symptom of an underlying problem, a pathology of what is going on in the body.
So, paracetamol could give a temporary relief but could also cause a lot of delay in treating the primary illness and rushing the child to the hospital promptly for medical attention. Paracetamol gives the false impression that the child is okay (masking effect- preventing you from knowing what exactly is the cause of the fever) whereas there could be an underlying illness.
Furthermore, he says drug abuse is not just limited to paracetamol and that in some other instances, some mothers give their children antibiotics like ampiclox and anti-malaria routinely. It’s when the child is about dying or the sickness is getting worse that they rush to the hospital for medical help.
This is a dangerous thing to do. For instance, a child that was brought to the hospital was with anemic heart failure with low blood level meanwhile the mother kept administering drugs to the child by herself.
Paracetamol, also known as acetaminophen (often known by its brand name panadol) has long been a standard remedy for fever and pain in children. It’s effective and readily available without prescription.
In excess, however, even good things can be harmful. Here’s what you need to know about paracetamol overdose and children.
Two types of overdosing can occur namely accidental, when children drink up syrup because it’s tasty or they are being inquisitive/curious or the doses are taken by mistake in the wrong amount or at the wrong time without knowing that it could cause them harm. That is why parents/adults are warned to keep all medicines out of the reach of children.
The other type of overdose, which is as illustrated above, is commonly seen now- mothers with extreme anxiety or ignorance feed their children excess dosages of paracetamol in order to bring a fever down. This is intentional misuse.
A person’s tolerance to overdose varies with age, state of health, how the substance was consumed and other factors.
In children, paracetamol overdose can occur more easily than in adults. Doses are calibrated with body weight and in children, even a little extra may be too much. Parents sometimes do not check the dosage of the drugs they give their children as they are available in different values across different brands.
Omonaiye says oftentimes, most mothers give their children paracetamol when they are running temperature. But a high temperature could be a sign of an underlying illness which need to be treated. Taking paracetamol over a long period of time could cause kidney damage. Too much paracetamol overloads the liver’s ability to process the drug safely. An overdose can lead to life-threatening liver problems.
There is only a slight difference between the maximum daily dose of paracetamol and an overdose which can cause liver damage. Large amounts of paracetamol are very dangerous but the effects often don’t show until after two to three days after taking it. However, treatment must be started early to be effective before the effects begin.
Before you give your child paracetamol, consider whether he or she needs it. For example, a fever is a common sign of illness.
A wide range of symptoms can occur when a person overdoses and everyone responds differently. Symptoms depend on a variety of factors including which drug is taken, the amount taken and the person’s state of health at the time. Parents should look out for signs of paracetamol poisoning when a child is ill. Initially, there will be vomiting, maybe with some blood, the child will feel drowsy and will suffer liver damage within one to three days.
General symptoms of drug overdose may include nausea, vomiting, abdominal cramps, diarrhea, dizziness, loss of balance, seizures (fitting), drowsiness, confusion, breathing difficulties/not breathing, internal bleeding, hallucination, visual disturbances, snoring deeply, turning blue and coma.
The body often heals with or without treatment. However, death is a risk in some cases. This may be instant or may follow more slowly if organs are permanently damaged. Treatment for drug overdose may be short term or may be prolonged.
In order to avoid drug overdose:
-Always read medication labels carefully and take prescription medications only as directed. Keep all medications in their original packaging.
-Avoid drugs of any kind unless prescribed by a doctor.
-Always inform your doctor or other health professional of a previous overdose.
-Do not stockpile unnecessary drugs. Return them to the pharmacist if you no longer need them.
-Keep all drugs and poisons locked away in a safe, secure place and out of the reach of children.
-Be cautious when taking different drugs or substances (including alcohol) at or around the same time as they can interact negatively and increase the risk of overdose.