Medication safety for children
Important advice for caregivers
Each year, an estimated 71,000 children are treated in emergency rooms for accidental medication poisonings, many of which are caused by dosing mistakes. Thankfully, while health care professionals or poison control resources resolve most issues, extreme cases that go untreated can result in complications, particularly in very young children.
"Many well-intentioned caregivers can get mixed up when it comes to administering medication," says Dr. Michael App, a pediatrician in Grand Rapids, Mich. "With so many factors playing a role in proper dosage, such as weight and age of the child, it is essential that caregivers closely follow the directions on the label to avoid potentially life-threatening mistakes."
Several manufacturers of children's medications are also making efforts to improve safety and reduce the likelihood of errors. Perrigo Company, the world's largest manufacturer of over-the-counter pharmaceutical products for retailers' store brands, has been investing in equipment to insert "flow restrictors" in the bottles of all of their pediatric acetaminophen products. Flow restrictors reduce the size of the bottle opening and limit access to the medicine inside the bottle. Perrigo has added flow restrictors to all of its infants' products and began converting the packaging of all of its children's products with flow restrictors in January 2012. Perrigo is also participating in the Centers for Disease Control and Consumer Healthcare Products Association PROTECT initiative, which is bringing together experts to create strategies to reduce unsupervised medication ingestion in children.
Experts remind caregivers to be diligent and avoid these common medicine mistakes:
Not paying attention to potential drug interactions
Caregivers should always check medication labels and take care to avoid administering multiple drugs at the same time, unless recommended or prescribed by a pediatrician. Also, before administering medicine, caregivers should always review the enclosed packaging materials and directions.
Overmedicating due to measuring errors
When administering medicine, caregivers should always use the dosing device provided by the pharmacist or manufacturer, and never attempt to "eyeball" the proper amount. That household teaspoon your mom used? According to a study in the International Journal of Clinical Practice, household spoons or similar objects can hold two to three times more liquid than standardized materials. Most pediatricians recommend using a syringe over any other dispensing device for the most accuracy.
Basing the dose on age instead of weight
"Children grow at different rates, which makes it hard for parents and doctors to base dosage recommendations on age," says App. "Since children metabolize medicine differently depending on how much they weigh, this is how most manufacturers label their dosage recommendations – not based on age. This is especially important for children who are over- or underweight."
As with adults, doctors need to know every medication or vitamin that a child is taking, as certain vitamins can decrease the effectiveness of medicines or cause complications. Caregivers should always have a list of medicines on hand that lists the types and dosage amounts of every medication, vitamin and supplement that a child takes, as well as a list of allergies.
Not taking medicine as directed
Most prescriptions, especially antibiotics, are meant to be used in full. Even though a child may feel better, it is important to complete the dosage, or else the illness could recur. Furthermore, this practice can ultimately contribute to the development of antibiotic-resistant bacteria. In the same vein, caregivers should avoid giving leftover pills from a previous prescription for something they "self-diagnose" to be the same as a previous illness. It is also important to avoid giving medicine for any purpose other than that specified by the instructions.
Failing to adhere to expiration dates
Manufacturers list expiration dates on packaging for a reason, as these dates are generally based on internal testing that demonstrates the longest period a medicine is known to be effective. Using medicine left in the cabinet after it has expired can result in reduced effectiveness.
"Parents should always ask their pharmacist or pediatrician if there are any special precautions or directions with any drug – over-the-counter or prescription – their child is taking," says App.