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Medications > Medication Mistakes

Top 12 Medication Mistakes

Twelve common medication mistakes and how to correct it by doing it right. Read these steps to help prevent medication mistakes.

1. Stopping the antibiotics a few days early.

Since many children spit out their medicine or clamp their mouths shut at the sight of a measuring device full of strange liquid, it's understandable why you might be tempted to stop your child's antibiotics a few days early, especially if she seems better. It's easy to forget to finish the prescription if your child feels better. If your child gets only some of a prescription, some harmful bacteria may survive. What's worse, the bacteria left behind in the body could become resistant to antibiotics. (You've heard of the "superbugs".) This means that your child is at a greater risk of developing an infection that involves complex treatments requiring two or three antibiotics and, in some cases, hospitalization.

Do it right

Take a no-nonsense approach and follow the instructions on the prescription label. If it says to administer the medicine for ten days, complete the full course. Keep a reminder note for the medicine in a conspicuous place, such as the refrigerator door. You can ask the pharmacist to flavor medications in a flavor your child will take more eagerly.

2. Forgetting to give your child a dose of their prescription.

Do not simply double up the next dose. Giving two doses of an antibiotic, antiviral, or anti-fungal medication can cause diarrhea or stomach upset. And some medication, such as insulin for diabetes, can be extremely harmful if given in double doses.

Do it right

If you've missed a dose of an antibiotic by only an hour or two, give the dose as soon as you remember and then proceed with the next ones. If it's already time for the next dose, give an extra dose at the end of the prescription (on day 11, if it's a 10-day prescription). If in doubt, be sure to consult your child's doctor or pharmacist.

3. Using antibiotics when not needed.

Some parents pressure doctors into giving an antibiotic for a viral infection, such as an upper respiratory infection or cold. Others may give one child's leftover antibiotics to another child. Best case scenario, the child simply does not need an antibiotic, is not allergic to the one given, and does not get diarrhea from the dose. Worse scenarios happen though. Diarrhea is a frequent side effect, and if the antibiotic is required to treat infection, diarrhea is acceptable. If the antibiotic is overused, the child has unnecessary diarrhea. A child might have a serious allergic reaction to the antibiotic. Giving antibiotics without a professional exam can hide a serious infection, such as meningitis, by making some of the symptoms go away but the antibiotic is the wrong one to completely kill the infection.

Do it right

First, throw out medication left over from a finished prescription. Most liquids don't last beyond 2 weeks anyway. Second, don't assume your child needs an antibiotic every time he develops a sore throat and fever. In general, antibiotics are good for some ear infections (such as those lasting more than 3 days), urinary tract infections and strep throat. (The only way to confirm strep is with a throat swab since even a doctor cannot tell from looking that it is strep, viruses can give the same picture). Antibiotics do not treat colds, the flu or stomach viruses. Do not pressure your child's doctor for an antibiotic. The doctors at Pediatric Partners will only treat indicated bacterial infections. Sometimes you may need to bring your child back if an ear infection develops during a cold. This can be an inconvenience, but your child won't get doses of strong medicine he doesn't need, and he'll be less likely to develop an antibiotic-resistant infection.

4. Using a regular teaspoon to measure out liquid medicine.

A true teaspoon holds 5 milliliters of liquid. Depending on the style of the spoon and whether you fill it to the rim, the dose you give your child may be as little as 2 milliliters to as much as 9 milliliters. Therefore you may give your child a dose that's too small and does not provide maximum relief, or one that's too great, which can lead to unnecessary side effects.

Do it right

Use the measuring device that comes in the package. For medicine that doesn't come with a measuring device, use a calibrated medicine syringe, cup, or spoon.

5. Giving your child a half dose of an adult medicine.

Because you may not think cough medicine is a powerful drug, you give a portion of an adult product for your child. This can be very dangerous. For instance, many adult cough syrups often contain alcohol, which can intoxicate your child. What's worse, in incorrect dosages the cough suppressant dextromethorphan (found in many adult cough syrups) can cause nausea and vomiting in children, and the decongestant pseudoephedrine can cause heart rate irregularities.

Do it right

Give your child only medicines that are made for children or recommended by your child's doctor. Use the dosing mechanism that comes with the medicine. We do not currently recommend any cough medications for children. If you cannot find a children’s form of medication, chances are it is not recommended for children.

6. Mixing your child's medicine with food

Mixing your child's medicine with food to get them to take it, without consulting a doctor or pharmacist. Pain relievers and some antibiotics can be mixed with applesauce or juice, as long as you make sure your child finishes all the food or juice to get the full dose. Some antibiotics need to be taken on an empty stomach because food interferes with their absorption.

Do it right

When you receive a prescription or buy a new over-the-counter medication, ask your pharmacist if it should be taken on an empty stomach or with food. If your child hates the taste of one medicine, ask the pharmacist if it can be flavored. Some antibiotics come in chewable tablets, which may be easier for some kids to take. For the really difficult child, compounding pharmacies can make medicines in the form of gummy candy, lollipops, or other good-tasting solutions. Remember that not all things require medicine. If the child doesn't want to take an over-the-counter cold remedy, that's fine. Treat symptoms in other ways, such as elevating the head and adding moisture to the nose.

7. Giving your child a pain reliever and a multi-symptom cough medicine.

In trying to get rid of your child's stubborn cough with a multi-symptom cold medicine, you may unknowingly give him an overdose of acetaminophen or ibuprofen if you're offering a pain reliever, too. That's because many multi-symptom cold remedies also contain pain relievers. Although a double dose of acetaminophen may not harm your child the first time, it could cause liver damage if continued over several days.

Do it right

Check labels to see if you're doubling up on any ingredient. To be extra safe, don't buy multi-symptom remedies. Choose products that treat only the symptoms your child has. The goal is to avoid over medicating your child, which can cause drowsiness, irritability, or, in rare cases, liver damage.

8. Treating every stomach upset with an over-the-counter medication.

Diarrhea in kids is usually caused by a bacteria or virus that needs to be left alone to run its course. If you suspect that your child has a stomach virus (which is often accompanied by fever and body aches), anti-diarrhea medications are usually not the best choice. Over-the-counter medicines, which slow down the movement of stool, are not recommended in children because they prolong the contagious period. If the diarrhea is an infection, it is best to let it run its course so your child recovers more quickly.

Do it right

Try other remedies before reaching for the medicine. For constipation, increase water, give prune juice and add fruit, bran cereals, and other high-fiber foods to your child's diet. For diarrhea (which can cause dehydration in young children within a matter of hours), give your child electrolyte solutions and let the diarrhea run its course. Probiotics ("good" bacteria) are gaining popularity and can be given safely. They are available over the counter. Call a doctor if the diarrhea causes dehydration (a decrease in urination, no tears when a baby cries, high fever, listlessness, and/or sunken eyes).

9. Forgetting to check the expiration date before giving your child an old medication.

Most over-the-counter medications have a shelf life between one and two years, although liquid medications that need to be refrigerated may last only a few weeks before spoiling. Most medications simply lose their effectiveness after the expiration date, but a few medications actually become toxic after the expiration date.

Do it right

Throw out any medicine that has expired. When buying an over-the-counter medication, buy only packages if the expiration date is more than six months away.

10. Not knowing your child's list of drug allergies.

Many parents forget the name of the medication that their child had a reaction to, or even forget which of their children had a reaction to a medication. Some parents confuse well known side effects with allergies, such as a mild rash with amoxicillin or stomach aches and diarrhea with any antibiotic. Giving an antibiotic with a mild allergic reaction again may produce a more serious reaction the next time. Labeling your child with inappropriate allergies (true side effects) may make it difficult for a doctor to find an appropriate antibiotic in a time of serious infection.

Do it right

Keep a list for each of your children about any allergic reactions to medications. Note the date, the name of the antibiotic, and the reaction (rash, hives, breathing difficulty). Keep the list where it is easily accessible. Tell your doctor the type of reaction so he can decide if it is a true allergy or a side effect and note it in the medical record. Tell your pharmacist about all allergic reactions, so they can monitor future prescriptions. Use the same pharmacy whenever possible.

11. Not telling your doctor and pharmacist every medication and supplement you are giving your child.

Many parents give supplemental vitamins or herbal treatments to children. It is important that your doctor and pharmacist know these so that we can watch for drug interactions. Even topical medications (such as those for acne) should be reported.

Do it right

Write down all medications, supplements, vitamins, creams, and inhalers you give your child and give the list to your doctor and pharmacist.

12. Treating every fever.

Fever is a symptom. It often is from illness and can make people miserable, but it is the body's natrual defense. We don't recommend treating fevers in any baby under 3 months without first talking to us. We also are more cautious in children who are not up to date on their vaccines. Most children, however don't need a fever reducer at temperatures under 102F. 

Do it right

Help your child stay comfortable during illness. If that requires a pain reliever, that is fine, but the goal is never to bring the temperature to normal. Dr. Paul Offit has a wonderful blog The Case For Letting Fevers Run Their Course. More on fever management from Dr Stuppy's blog:

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