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Dosing Confusion Common With Kids' Liquid Medicines

Study: Packaging for OTC Products Hard for Parents to Understand

Voluntary Guidelines continued...

Darren A. DeWalt, MD, MPH, of the University of North Carolina, Chapel Hill, says it defies logic that pharmaceutical companies spend hundreds of millions of dollars developing new drugs -- including determining the appropriate dosage to give -- and then fail to provide clear dosing instructions for them.

DeWalt, whose research focuses on how well patients understand doctors’ instructions and the impact on medical care, says the fault does not lie with the product labelers alone.

“At every level, including the clinic and the pharmacy, we are not doing a very good job of helping parents understand what they need to know when they give these medications at home,” he tells WebMD.

Teaspoon, Tablespoon Confusion

DeWalt says one of the biggest areas of confusion involves teaspoon and tablespoon dosing recommendations.

He says people often confuse the two and use tablespoons, which are typically three times the size of teaspoons, when instructions call for teaspoons.

“This happens all the time,” he says. “Most of the time there is no real harm. But if it happens with, say, Tylenol several times a day for several days, there could be issues with liver toxicity. Or if it happens with Benadryl that can knock a child out.”

Devices for delivering medicines often have extra markings that are not necessary for following label directions.

In the newly published analysis, four out of five measuring devices included these superfluous markings.

And some products included units of measurement that hardly anyone understands, such as "drams" and "cubic centimeters."

“I couldn’t tell you what a dram is, and it’s a safe bet that very few people can,” DeWalt says.

In an editorial published with the study, DeWalt recommended that milliliters be adopted as the standard unit for delivering liquid medications.

Yin says if this happens, efforts to educate the public and health care providers about this unit of measure will be needed.

“This is not a term many parents understand,” she says. “And doctors, nurses, and pharmacists will need to use this term. There has to be a united front, or it will just add to the confusion.”

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