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Pharmacists answer Parents' often Asked Questions

It is usually when parents are faced with a sick child they have questions concerning the proper use of medications. I therefore asked two pharmacists at All Children’s Hospital to answer some common concerns parents have when giving their ill child a prescription medicine.

1. When the child’s physician prescribes a medication three or four times a day, does this mean every eight or six hours or to divide the doses into the child's waking hours?

Dave Grinder*: Most medications do not require rigid adherence to a dosing schedule of every six to eight hours and are meant to be given during the child's waking hours. For example, if a medication is prescribed every eight hours, usually it can be given morning, noon, and evening. However, a few medications must be given at specific intervals to keep up their blood levels, even if this means awakening the child up at night. Examples asthma, anti-seizure, and heart medicines. If parents are unsure about the timing of a medicine, they should ask their child’s physician or pharmacist for clarification of the instructions.

2. When giving a medication to a child, what should parents do if all of it does not end up in the youngster’s mouth?

Ann McLocklin: Most of the time, a parent should estimate the amount their child did not receive and give that amount again. Parents do need to be careful, however, about drugs that are potentially toxic, like cough medications and anti-wheezing drugs. There is usually a large margin of safety with antibiotics. When parents are not sure if they should give more medication, a call to their child’s physician or pharmacist is in order.

3.What should parents do it their child throws up all or most of the medication?

Ann McLocklin: Parents should try again a little later, once the youngster has calmed down. The entire dose should be given. For some medications, like anti-seizure or heart medications, throwing up part of the dose can be important. In these situations parents should notify their child’s physician or pharmacist for advice.

4. If a medication is supposed to be refrigerated, how long can it be out and still be effective?

Dave Grinder: The time a refrigerated medication can be left out of the refrigerator is highly variable and depends on the medication. For example, Growth Hormone can be left at room temperature for seven days. The antibiotic augmentin cannot be out of the refrigerator for more than a couple of hours. If a child’s medication requires refrigeration, leave it in the refrigerator! Some medications for children need to be refrigerated only because they taste better cold, not because they lose effectiveness. If the child will be traveling, ask the child’s physician if there is a chewable alternative. If the medication is accidentally left out of the refrigerator, call the pharmacist before discarding or giving the medicine.

5. Why is it wrong to give one child a sibling’s medication when a parent knows the other child most likely has the same illness?

Ann McLocklin: It seems like a good idea if one child has the "pink stuff" for an ear infection to give it to a brother or sister with the same symptoms. However, giving a child someone else’s medication could lead to problems. First, there will not be enough medication to complete the proper course of treatment for either child. Second, giving medication to children without the benefit of a physician’s examination may result in the wrong medication for the child’s infection. Two children, with the same illness, may require different medications taken under different directions. Always, complete the full course of therapy prescribed and throw away any unused medication. Never give one child another child’s medication.

6. How can parents tell if their child is having an allergic reaction a medication?

Dave Grinder: Most medications are given to children because they are ill. Sometimes it is very difficult to tell the difference between an allergic reaction and the symptoms of the illness. For example, a rash that develops while taking medication for an ear infection could be from the medicine or from the virus causing the illness. Most reactions occur soon after receiving the medication, but some reactions can develop slowly over the course of several days, and even after the medicine is finished. Vomiting, stomach cramps, headache, nausea, and pain are generally not symptoms of an allergic reaction. Parents should always call their child’s physician or pharmacist if they are concerned about a possible reaction to the medicine.

7. When parents use a dropper to give their child medication, must it be washed after it has been in their youngster’s mouth?

Ann McLocklin: Droppers are a convenience for parents in giving medications to very young children. The dropper should be washed off after each use or it could be contaminated. Remember to use a separate dropper for each child when giving a non prescription medication like acetaminophen.

*Dave Grinder, R.Ph., is Director of the Pharmacy at All Children’s Hospital and editor of "The Journal of Pediatric Pharmacy Practice."

**Ann McLocklin, Pharm.D., is a Clinical Oncology Pharmacist at All Children’s Hospital.


As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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