Tuesday, July 19, 2011

Tips on safer dosing of medications for children

Here are some of the best tips I've learned over the years to avoid confusion and errors:

1. Never use a kitchen teaspoon or tablespoon to measure out the volume of medicine to give your child.  Eating utensils and cooking measurers are notoriously inaccurate.  Instead, use a medicine syringe.  These are often found in the package, you can purchase them at your local drugstore, or most pharmacies will give you a dosing syringe or two (especially if you are filling a prescription at the same time).

2. FIRST, figure out what your goal dose is for your child in milligrams (mg) of medicine rather than in volume of fluid.  THEN, see what the concentration of mg is per millilter (5ml is one teaspoon, therefore the concentration is often displayed as mg per 5ml).  For tablets or capsules you want to verify the mg per tablet/capsule.
Once you know what the goal dose is in mg and how many mg there are per ml, then you can calculate the number of ml you need to deliver the desired dose of mg.
(This also works for tablets or capsules in older children to determine how many tabs or caps to give.)
This is how pharmacists and doctors figure out how much medicine to dose for your child.
The trick is that many medicine come in multiple concentrations so you really have to pay attention to the specific concentration of the medicine you are about to give your child on that occasion.

3.  Make sure that shake up your liquid medicine before giving it.  This is particularly important liquid medicines that are suspensions.  Suspensions are liquids with small solid particles "suspended" in them.  Since the active medicine is in the solid particles, it is important to "re-suspend" the liquid by shaking the bottle before dosing each time so that the concentration of mg per ml can remain consistent.

3.  Here is the weblink to an article from the AAP on how to most safely dose liquid medications for children: www.healthychildren.org/English/health-issues/conditions/treatments/Pages/Using-Liquid-Medicines.aspx.

4. Teaspoons and Tablespoons are not the same.
Be aware that a teaspoon is 5ml and a tablespoon is 15ml.
This is a three-fold difference, therefore most pediatricians are taught to dose in ml (or teaspoons) and avoid dosing in tablespoons.  If you think your doctor wrote for your child's dose in tablespoons, call to clarify before giving the first dose.

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