Monday, March 30th, 2015
One of the most common medication mistakes parents make is measuring the incorrect amount of medicine. Thankfully, the latest dosage guidelines from the American Academy of Pediatrics (AAP) states that parents should never use spoons (including teaspoons and tablespoons) as a measurement tool for children’s medicine.
Instead, cups or syringes labeled with clear metric measurements in milliliters (mL) are the only way to ensure that children consume the correct dose of medication.
The smallest error in measurement can be toxic to a young child. “Each year more than 70,000 children visit emergency departments as a result of unintentional medication overdoses,” states the AAP’s press release. “Sometimes a caregiver will misinterpret milliliters for teaspoons. Another common mistake is using the wrong kind of measuring device, resulting in a child receiving two or three times the recommended dose.”
Many over-the-counter medications cause confusion because labels recommend metric dosing, but measuring devices are also included that may be marked in teaspoons. Now, with the latest guidelines, “we are calling for a simple, universally recognized standard that will influence how doctors write prescriptions, how pharmacists dispense liquid medications and dosing cups, and how manufacturers print labels on their products,” said Ian Paul, MD, pediatrician and lead author of the AAP statement.
In order to decrease confusion and a child’s risk of potential overdoses, the AAP’s 2015 policy statement includes the following updates to increase accuracy:
- Standard measurement language should be adopted, including mL as the only appropriate abbreviation for milliliters. Liquid medications should be dosed to the nearest 0.1, 0.5, or 1 mL.
- The dose frequency should be clearly stated on the label. Common language like “daily” should be used rather than medical abbreviations like ‘qd’, which could be misinterpreted as ‘qid’ (which, in the past, has been a common way for doctors to describe dosing four times daily).
- Pediatricians should always review mL-based doses with families when they are prescribed.
- Dosing devices should not have extra markings that can be confusing; they should not be significantly larger than the dose described on the label, to avoid two-fold dosing errors.
- Drug manufacturers should eliminate labeling, instructions, and dosing devices that contain units other than metric units.
Caitlin St John is an Editorial Assistant for Parents.com who splits her time between New York City and her hometown on Long Island. She’s a self-proclaimed foodie who loves dancing and anything to do with her baby nephew. Follow her on Twitter: @CAITYstjohn
Image: Liquid medication via Shutterstock
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Friday, July 26th, 2013
A flow restrictor on liquid medication bottles may prevent the accidental ingestion of the medications by young children who figure out how to outsmart the “child-proof” caps on the bottles. More from ScienceDaily.com:
Standard child-resistant packaging is designed to prevent or delay young children from opening bottles, giving caregivers reasonable time to intervene. However, in order for the packaging to work effectively, “Caregivers must correctly resecure the cap after each and every use. If the cap is not correctly resecured, children can open and drink whatever medication is in the bottle,” according to Daniel S. Budnitz, MD, MPH, and colleagues from the Centers for Disease Control and Prevention, Emory University, and the Georgia Poison Center.
To address a potential second line of defense, the researchers studied whether flow restrictors (adapters added to the neck of a bottle to limit the release of liquid) had any effect on the ability of children to remove test liquid, as well as how much they were able to remove in a given amount of time. 110 children, aged 3-4 years, participated in two tests. In one test, the children were given an uncapped medication bottle with a flow restrictor, and in the other test, the children received either a traditional bottle without a cap or with an incompletely-closed child-resistant cap. For each test, children were given 10 minutes to remove as much test liquid as possible.
Within 2 minutes, 96% of bottles without caps and 82% of bottles with incompletely-closed caps were emptied. In contrast, none of the uncapped bottles with flow restrictors were emptied before 6 minutes, and only 6% of children were able to empty bottles with flow restrictors within the 10-minute test period. Overall, older children were more successful than younger children at removing liquid from the flow-resistant bottles. None of the youngest children (36-41 months) were able to remove 5 mL of test liquid, the amount in a standard dose of acetaminophen for a 2- to 3-year-old child.
Manufacturers voluntarily added flow restrictors to over-the-counter infant acetaminophen in 2011. Based on their effectiveness, the authors suggest that flow restrictors could be added to other liquid medications, especially those harmful in small doses.
Image: Liquid medication, via Shutterstock
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Thursday, September 27th, 2012
While most parents whose low income qualifies them for health coverage through Medicaid fill prescriptions for antibiotics and other medications for acute illnesses, many fail to fill pediatricians’ orders for vitamin and mineral supplements, a new study has found. Reuters Health reports:
Antibiotics and other drugs for infections were filled 91 percent of the time, versus 65 percent of prescriptions for vitamins and minerals, for example.
“When your child has an ear infection and is in pain, you have much more of a sense of urgency,” [lead researcher Dr. Rachael] Zweigoron [of the Medical University of South Carolina in Charleston] said. But if a doctor recommends a vitamin D or iron supplement, she added, parents might not see the immediate need.
That raises the question of whether parents always know why a pediatrician has prescribed a medication or supplement. “Are we, as pediatricians, doing a good enough job of explaining the importance to parents?” Zweigoron said.
The findings, which appear in the journal Pediatrics, are based on 4,833 kids seen over two years at two clinics connected to Lurie Children’s Hospital of Chicago.
All of the children were on Medicaid, the government health insurance program for the poor. So it’s not clear if the findings would be the same for U.S. kids with private insurance.
Image: Child taking medicine, via Shutterstock
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Wednesday, June 29th, 2011
McNeil Consumer Healthcare, a unit of Johnson & Johnson, has announced a recall of 718,000 bottles of Tylenol, Sudafed, and Benadryl products. One lot (34,000 bottles) of eight-hour extended release Tylenol caplets was found to have a “musty or moldy odor” that might upset the stomachs of some consumers.
Concerned parents should note that none of the products on the new list–some of which were partially recalled at the wholesale level in January–are marketed as children’s products. But in May, Johnson & Johnson and other companies announced an overhaul of the way they make concentrated liquid drops of children’s pain and fever medications that contain acetaminophen. Shortly thereafter, the FDA voted to revamp the way infant medications are labeled and dosed.
Click here for a complete list of products that are part of today’s Tylenol recall.
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