Medication Safety

Giving your child a medication can be both confusing and scary.  Giving the wrong medication or wrong dose can cause significant side effects. However, with a little knowledge and some double-checking, you can give medication safely and prevent dangerous reactions.  In many cases, medication is not needed for simple childhood viral illnesses like colds. If you are unsure about your child’s symptoms, it is best to check with your pediatrician.

Administering Medication

To ensure the safe use of prescription and over-the-counter (OTC) medicines, discuss your child’s symptoms with your doctor and pharmacist. It is very important that the physician and pharmacist are aware of your child’s current weight and any other medications he or she is taking.

Before administering medications, you should know:

• the name and purpose of the medication
• how much, how often, and for how long the medicine should be taken
• how the medicine should be administered (whether it should be taken by mouth; breathed into the lungs; inserted into the ears, eyes, or rectum; or applied to the skin)
• any special instructions, like whether the medicine should be taken with or without food
• how the medicine should be stored
• how long the medicine can safely be stored before it needs to be discarded (asthma inhalers, for example)
• common side effects or reactions
• interactions with other medications your child may be taking
• what happens if your child misses a dose

Many OTC cough and cold medications are meant to be taken only when your child has symptoms. However, other medications, such as antibiotics, should be taken as prescribed by your child’s doctor. Your child should finish the entire prescription to stop the infection from reoccurring.

Medication Tips

• Don’t diagnose your child yourself
• Don’t give leftover medication
• Don’t ever give your child medication intended for someone else
• Read labels of OTC medications
• Don’t call medicine “candy” — this tactic will backfire in the future
• Develop a relationship with your pharmacist — they are an excellent source of information for many OTC as well as prescription medications

Aspirin Alert!

Never give aspirin to children, especially during viral illnesses. Using aspirin during an illness caused by a virus (such as the flu, chickenpox, or an upper respiratory infection) can cause Reye Syndrome, a potentially life-threatening disease with symptoms such as nausea, vomiting, and extreme fatigue that progress to a coma. Because some OTC medicines (including some that treat headache and nausea) contain aspirin, you should always read labels and check with your doctor before using them. Be aware that some aspirin-containing medications use words other than aspirin (such as salicylate or acetylsalicylate), so be sure to avoid these as well.

Important Medication Precautions for Children

• Since many medicines look the same, always check to ensure it is your child’s prescription. It is easy to grab the wrong bottle when you are tired.
• Read all instructions.  Both prescription and OTC medications come with printed inserts about common side effects and detailed instructions on taking the medication. Be sure to read all information carefully before administering the medication and call the doctor or pharmacist if you have any questions.
• Have your child take the medicine exactly as directed. For example, with or without food or “on an empty stomach”, which translates to 1 hour before or 2 hours after a meal, as food may prevent the medicine from working properly.

Proper Doses: Giving the correct dose is important because most medicines need to be taken in specific amounts and timeframes to be effective. The dose will be written on the prescription label or on OTC medications, should be printed on the package insert, product box, or product label. Never use tableware or a kitchen spoon to measure medication because these don’t provide standard measurements. Instead, visit your local pharmacy or drugstore to find a measuring device designed to deliver accurate medication doses.

You can dispense medicine in a variety of ways and they best choice depends on your child’s age and willingness to take medicine. For babies who aren’t yet able to drink from a cup, try a calibrated dosing syringe which lets you slowly dispense the medication into your baby’s mouth, making it less likely to be spit out. Be careful when using a syringe though — many come with a small cap on the end that can be a choking hazard to young children. Store medication syringes in a safe place out of the reach of children.

Other options for young kids are plastic droppers, cylindrical dosing spoons (these have a long handle that’s easier for children to grab), and, if your child can drink easily from a cup without spilling, the small dosage cups that come with many medications. Some medicine dispensers are fashioned like pacifiers and prove effective with infants and toddlers. With these, you put the medicine in a small measuring cup attached to a pacifier and then give the pacifier to the baby to suck — most of the medicine slips past the taste buds, making it go down easily.

Whatever method you use, it’s important that your child takes all of the medicine each time it is given.

Side Effects: It is possible for anyone to experience side effects and/or allergic reactions from medications, so keep a watchful eye on children. The pharmacist or product packaging may warn you about specific side effects, such a drowsiness or hyperactivity.

If your child experiences side effects such as a rash, hives, vomiting, or diarrhea, contact your doctor or pharmacist.  Penicillin and other antibiotics are among the most common prescription drugs to cause an allergic reaction.

If your child develops wheezing, has trouble breathing, or difficulty swallowing after taking medication, seek emergency help immediately by calling 911 or going to the hospital.  These could be symptoms of a serious allergic reaction that requires emergency care.

Safe Storage: Safe storage of medications is extremely important. Read the medication’s instructions — some drugs need to remain refrigerated, but most should be stored in a cool, dry location away from direct sunlight. Store medications in their original containers in a dry, locked location out of the reach of children. Child-resistant caps can often be difficult for adults to open, but relocking and recapping child-resistant bottles properly will help protect children.

Safe Disposal

When disposing of medications, make sure they stay out of the reach of children and don’t contaminate the environment.  Keep these suggestions in mind:

• Break down tablets or capsules and return them to their bottle. Remember to put the child-resistant top back on. Then, secure the bottle further – for instance, with tape or enclosing it in a bag – before finally tossing it into a garbage can that is well out of the reach of children.
• Return the medication to a local pharmacy. Many pharmacies take back expired medicines. However, each pharmacy has different policies regarding old or unused medications, so contact yours to determine if they will accept them.
• Local household hazardous waste collection facilities often take expired medicines.  These facilities accept antifreeze, oil, and used batteries for proper disposal. Similar to pharmacies, each facility has a different policy regarding unused medication, so call first.

Medications can be very helpful for many illnesses that your child may contract. Given at the correct dose and interval, most childhood medications are safe and effective. If you have concerns, please contact your child’s doctor or pharmacist before administering medication.

Dr. Doug

If you have questions or would like to make a suggestion for a future topic, please send an email to DrCampbell@learningcaregroup.com.

Dr. James Douglas Campbell, MD, FAAP, MHA, LLC, is a pediatric health professional who advises Childtime on the needs of our program as a whole, and provides consultation and technical assistance on child health issues. Dr. Campbell received his Doctorate of Medicine from the University of Florida and a Masters of Health Administration from the University of North Florida College of Health. He is Board Certified with the American Board of Pediatrics and a Fellow of the American Academy of Pediatrics. He has been taking care of children in Jacksonville, Florida since 1981.