"Breaking the tablets by hand", "pulverizing the tablets into powder" and "reducing the particles by half" ... Many parents have had this experience when breastfeeding their children. How to accurately control the dosage of children and ensure the safety of medication is a very important issue.
For adults, the dosage will be clearly marked in the instructions, but a large number of commonly used drug instructions do not indicate the dosage of children. A better situation is to indicate the corresponding dosage range according to the child's weight and age, and more generally, "children's dosage should be reduced as appropriate" or "according to the doctor's advice", lacking clear indications, usage and dosage, and not clearly indicating information such as adverse reactions warning. The phenomenon of "unclear drug instructions" tests the clinical experience and ability of pediatricians, and also puts forward higher requirements for parents' drug knowledge and drug use level.
The phenomenon of "taking medicine depends on breaking, and the dosage depends on guessing" is largely due to the shortage of special drugs for children. In order to solve the problem of drug shortage, many times doctors can only choose to divide adult drugs into appropriate doses for children. However, in practice, the resulting problems such as unclear dosage and inaccurate drug distribution increase the risk of children's drug use. In recent years, drug poisoning caused by children's overdose is common, which highlights the importance and urgency of strengthening the safety of children's medication.
There is a relative shortage of special drugs for children, which needs to be solved from drug research and development and production. Globally, there are relatively few varieties, quantities and dosage forms suitable for children. This is closely related to the high cost of children's drug research and development and clinical trials, and the characteristics of children's immaturity and disease process. Children's drugs are aimed at a small number of people, and the market demand is far less than that of adult drugs, but relatively speaking, R&D investment is large and the requirements are high. Many parents are reluctant to let their children participate in clinical trials, which makes it more difficult to carry out clinical trials of children's drugs and collect data. In addition, children's onset often has the characteristics of short time and rapid progress, and the requirements for clinical trial bases are also high. The current situation of high investment, high requirements and small market size has made many pharmaceutical companies lack enthusiasm. For China, the market demand for children's drugs is relatively large, and the demand for basic drugs has been met at present. In the future, we should further develop and improve the systems of children's drug research and development, clinical trials, supply, use and payment.
According to the data of the seventh national census, there are 253.38 million children aged 0- 14 in China, accounting for 17.95% of the total population. Their health is related to the happiness of thousands of families. China has always attached importance to ensuring the supply of medicines for children. From the promulgation of "Several Opinions on Protecting Children's Medication" and the specific requirements for ensuring children's medication to the establishment of an expert committee on children's medication to guide the approval and use of children's medication; The situation of children's drug use in China has been continuously improved, from requiring strengthening the equipment of children's drugs in medical institutions, increasing the accessibility of children's drugs, giving priority to the examination and approval of children's drugs, to drawing up three batches of children's drug lists one after another and encouraging research and development. In 20 19, 38 kinds of medicines for children were added through routine access in the adjustment of China's medical insurance catalogue, and the protection of medicines for children in the 2020 edition of the medical insurance catalogue continued to increase. The introduction of relevant policies has greatly encouraged the research and development of children's medication in China, promoted the increase of varieties, dosage forms and specifications of children's medication year by year, and improved the safety and convenience of children's medication.
Children are the future of the motherland, and the importance of ensuring children's medication is self-evident. Although the pill is small, it is related to people's livelihood and welfare. In the future, we should constantly improve policies, encourage children's drug research and development, clinical trials, carry out comprehensive evaluation, force children's drugs to carry out pediatric research and improve drug instructions, and carry out monitoring of adverse drug reactions of children to ensure the safety of children's drug use, reduce the risk of drug use, and ensure the healthy growth of children. With the concern of the whole society and the concerted efforts of Qi Xin, children's medication will be better guaranteed, which will help build a healthy China. (Li Hongmei)