Tragedy's lesson: Adult medicines are not for kids

GINA SALAMONE

One reckless mistake was all it took to end the short life of a smiley 6-year-old East Harlem girl.

When Taylor Webster complained of a headache on Saturday, her foster mother, Joanne Alvarez, gave her children's-strength Motrin and then stuck a prescription fentanyl patch on her neck just before midnight.

The patch packs enough medication to relieve the pain of an adult for up to three days, and the label advises not to use it on kids under 16. The dose killed Taylor by the time Alvarez's adult daughter checked on her Sunday afternoon.

While Alvarez is far from a model mom, her deadly decision is not uncommon.

Hnin Khine, a pediatrics specialist working in the emergency room at Montefiore Medical Center's Children's Hospital in the Bronx, often encounters kids who have overdosed on prescription drugs.

"There are occasions where parents don't realize that some of the substances can be toxic to children, and they may inadvertently give it to them as medicine," she says. "We see more often kids where the parents are not careful with their medications and they're left around, and the kids get into it and take medicines that are for adults."

As reported Tuesday in the Daily News, Alvarez, 54, was already under investigation by the Administration for Children's Services for spanking Taylor excessively. And ACS investigators allegedly found Alvarez's apartment to be filthy during a visit last month.

The foster mom, who has five biological and two adopted kids, told cops that fentanyl patches - which stick to the skin and release medication into the bloodstream - were prescribed for her by a doctor for chronic pain from a car accident.

Weighing just 59 pounds, Taylor's body was not built to handle any adult dose of the drug.

"It was a pain patch, and that transdermal route of administration is particularly unsafe for children," explains Orly Avitzur, M.D., medical adviser for Consumer Reports. "They are rarely given a patch to wear."

Taylor, described by neighbors as a cheerful child, is not the only victim of a parent's misguided drug decision.

In January, Khine saw several infants and toddlers suffering seizures within a few days of one another. After questioning the parents, she realized that all let their kids use camphor - a waxy substance with a strong odor, obtained from certain evergreen trees - thinking it would ease their cold symptoms.

Camphor is found in Vicks VapoRub, which is approved by the Food and Drug Administration because of its low drug dosage.

But bodegas were selling camphor in unregulated medications, mostly manufactured in China, with camphor levels much higher than FDA regulations allow. Khine informed the city's Department of Health, which issued alerts, but not before Montefiore treated four children who overdosed on the drug.

"We had cases of camphor products that people rubbed on their children and then they let them inhale it and it reaches toxic levels, and they develop a seizure from it," Khine shares. "In those cases, the parents don't realize that it has side effects."

Moms and dads also commonly cut a pill for grownups in half, thinking that's the appropriate dose for kids.

"Parents have to realize that children are not little adults," warns Khine. "Children need to have their own medication and have to take only what they're prescribed. You cannot just cut half of what the doctor told you to take and give it to your children. It doesn't work that way."

Giving a child too little medication is also a problem. While usually not fatal, it can lead to symptoms lingering for longer than they should.

"For most kids, the medicines they get are because they have a fever in early childhood," says Patricia Carey, M.D., medical director in the emergency room at St. Luke's-Roosevelt Hospital Center. "So the parents will have taken them to their pediatrician or to a hospital maybe two years ago, at which point the kid was a year old and weighed twentysomething pounds. And the doctor or nurse there said give them a teaspoon or two teaspoons of Tylenol, and they maintain that dose for years if nobody instructs them.

"Because it's weight-based, they end up giving them inadequate amounts," Carey adds. "Then the fever won't come down. And when we review the dose they're giving, oftentimes it's not enough."

When in doubt, don't treat your kids with anything from your medicine cabinet or the corner store.

"The best thing to do if you want to give your child any medication is to always call your doctor first," warns Elizabeth Shaw, deputy editor of Parenting magazine. "And, obviously, never give them any adult-strength medicine - ever."

10 COMMON MISTAKES WITH KIDS AND DRUGS

1. Giving the wrong dosage. "You have to realize that what you give to a 2-year-old isn't the same as what you give to a 12-year-old," says Hnin Khine, a pediatric emergency room specialist at Montefiore Medical Center. "It's weight-dependent for all the medication that we prescribe."

2. Leaving medications in the reach of kids. "I just saw a kid yesterday who digested his grandmother's pills," says Khine. "The kid took hold of the bottle, opened it and took it. They were blood pressure pills."

3. Assuming caps keep kids out. "Parents put the child-proof caps on all the pill bottles, but most kids I know can get those off," says Patricia Carey, medical director in the emergency room at St. Luke's-Roosevelt Hospital Center.

4. Sharing medicine. "Don't share medication, even among children," Carey warns. "One child's medicine may not be appropriate for the other one, if for no reason other than the weight issue."

5. Buying over-the-counter medications. "Don't give your children medicines without talking with their doctor," says Carey. "Pediatricians are usually very accustomed to phone consults, so you don't necessarily have to go to the office every time you want to give your kid medicine."

6. Leaving your children at another home that's not child-proofed.  "Even if they're the grandparents and the kids only visit once a week, they need to think about having the medicines up really high and having the cabinets fixed in such a way that kids can't operate them," Carey says.

7. Transferring cleaning products into food containers.  "Another thing we see a lot of is parents transferring cleaning products into Coke bottles so they can carry it around," says Khine. "Children mistake it for a drink. It can cause detrimental effects on children. Some have died from that."

8. Believing that common adult pills are safe. "If it's Tylenol or Motrin, if you just give the wrong dose, it's not so detrimental that they end up in the emergency room," says Khine. "But if you do it chronically, it's a problem."

9. Using household spoons as measurement tools. "A lot of kids' medicines will come with a dropper or a measured cup, and a lot of parents end up giving liquid medicine with a kitchen teaspoon. That's a really inaccurate measurement because kitchen spoons are all different sizes," says Elizabeth Shaw, deputy editor of Parenting magazine.

10. Giving kids a mix of medications. "Parents may not realize that they gave their kid a multisymptom product that might have acetaminophen, and then give a separate dose of acetaminophen and unwittingly overdose," says Shaw.

Additional reporting by Nicole Carter, Leah Chernikoff and Nicole Lyn Pesce