The right medication at the right dose
The journal Pediatrics recently published a study that showed about 85% of parents make mistakes when measuring out doses of liquid over-the-counter medications.
That reminded me of this short video from Nationwide Children’s Hospital in Ohio talking about medication errors made by parents or other caregivers.
Using over 10 years of data from the National Poison Center, researchers found that children under the age of 6 are exposed to a medication error every 8 minutes: too much, too little, or the wrong drug altogether.
Most often, they found parents gave their child too large a dose; either the medication was not measured properly or it was given more frequently than directed on the package.
Of course, the packaging is part of the problem. For very young children, many medications are in liquid rather than tablet form. Different manufacturers include different measuring devices—spoons, cups, syringes or droppers—and the directions may be in teaspoons (tsp), tablespoons (tbsp) or milliliters (mL).
To make it more confusing, the measuring devices themselves might display markings for all—tsp, tbsp and mL!
The Pediatrics report recommends that all measurements be in milliliters, and the syringe-type measuring tools be used for the smallest doses.
When in doubt, talk to the pharmacist or call your pediatrician’s office.
Related post: Be informed—Poison Control number
Nationwide Children’s Hospital recommends always using the measuring device that comes with the product—never use a spoon out of your silverware drawer!
And don’t hang onto those little cups and syringes thinking you can use them again. Just throw them away and use the new ones that come with the medication.
Also, to prevent overdosing, write down when a medication is given. This step is especially important if a child is to be given another dose by another caregiver, such as a babysitter or a school/daycare staffer.
More tips on kids’ medication safety
The Food and Drug Administration (FDA) has a great webpage and other resources for kids’ medication safety.
They offer the following tips:
- Always follow the directions on the Drug Facts label of your medicine. Read the label every time before you give the medicine.
- Know the “active ingredient” in the medicine. This is what makes the medicine work and it is always listed at the top of the Drug Facts label. Many medicines used to treat different symptoms have the same active ingredient. So if you’re treating a cold and a headache with two different medicines but both have the same active ingredient, you could be giving two times the normal dose. If you’re confused, check with a doctor, nurse, or pharmacist.
- Give the right medicine, in the right amount. Medicines with the same brand name can be sold in different strengths, such as infant, children, and adult formulas. The dose and directions also vary for children of different ages or weights. Always use the right strength and follow the directions exactly. Never use more medicine than directed unless your doctor tells you to do so.
- Talk to your doctor, pharmacist, or nurse to find out what mixes well and what doesn’t. Medicines, vitamins, supplements, foods, and beverages aren’t always compatible.
- Use the dosage delivery device that comes with the medicine, such as a dropper or a dosing cup. A different device, or a kitchen spoon, could hold the wrong amount of medicine. And never drink liquid medicine from the bottle.
- Know the difference between a tablespoon (tbsp) and a teaspoon (tsp). A tablespoon holds three times as much medicine as a teaspoon. On measuring tools, a teaspoon (tsp) is equal to “5 mL.”
- Know your child’s weight. Dosage amounts for some medicines are based on weight. Never guess how much to give your child or try to figure it out from the adult dose instructions. If a dose is not listed for your child’s weight, call your health care professional.
- Prevent a poison emergency by always using a child-resistant cap. Relock the cap after each use. Be especially careful with any medicines that contain iron; they are the leading cause of poisoning deaths in young children.
- Store all medicines in a safe place. Some are tasty, colorful, and many can be chewed. Kids may think they’re candy. Store all medicines and vitamins out of your child’s (and your pet’s) sight and reach. If your child takes too much, call the Poison Center Hotline at 800-222-1222 (open 24 hours a day, 7 days a week) or call 9-1-1.
- Check the medicine three times before using. For any medicine, it is always good practice to first, check the outside packaging for such things as cuts, slices, or tears. Second, once you’re at home, check the label on the inside package to be sure you have the right medicine and that the lid and seal are not broken. Third, check the color, shape, size, and smell. If you notice anything unusual, talk to a pharmacist or other health care professional before using.
Since it’s the beginning of cold and flu season, and parents will no doubt be stocking up on over-the-counter remedies for their kids, I thought it would be useful to share this information.