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Administering Oral Medications

Taking medicine by mouth is one of the rituals of childhood. It seems so simple that we can easily forget important parts of the process.  There are also a few things to avoid. Here are some General Quick Tips – detailed information follows:

General Oral Medicine Tips

  • Keep all medicines locked away and in child-resistant containers
  • Keep a good count of tablets and pills to be sure none disappear
  • Try to give every dose on a regular schedule
  • When you get the prescription, ask your doctor what to do if you forget a dose, and write the answer here: _________________________
  • If child spits or vomits within 15 minutes, repeat dose.
  • Continue to give the medicine until it is all gone, or until your doctor asks you to stop.
  • Only give a prescription medicine to the person it is for. NEVER share prescriptions
  • Parents should keep the container for teens on antidepressants. Give out one pill each time. This can prevent intentional overdose.

Oral medications come in a wide variety of forms. There are liquid solutions, suspensions, and syrups, chewable tablets, as well as standard tablets and capsules. Some oral medications come in the form of “sprinkles” that you can mix with foods. The form of the medication is often almost as important as the medicine itself.

Oral Liquid Medicines

Oral liquid medicines can make it easy to give medication to young children who can’t swallow pills or capsules. They can also make it easy to over- or under-dose the medicine, however, since usually you must measure each dose yourself. Many liquid medicines, especially antibiotics and many seizure medications, come prepared as “suspensions.” This means that the medicine is actually in tiny particles floating in the liquid syrup. The particles can settle to the bottom of the bottle, so it is important to

Many liquid medicines expire very rapidly. In fact, the pharmacist usually prepares the medicine right before you get the prescription. These medicines often require refrigeration to keep them fresh through the whole treatment course. Refrigeration does not usually harm other liquid medications, so when in doubt, refrigerate!shake the bottle well before each and every dose. If you don’t shake the bottle before the dose, you will give nothing but syrup for the first half of the bottle, and then far too much medicine when you get closer to the bottom. You don’t have to shake medicines that are called “solutions,” but shaking won’t hurt them. When in doubt, shake!

Dosing in liquid medicines is by volume. That is, you will give your child a specific measured number of cc’s, ml’s, or teaspoons or tablespoons.

Guide to Measuring Liquid Medicines

1cc = 1 ml (a cc and an ml are the same thing)
1 teaspoon = 5 cc = 5 ml
1 TABLESPOON = 3 teaspoons = 15 ml

Very few medicines require using one or more tablespoons – Please double check very carefully if someone tells you to give a tablespoon or more of a liquid medicine.
Pharmacists usually dispense liquid medicines with a proper measuring device. This may be a special syringe (no needle!) or a specially shaped spoon that is marked into cc/ml and teaspoon markings. Because liquid medicines usually have sugar in them, it’s important to wash the device after each use to prevent germs from growing on it. If you use a syringe for medicine, please be sure to remove any cap or cover before you give the medicine. Children have choked to death on these covers when they got into their air passages.Most manufacturers make liquid medicines in such a way that some easily measured amount of liquid is the “right dose” for children at different ages. For example, children’s antibiotic liquids come in different concentrations so that your doctor can usually prescribe an easy amount such as one teaspoonful, or one and a half teaspoonfuls of medication. If your medication label says to use some unusual amount, such as, for example, “1.37 teaspoonfuls,” please carefully double-check with your doctor or pharmacist. Anyone who has ever watched a child take liquid medicine knows that such accurate measures don’t make sense!

It is always a good idea to remind your child that the medicine will help him or her to get better, but also that it is medicine, not candy or a treat. Manufacturers always have to struggle to make a medicine taste just good enough that a child will take it, but not so good that s/he is tempted to take too much. If your child does not like the taste of the medicine, you may want to have a glass of water or juice ready to help wash it down. Please also be sure the cap is securely fastened back on the bottle after each use.

Please: never hold a child’s nose closed in order to get him or her to swallow medicine.This will terrify the child because s/he feels s/he cannot breathe. It may actually work the first time you try it, but it will make the next dose nearly impossible to give.

Liquid Medicine Tips

  • Keep bottle tightly closed
  • Shake before using
  • Keep refrigerated unless otherwise instructed
  • Use medicine measuring device or measuring spoon, not household teaspoons.
  • Wash measuring device after use and dry thoroughly
  • Use measuring syringe if possible and give small squirts at a time.
  • Let baby swallow each squirt before giving next squirt

Chewable tablets

Chewable tablets are a wonderful option for a growing number of medications. They help a great deal in giving medication to toddlers and pre-school children. Please be sure to give them exactly as directed. Just like with the liquid medicines, there is the danger that a child may like the taste too much, and try to eat the tablets like candy. Most manufacturers package chewable tablets in “blister packs” that make it hard to get at more than one tablet at a time, but children are ingenious and industrious. Please keep these medications safely locked away when you are not using them. Always dispense chewable medicines yourself on schedule – NEVER ask a child to get his or her own chewable medicines.

Capsules and Tablets

Most children can start swallowing capsules and tablets by late school-age. Some children can start earlier, but please be careful that your child doesn’t chew the pill. Capsules and tablets dissolve in the stomach at a carefully designed rate. Chewing can release too much medicine all at once, or can destroy some of the medicine. Some pills are fine if chewed or broken, so please check with your doctor if it seems this might help your child. Also, please remember that some people reach adulthood without being able to swallow pills.

Tips for swallowing pills

  • Have some water or juice handy
  • Tablets (solid pieces of medicine) sink in water, so have your child take a sip of water and hold it in the mouth. Then drop the tablet into the throat and swallow with the head held slightly up. The tablet will sink to the bottom of the water and will be the first thing to be swallowed.
  • Capsules (bits of medicine inside a shell) float in water, so use the opposite technique: Sip water and hold it in the mouth, put the capsule in the mouth, and tip the head slightly forward. Then swallow – the capsule will float right down!
  • If a person gags or chokes on a pill they almost always spit it out. Wait at least half an hour before trying again. If it doesn’t work the second time, your child probably isn’t ready for pills yet.

Tips for Pills

Sip water or juice before putting pill in mouth
Keep liquid in mouth, then put pill in mouth
Tablets: tip head backward and swallow
Capsules: tip head forward and swallow

Medication Sprinkles

A small number of medications as well as some vitamin formulations are available as “sprinkles.” The sprinkles typically contain the medication or vitamin inside a protective coating. Each sprinkle particle is tiny – about the size of a sugar grain. Sprinkles are designed so that you can sprinkle them over your child’s favorite food – in theory making it easy for your child to swallow the medicine. There are a few tricks to know about, however! First, please avoid just sprinkling the medicine on top of a spoonful of food – your child will see and taste the medication right away. Instead, pour the correct amount of sprinkles into a small dish or cup, and add the spoonful of food you will use. Mix it up well with a baby spoon. Then scoop up the entire amount with the spoon and feed it to your child. If you use a sticky, thick material such as chocolate syrup or peanut butter, your child will be less likely to spit out the medicine. Please never use honey for this purpose in a child under 2 years of age, because of the risk of infant botulism.