Thursday, July 30, 2015

10 safety tips to follow when using liquid medicines

Three out of four people make mistakes when measuring doses of liquid medicines, particularly when using dosing cups that come with OTC medicines. More than one-third of the mistakes are large overdoses, which can be particularly serious in children.

10 safety tips to follow when using liquid medicines


Three out of four people make mistakes when measuring doses of liquid medicines, particularly when using dosing cups that come with OTC medicines. More than one-third of the mistakes are large overdoses, which can be particularly serious in children.

The errors are most often due to: 

1) confusing teaspoons with tablespoons, especially since the markings “tsp” and “tbsp” look similar;

2) confusing mL (milliliters) with teaspoons;

3) assuming that the entire dosing cup is the correct dose. 

As a follow up to an earlier Check-up blog that discussed steps parents should take to prevent medicine mishaps in general, here are some recommendations specifically meant for preventing errors when giving liquid medicines:

Never use a household teaspoon or tablespoon to give liquid medicines. They are inaccurate and may deliver more or less medicine than prescribed. Today's over-the counter (OTC) liquid medicines almost always come with their own measuring devices. Some pharmacies automatically supply a proper device for measuring prescription liquids. If not ask for one.

With OTCs, use only the device that comes with the medicine. These are marked with the measurements you need to prepare a dose accurately. If a dosing device does not come with the product, or you have misplaced the device, ask a pharmacist to recommend one. Never use a device supplied with one medicine for a different medicine. This can lead to dosing errors.

Know a child's current weight before administering OTC liquid medicine to a child. The most accurate dose is based on the child's weight, not age. Tables are often provided on the medicine label to help select the proper dose according to the child's weight.

Never read medicine labels or measure liquid medicines in a dimly lit or dark room, or when you are very tired or distracted. Always turn on the light (and put on your glasses if you wear them) when preparing any medicine.

Look at the liquid medicine at eye level when measuring a dose in a dosing cup, oral syringe or dosing spoon. If possible, measure on a flat surface, bending down to read the liquid volume. Otherwise, hold the dosing cup or spoon up at eye level to read the volume.

Immediately replace the cap after measuring liquid medicine. Be sure child-resistant caps are locked into place after use—you should hear a clicking sound if the medicine has a locking cap that turns. If using an oral syringe with a special ribbed adapter that allows the medicine to be drawn directly from the bottle, remove the adapter and replace the child-resistant cap on the bottle since the adapter is not child-resistant. Never store the syringe on the adapter. Storage this way is also not child-resistant.

Store adult and child preparations of liquid medicines in separate areas. This will decrease the chance of accidentally confusing the containers with one another. Make sure all medicine is stored up and away and out of reach of children.

Wash the dosing device after giving the medicine. If you don't, potentially harmful bacteria can grow on it. If you wash a dosing device immediately before administration, be sure to dry it well. Leaving liquid residue on the device can interfere with dosing accuracy.

Store both the medicine and dosing device together. An oral syringe can be attached to a bottle with a rubber or elastic band or a dosing cup can usually be placed over the cap. This way you will always have the correct measuring device on hand when you need it

Don't combine more than one liquid medicine in a dosing device at the same time. Doing so makes it hard to measure out the correct dose for each medicine. Measure each medicine in a separate dosing device. Also, don't mix the liquid with any other medicine or food unless product label specifically says it is okay. It may not be compatible.

Read more from the Check Up blog »

President, Institute for Safe Medication Practices
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Check Up covers regional health news and a wide array of healthcare topics from pharmaceutical happenings to patient safety. Read about some of our bloggers here.

Portions of this blog may also be found in the Inquirer's Sunday Health Section.

Michael R. Cohen, R.Ph. President, Institute for Safe Medication Practices
Daniel R. Hoffman, Ph.D. President, Pharmaceutical Business Research Associates
Hooman Noorchashm, M.D., Ph.D. Cardiothoracic surgeon in the Philadelphia area
Amy J. Reed, M.D., Ph.D. Anesthesiologist and Surgical Intensivist in the Philadelphia Area
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