Tuesday, November 30, 2010

Children's liquid medicine: are you giving the right doses?

Does this train of thought sound familiar, as you’re divvying out cold medicine to your sick kiddo: hmmm…5mL equals one teaspoon? Or is it tablespoon? I need Google…

If you sometimes feel like you need to be a pharmacist to decipher those over-the-counter cold medicine labels and measurements, you’re not alone.

A new study released today by the Journal of the American Medical Association found inconsistencies with the labeling and measuring devices in 200 of the top-selling cough/cold, allergy, analgesic and gastrointestinal over-the-counter liquid medications for children. Read more about it in this article from TIME Magazine.

Among the findings of the researchers, a standardized measuring device was provided for 148 products. Within these 148 products, nearly all of them contained one or more inconsistencies between the labeled directions and the accompanying device with respect to doses listed or marked on the device, or text used for unit of measurement. Almost a quarter of products lacked necessary markings.

The researchers also found that a nonstandard abbreviation for milliliter (not mL) was used by 97 products. Of the products that included an abbreviation, 163 did not define at least one abbreviation.

“As a parent, I have noticed some of the inconsistencies, but of course it is easier for me as a physician to make the necessary adjustments,” said Dr. Eduardo Gonzalez, family medicine physician on the medical staff at Texas Health Arlington Memorial Hospital. “A measuring standard throughout the over-the-counter medicine industry would go a long way in making the use of these types of medication safer for the consumer and also help physicians provide proper dosing advice.”

What is the danger here? The authors of the study say the risks may vary, but the potential for harm is substantial. More than half of U.S. children are exposed to one or more medications in a given week, and more than half of these are over-the-counter medications.

The authors recommend that:
•    a standardized measuring device should be included with all nonprescription liquid products;
•    within each product, consistency should be ensured between the labeled dosing directions and markings on the associated measuring device; and
•    across products, measurement units, abbreviations, and numeric formats should be standardized.

“Parents probably need to better informed of the inconsistencies,” Dr. Gonzalez said. “Pharmacies might provide literature concerning common dosages just as 5 ml equals 1 tsp, etc., or even provide measuring devices that are more standardized. Parents should ask their doctors if they are not sure what to give their children if all else fails.  Most people do not really think anything taken over-the-counter might have potential consequences.”

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