(CNN) -- If the kids become too much to handle, slip 'em a little cold medicine. It's an often-repeated joke -- or advice -- that parents share on the playground or on Twitter and Facebook pages. One mom, Jill Smokler, said she doesn't vilify parents who medicate their kids: "It's not the end of the world." "It's certainly better than being pushed to edge, spanking a child or slamming doors or really losing it," she said. But drugging children with over-the-counter or prescription medications can have unintended consequences, said the author of a research published Thursday, who likened the practice to child abuse. The research, published in the Journal of Pediatrics, found an average 160 annual cases in which pharmaceutical drugs were maliciously used on children. "We believe the malicious use of pharmaceuticals may be an under-recognized form and/or component of child maltreatment," wrote the author, Dr. Using information from the National Poison Data System, Yin found that children were most commonly receiving analgesics, stimulants/street drugs, sedatives, hypnotics, antipsychotics and cough or cold medications. Of those, 14 percent resulted in injuries, and 18 children died. More than half of the cases involved at least one sedating drug; 17 of the 18 deaths included sedatives. Intravenous fentanyl is often used for anaesthesia and analgesia. During anaesthesia it is often used along with a hypnotic agent like propofol. It is also administered in combination with a benzodiazepine, such as midazolam, to produce sedation for procedures such as endoscopy, cardiac catheterization, and oral surgery, or in emergency rooms. Fentanyl is sometimes given intrathecally as part of spinal anaesthesia or epidurally for epidural anaesthesia and analgesia. Because of fentanyl's high lipid solubility, its effects are more localized than morphine, and some clinicians prefer to use morphine to get a wider spread of analgesia. Rate of absorption is dependent on a number of factors. Body temperature, skin type, amount of body fat, and placement of the patch can have major effects.
PO administration: 0.1-0.3 mg q4-6hr; increase by 0.1 mg/day to 0.15-0.75 mg/day if required; do not exceed 2.4 mg/day TD administration: 100-200 mcg/day patch q7Days; initiate 0.1-0.3 mg PO q4-6hr for first 2 days to allow for adequate drug levels Not recommended as routine treatment for hypertension (Beers criteria) Potential for orthostatic hypotension and adverse CNS effects May cause bradycardia Immediate release: Lower initial doses than for nongeriatric adult dosing, as well as gradual adjustments, are recommended Extended release: May require lower initial dose than for nongeriatric adult dosing Skin reactions; patch (15-50%) Dry mouth (40%) Somnolence (19-38%) Headache (19-29%) Fatigue (13-24%) Drowsiness (33%) Dizziness (13-16%) Hypotension, epidural (45%) Postural hypotension, epidural (32%) Anxiety (11%) Epidural clonidine is not recommended for obstetric postpartum or perioperative pain management because the risk of hemodynamic instability (eg, hypotension, bradycardia) may be unacceptable in this population Dilute product with strength of 500 mcg/m L prior to use Epidural: Hemodynamically unstable patients (risk of severe hypotension) Do not discontinue suddenly (risk of rebound hypertension) Patch: May need to remove if severe erythema and/or localized vesicle formation develop at application site or generalized rash; consult physician Severe coronary insufficiency May cause xerostomia Recent MI Cerebrovascular disease Chronic renal failure Raynaud's disease Thromboangiitis obliterans History of depression (may exacerbate depression in cancer patients) May impair ability to perform hazardous tasks Remove patch before MRI (may cause burns) Hypotension may occur; usually responsive to IV fluids and, if necessary, appropriate parenterally administered pressor agents Cardiac conduction abnormalities: Sympatholytic action may worsen sinus node dysfunction and atrioventricular (AV) block, especially if coadministered with other sympatholytic drugs Titrate slowly and monitor vital signs frequently in patients at risk for hypotension, heart block, bradycardia, syncope, cardiovascular disease, vascular disease, cerebrovascular disease or chronic renal failure; measure heart rate and blood pressure prior to initiation of therapy, following dose increases, and periodically while on therapy; avoid concomitant use of drugs with additive effects unless clinically indicated; advise patients to avoid becoming dehydrated or overheated Epidural administration may result in mild respiratory depression (usually with higher than recommended dose) Use with caution in cerebrovascular disease Avoid as first line antihypertensive in the elderly due to high risk for adverse side effects Children may be particularly susceptible to hypertensive episodes when experiencing GI illnesses that lead to vomiting Discontinue oral immediate release formulations within 4 hr of surgery; restart as soon as possible following surgery Due to different pharmacokinetic profiles, oral formulations are not interchangeable with extended release on a mg-mg basis due to different pharmacokinetic profiles Central sympatholytic via stimulation of central alpha receptors; results in reduced sympathetic outflow, causing decreased PVR, HR, BP, and renal vascular resistance; produces presynaptic and postjunctional alpha-2 adrenoreceptor analgesia by preventing pain signal transmission to brain Postsynaptic alpha2-agonist stimulation may regulate subcortical activity in the prefrontal cortex, which may regulate the area of the brain responsible for attention, emotions, and behaviors, and thereby reduces hyperactivity, distractibility, and impulsiveness The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. Commonly reported side effects of clonidine include: drowsiness, fatigue, hypotension, lethargy, sedated state, headache, and upper abdominal pain. See below for a comprehensive list of adverse effects. Applies to clonidine: oral tablet, oral tablet extended release Other dosage forms: Along with its needed effects, clonidine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur while taking clonidine: Some side effects of clonidine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. "UK Summary of Product Characteristics." O 0Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: Applies to clonidine: compounding powder, injectable solution, oral suspension extended release, oral tablet, oral tablet extended release, transdermal film extended release Very common (10% or more): Hypotension (45%), orthostatic hypotension (32%) Common (1% to 10%): Chest pain, tachycardia Uncommon (0.1% to 1%): Sinus bradycardia, Raynaud's phenomenon, palpitations Rare (0.01% to 0.1%): Atrioventricular block, palpitations, bradycardia, syncope, congestive heart failure, electrocardiographic abnormalities (i.e., sinus node arrest, high degree AV block), cerebrovascular accident Frequency not reported: Bradyarrhythmia, hypertension, rebound hypertension Very common (10% or more): Contact dermatitis with the patch formulation (19%) Common (1% to 10%): Sweating Uncommon (0.1% to 1%): Pruritus, rash (localized or generalized), urticaria, erythema Rare (0.01% to 0.1%): Alopecia, excoriation, burning Very rare (less than 0.01%): Papules, throbbing, blanching, generalized macular rash, facial/tongue angioedema Frequency not reported: Hives, localized hypo or hyper pigmentation Very common (10% or more): Dry mouth (40%), upper abdominal pain (15%), nausea (13%), vomiting (10%) Common (1% to 10%): Constipation, parotid gland pain Uncommon (0.1% to 1%): Colonic pseudo-obstruction Very rare (less than 0.01%): Parotitis Most adverse effects are mild and diminish with continued therapy.
Fentanyl also spelled fentanil is an opioid used as a pain medication and together with other medications for anesthesia.2 Fentanyl is also made illegally and used as a recreational drug, often mixed with heroin or cocaine.4 It has a rapid onset and effects generally last less than two hours.2 Medically, fentanyl is used by injection. ADHDMedCalc” makes no claims as to the accuracy of the information contained herein. The user acknowledges and agrees that this Site and its ADHD medication calculator/converter will be used only as a reference aid, and that the information contained in the product is not intended to be nor should it be used as a substitute for the exercise of professional judgment.