Medicines for heart children

The aim of this fact sheet is to provide parents with information and advice about medicines for heart conditions.

Some children with heart conditions will need to take medicines. The kind of medicines they need will depend on their heart condition.

It is important to understand what the medicine is for, and how often it should be given. If you have any questions about the medicines you can talk to the paediatric pharmacist at the hospital that treats your child or your child’s cardiologist.

Giving medicine
Some children with heart conditions take several medicines each day, all with different doses. You may find it helpful to keep a list of all the medicines your child has to take and tick them off as you give them.

Some medicines can be given in different forms, for example, tablet, liquid, or sugar free liquid. Ask your pharmacist if you think a different form would suit your child better.

Spitting and vomiting
If your child spits the medicine out or vomits at some point after taking the medicine, you may not be sure if you should give them another dose. Ask for advice about this from the pharmacist or doctor. 

At school
If your child needs medicines during the school day, you may want to work with the school to draw up a health care plan. A health care plan is a written document that helps to ensure that the school have all the necessary information they need, and that they have all the appropriate systems in place to help your child manage their medicines while in school.

It is important to make the school aware of any side effects of the medication that may affect your child. For example:

• diuretics can make your child need the toilet urgently and frequently; and 
• anticoagulants can prevent your child from taking part in contact sports. 

The medicines
Below are some generic medicines that are commonly used to treat symptoms associated with heart conditions:

Diuretics
In congestive heart failure the body tends to retain fluid. Diuretics help the kidneys to get rid of excess fluid so that the heart can work more efficiently.

Diuretics will make your child need the toilet more frequently and more urgently. Vomiting or diarrhoea can make a child on diuretics dehydrated. If this happens, talk to your GP as soon as possible.

Angiotensin Converting Enzyme (ACE) Inhibitors
These drugs reduce blood pressure by dilating the blood vessels. Lower blood pressure means the heart does not have to work so hard to pump blood round the body.

Anti- arrhythmics
These drugs are used to treat arrhythmias (a fast or irregular heart beat). Different anti-arrhythmic medicines are used depending on the specific type of arrhythmia.

Anticoagulants
Anticoagulants help to prevent blood clots by thinning the blood. Two of the most common anticoagulants are:

• warfarin; and
• aspirin.

It is important to monitor the blood regularly to make sure children are getting the correct dose of anticoagulants. This can be done using blood test monitors called INR machines. Your child’s cardiologist or haematologist can give you more information on this procedure.

Children on anticoagulants should carry a record with them of the dose they are on and the result of their last blood test. This will make sure they receive the correct treatment in an emergency.

Children on anticoagulants must avoid contact sports and other situations where they may be bruised or cut. If a child is already taking warfarin then they should not take any medicines containing aspirin as this is also an anticoagulant. 

Beta-blockers
These drugs are used for a number of reasons. Some are used to control high blood pressure, whilst others are used to treat arrhythmias.

Drug interactions & side effects
It is important that you ask your child’s cardiologist or the hospital pharmacist about any interactions with other drugs or side effects that you should be aware of.

It may be helpful for your child to carry a note of all the medicines they are on. In an emergency situation, this can be given to medical staff so that they are aware of the drugs your child is already taking. Medic Alert bracelets are another way of alerting medical staff to health conditions, allergies and drugs being taken. For more information visit www.medicalert.org.uk
 
If you think your child is suffering a reaction to a drug or is showing any other symptoms that may be related to their medicines, contact the GP or cardiologist immediately. 

General tips
Here are some useful tips to consider:

• Always read any instructions that come with medicines. 
• Check that you do not use medicines after their expiry date.
• Check that medicines are stored at the right temperature and out of reach of small children.
• If you need a repeat prescription then it can help to make a note on a calendar or in your diary. Allow enough time in case your local pharmacist does not normally stock the medicine you need.
• Keep a note of the contact details of the hospital paediatric pharmacist in case you have any queries about the medicines.
• Sometimes GP’s or local pharmacists will not know how certain heart medicines should be given to children. If this is the case, put them in touch with the hospital pharmacist.