Travelers to malaria-risk areas in Mexico, Haiti, the Dominican Republic, and certain countries in Central America, the Middle East, and Eastern Europe should take hydroxychloroquine sulfate or chloro-quine as their antimalarial drug.
The first dose of hydroxychloroquine sulfate should be taken one week before arrival in the malaria-risk area. It should then be taken once a week, on the same day of the week, while in the malaria-risk area, and once a week for four weeks after leaving the malaria-risk area.
Hydroxychloroquine sulfate should be taken on a full stomach, for example, after dinner, to minimize nausea. While hydroxychloroquine sulfate may be better tolerated than chloroquine, rare side effects may include nausea and vomiting, headache, dizziness, blurred vision, and itching. Hydroxychloroquine sulfate may worsen the symptoms of psoriasis.
antimicrobial drugs Drugs that destroy or inhibit the growth of microorganisms.
antipsychotic drugs Medications used to treat psychosis. Standard antipsychotic drugs appear to be effective for children and adolescents with schizophrenia. Clozapine is helpful for at least half of those who do not respond to typical drugs. In a few cases psychotic symptoms seem to disappear entirely. unfortunately, children may be more susceptible than adults to the toxic effects of cloza-pine; about one-third of them have to stop taking it because of the side effects. Newer antipsychotic drugs that may be safer and just as effective are now being tested.
antipyretic drugs A type of medication designed to lower fever by reducing the body temperature. Most popular types of antipyretics include acetaminophen, aspirin, and other nonsteroidal antiinflammatory drugs (nsaids), such as ibuprofen.
antiseptic A germicide used for human skin or tissue (not inanimate objects) that inhibits the growth and reproduction of microorganisms. It will weaken microbes but does not usually kill them. Health-care antiseptics in soaps or other products help prevent the spread of infection in medical facilities. Antiseptics include alcohol (ethanol or isopropanol), iodine (iodophor), povidone-iodine (Betadine), hydrogen peroxide, chlorhexidine, or hexachlorophene (Phisohex).
over-the-counter antiseptics applied to the skin can help prevent infection in minor cuts, scrapes, or burns. Antiseptics can be kept in the first aid kit to pour on an animal bite, after cleaning it with soap and water, or to apply to a dirty cut after washing it out with soap and water. Normal cuts and scratches do not require antiseptics.
However, if an injury is extensive, it should be treated by a doctor. Antiseptics should not be used for cuts that are deep, that keep bleeding, or that require stitches. In addition, antiseptics should not be used for scrapes with imbedded particles that cannot be flushed away, large wounds, or serious burns. Over-the-counter antiseptics should not be used for more than one week on an injury; if the wound does not heal or worsens, the child should be taken for medical care.
Experts advise against using hydrogen peroxide as an antiseptic, since it does not kill bacteria and interferes with capillary blood flow and wound healing. other experts note that ethyl alcohol is not a good wound antiseptic because it irritates already-damaged tissue and causes a scab to form that may protect bacteria.
The U.S. Food and Drug Administration (FDA) advisory review panel has found some antiseptics that are not generally recognized as safe and effective. These products include mercury, cloflucarban, fluorosalan, and tribromsalan.
antiserum A preparation containing antibodies that combine with specific foreign proteins (anti-gens)—usually components of microorganisms such as viruses or bacteria. Antiserum is usually used (together with immunization) as an emergency treatment when someone has been exposed to a dangerous infection but has not previously been immunized against it.
Antiserum is prepared from the blood of animals or humans who have already been immunized against the organism.
The antiserum helps to provide some immediate protection against the microorganisms, while full immunity develops. However, these measures are not as effective in preventing disease as is immunization before exposure.
antitoxin An antibody produced by the body to fight off a toxin formed by invading bacteria or a biological poison such as botulism. Antitoxins are also produced commercially to contain an antibody that can combine and neutralize the effect of a specific toxin released into the blood by bacteria (such as those that cause tetanus or diphtheria). Antivenin is a type of antitoxin specifically made to combat snakebite poison. Antivenins are specific for each poisonous snake.
Antitoxins are prepared by injecting animals (usually horses) with specific toxins that provoke the animal's immune system into producing antibodies that neutralize the toxin. Then extracts are taken of the animal's blood to be used as antitoxins.
When used in treatment, antitoxins are usually injected into the muscle of the patient. Occasionally, the antitoxin may cause an allergic reaction or (even more rarely) anaphylactic shock.
antitussive drugs A type of medication used to suppress coughing, possibly by reducing the activity of the child's cough center in the brain or by depressing breathing. These drugs include both narcotics and nonnarcotics that act on the central and peripheral nervous systems to suppress the cough reflex. Because the cough reflex is important in clearing secretions from the upper respiratory tract, antitussives should not be used with a cough that produces mucus.
Codeine and hydrocodone are strong narcotic antitussives. Dextromethorphan is equally effective but does not carry the danger of inducing dependence as the narcotics do.
Antitussives are given by mouth (usually in a syrup with an expectorant and some alcohol). The medications also may be given as a capsule combined with an antihistamine and a mild painkiller.
antiviral drugs A group of drugs used to treat viral infections that include acyclovir, famcy-clovir, valacyclovir, and AZT (zidouvine, prescribed for the treatment of AIDS). Until the development of these drugs, no effective way to treat viruses existed.
To this point no drugs have been developed that eradicate viruses and cure the illnesses they cause. This is because viruses live only within cells; a drug capable of killing a virus would also kill its host cell. New antiviral agents interfere with viral replication or otherwise disrupt chemical processes of viral metabolism; some prevent viruses from penetrating cells. They are effective treatments for a variety of infections.
Relatively newly developed antivirals including acyclovir and famcyclovir are especially effective in treating herpes family (HSV) infections. Antiviral drugs reduce the severity of the herpes symptoms and may shorten the course of the infection, but the drugs cannot eliminate the virus completely. Recently scientists have been testing several varieties of a vaccine that appears to lessen the severity of herpes attacks. The vaccine is a combination of alum and a genetically engineered protein, gly-coprotein D (gD2) that sits on the outer surface of the herpesvirus and is targeted by the body's immune cells.
AZT, a drug used in the treatment of AIDS, works by interrupting the replication cycle of the HIV virus and has demonstrated effectiveness in delaying the progression of HIV infection.
Most antiviral drugs have few side effects, although the creams and ointments may irritate skin. Oral antiviral drugs can cause nausea and dizziness. Acyclovir, if not given with significant fluids, can crystalize in the kidneys, causing kidney damage.
anxiety A feeling of apprehension, fear, or worry not connected to a specific threat. Many experts believe that anxiety is a learned response to stress. For example, a child who has been stung by a bee will run away crying on the next appearance of a flying buzzing insect. Should the avoidance continue to be reinforced, the anxiety will continue and may develop into a phobia.
Cognitive psychologists believe that anxiety is the result of inappropriate thoughts. For someone who has an irrational fear of snakes, a picture of a snake can cause anxiety even though it is not possible to be hurt by a two-dimensional picture.
Children with learning disabilities may often have accompanying problems with anxiety, especially in connection to school work. Reading aloud, taking timed tests, or trying to start a writing assignment all may trigger anxiety and cause even further problems with the required task. Someone experiencing a high level of anxiety may "freeze up" and find it impossible to perform at all, or may show signs of restlessness and agitation, leading to erratic and inconsistent performance.
There is also a significant link between attention deficits and anxiety. To some degree, it can be hard to tell the difference between the two. An inability to focus and sustain attention may often lead to anxiety, and anxiety itself can make it very difficult for a child to pay attention to a task. In some cases, attention deficit disorders coexist with anxiety disorders.
It is also possible for someone with an anxiety disorder to be misdiagnosed with attention deficit hyperactivity disorder (ADHD). In evaluating ADHD, a differential diagnosis for anxiety may be important. It is equally important that those who work with individuals with ADHD take into account the possibility that anxiety may underlie some expressions of learning, communication, and social difficulties. (See also anxiety disorders.)
anxiety disorders Mental health disorders characterized by persistent worry. Anxiety disorders are the most common type of mental health disorder in children, affecting as many as 10 percent of young people. Studies suggest that children or adolescents are more likely to have an anxiety disorder if their parents have the same condition.
All children experience anxiety occasionally; for example, from about eight months of age through the preschool years, healthy youngsters may show intense anxiety when separated from their parents. Young children may have short-lived fears of the dark, storms, animals, or strangers.
Anxiety becomes a problem when it interrupts a child's normal activities, such as separating from parents, attending school, and making friends. Parents should consider seeking the evaluation and advice of a child and adolescent psychiatrist.
Anxious children are often overly tense. Some may seek a lot of reassurance, and their worries may interfere with activities. Because anxious children may also be quiet, compliant, and eager to please, their problems may be overlooked. Parents should be alert to the signs of severe anxiety so they can intervene early to prevent complications.
There are several types of anxiety disorders that affect children, including generalized anxiety disorder, separation anxiety disorder, social phobia, obsessive-compulsive disorder, and post-traumatic stress disorder.
Generalized Anxiety Disorder Children with generalized anxiety disorder have recurring fears and worries that they find difficult to control. They worry unnecessarily about almost everything—school, sports, being on time, even natural disasters. They may be restless, irritable, tense, or easily tired, and they may have trouble concentrating or sleeping. Children with generalized anxiety disorder usually are very eager to please others and may be "perfectionists," dissatisfied with their own less-than-perfect performance.
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