Digoxin

This increases the force of contraction of the heart muscle making it more efficient, and it also slows down the electrical impulses within the heart. It is used to give extra support to the heart muscle and to slow down the heart if it is beating too fast. It can occasionally make your child sick or nauseous and they may lose their appetite.

Diuretics

Frusemide and Chlorothiazide
These drugs enable the kidneys to produce and excrete more urine. When the heart is not working very efficiently it causes the body to retain fluid within the lungs and the liver. Consequently the lungs become heavier and work less efficiently causing the child to become breathless, which often results in difficulty in feeding in babies. These drugs tend to excrete potassium, sodium, and chloride in the urine and supplements of these substances are sometimes needed.

Spironolactone / Amiloride
These are slightly weaker diuretics that also do not cause the excretion of potassium. They are often used together with one of the other diuretics.

Potassium supplements

These are given with the diuretics to help replace the lost potassium, but your child will probably not like the taste very much.

Hydralazine and Captopril

These drugs are vasodilators, which means that they increase the size of the blood vessels and reduce blood pressure. They are also used to lower high blood pressure, but can also be used if the heart action is very weak, as by reducing the blood pressure it reduces the work of the heart.

Propranolol

Another drug that reduces the rate and force of contraction of the heart muscle, it is used to treat fast heart rates, high blood pressure, and to relieve the spasms of the heart muscle in Fallot's Tetralogy.

Anti-arrythmic Drugs

There are many anti-arrythmic drugs such as Verapamil, Disopyramide, Lignocaine, Phenytoin, Mexilitene, Flecainide, and Amiodarone. They are used to control arrhythmias - irregular or abnormal heartbeats.

Anticoagulants

These drugs thin the blood and are used in patients who have an artificial heart valve, to prevent blood clots forming in the valve. Warfarin is the drug used and regular blood tests are essential to assess the amount of thinning and to adjust the dose. All children on this drug should carry a card with them detailing the dose and result of the latest blood test, so that they receive the correct treatment in an emergency.
Any medicines containing Aspirin should be avoided when taking Warfarin, as it is also an anticoagulant. Aspirin is sometimes used in adolescents with heart conditions as it reduces the stickiness of the platelets in the blood.

Antibiotics

These are used to treat infection as in children without heart problems, but they are also used as a preventative measure on occasions where there is danger of bacteria getting into the blood stream and attacking the faulty areas of the heart, a condition called Bacterial Endocarditis. The most frequent occasion for prophylactic antibiotic cover is before dental treatments, but would also need to be considered for ear piercing and tattooing.

Paracetamol

This can safely be given if the child has a temperature. Use the recommended dose as shown on the side of the box according to the age of your child.

• The name
• The reason for giving it
• When and how it should be taken - i e before or after meals
• Interaction with any other medicines being given at the same time
• How long your child will need to take it for
• Any possible side effects

"In the beginning we wondered how we'd remember when all the different drugs had to be given and how we'd give them to such a small baby. But it wasn't long before we got in to a routine, just like you do with preparing feeds and changing nappies, and using a syringe made it really easy. It was simple to measure the correct dose, and the medicine could be given in smaller amounts right into the back of the mouth, so it was less likely to be spat out or spilt. We now use syringes for all our children!"