How to Give Medicine to Children : Part 2

by Food and Drug Administration (FDA)

(Page 2 of 2)

It's also important to read measuring instruments carefully. The numbers on the sides of the dosing instruments are sometimes small and difficult to read. In at least one case, they were inaccurate. In 1992, FDA received a report of a child who had been given two tablespoons of acetaminophen rather than two teaspoons because the cup had confusing measurements printed on it. The incident prompted a nationwide recall of medicines with dosage cups.

The following are some tips for using common dosing instruments:

Syringes: Syringes are convenient for infants who can't drink from a cup. A parent can squirt the medicine in the back of the child's mouth where it's less likely to spill out. Syringes are also convenient for storing a dose. The parent can measure it out for a babysitter to use later. Some syringes come with caps to prevent medicine from leaking out. These caps are usually small and are choking hazards. Parents who provide a syringe with a cap to a babysitter for later use should caution the sitter to remove the cap before giving the medicine to the child. The cap should be discarded or placed where the child can't get at it. There are two kinds of syringes: oral syringes made specifically for administering medicine by mouth, and hypodermic syringes (for injections), which can be used for oral medication if the needles are removed. For safety, parents should remove the needle from a hypodermic syringe.Always remove the cap before administering the medication into the child's mouth.

The illustration at right shows a standard hypodermic syringe with protective plastic cap on (top left) and off (top right) the device: When in place, the cap appears to be an integral, yet inconspicuous, part of the syringe.

The syringe can be loaded with cap in place: The plastic cap is simply intended to be a protective barrier to the syringe's nozzle.Figure A shows how a liquid medication can be drawn up into a hypodermic syringe without removing the cap. Liquid can easily enter the syringe nozzle through clearance around the cap.Figure B shows liquid medication being poured into the barrel of the syringe after removing the plunger, with the cap still in place. In either case, the potential exists for administering liquid medication without first removing the cap.

Potential hazard of using capped syringe when administering liquid medication: If left on a loaded hypodermic syringe, the cap could pop off in the child's mouth and could choke the child. FDA is working with manufacturers to eliminate the safety hazards posed by the caps. Until then, parents must be extra cautious when using capped syringes.

Always remove the cap before administering the medicine. Throw it away or place it out of the reach of children.

Droppers: These are safe and easy to use with infants and children too young to drink from a cup. Be sure to measure at eye level and administer quickly, because droppers tend to drip.

Cylindrical dosing spoons: These are convenient for children who can drink from a cup but are likely to spill. The spoon looks like a test tube with a spoon formed at the top end. Small children can hold the long handle easily, and the small spoon fits easily in their mouths.

Dosage cups: These are convenient for children who can drink from a cup without spilling. Be sure to check the numbers carefully on the side, and measure out liquid medicine with the cup at eye level on a flat surface.

FDA Proposes New Regulations

FDA is working on changing the labels of over-the-counter medications to make them more eye-catching, easier to read, and consumer-friendly. One such label appears on the recently approved OTC version of children's Motrin.

For prescription drugs, FDA took measures in December 1994 to provide more information to health-care providers about use of those products in children. This rule was final in January 1995.

The agency now lets prescription drug manufacturers base pediatric labeling on data extrapolated from adequate and well-controlled adult studies, together with other information about safety and dosing in children. This is allowed as long as the agency concludes that the course of the disease and the drug's effects are sufficiently similar in children and adults.

Presently, most prescription drugs do not contain pediatric doses on their labels. A 1979 regulation required full clinical trials in children as the basis for pediatric labeling. Doctors who need to prescribe those drugs to children do so based on their own experience and reports in medical literature. The new regulations will give health-care providers more information to prescribe medicine for children safely.

In addition, FDA is taking steps to increase the numbers of drugs being tested in children, and the agency is working closely with the National Institute of Child Health and Human Development to conduct pediatric studies.

The goal of FDA's changes is to help ensure that whenever a child receives medication, it is as safe and effective as possible.

Aspirin and Children

Remember those orange-flavored baby aspirin tablets? They're not usually for kids anymore.

Children and teenagers should never take aspirin, or products containing aspirin or other salicylates, if they have chickenpox or flu symptoms or are recovering from these or other viral illnesses. Such aspirin use has been associated with Reye syndrome, a rare but serious condition that can cause death.

"The incidence of Reye syndrome has dropped dramatically," says Debbie Lumpkins, an FDA microbiologist in the Office of OTC Drugs, "but that doesn't mean it can't still happen."

FDA has proposed adding a more descriptive warning label on aspirin and other products containing salicylates. The label would describe symptoms of Reye syndrome in more detail than it does now.

To reduce fever safely in children, use acetaminophen or ibuprofen products.

About the Author

www.fda.gov
FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.