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Teaspoons Behind Many Child Drug-Dosing Errors

Experts recommend medications be administered in milliliters only


The inaccuracy of kitchen spoons becomes even more worrisome given that drugs are prescribed to children based on their weight, to make sure they are receiving a precise dose, said Heather Free, a pharmacist in Washington, D.C., and spokeswoman for the American Pharmacists Association.

Kids are more sensitive than adults to many drugs, and getting the dose even slightly wrong can lead to problems.

"Just a tiny amount, a milliliter more, can increase toxicity levels or underdose the patient," Free said.

Some parents also have trouble distinguishing a teaspoon from a tablespoon, or the abbreviation tsp. from tbsp., Paul said.

"It's not readily apparent that abbreviation stands for teaspoon, not tablespoon, especially for those parents with low health literacy," Paul said.

To ward off dosing errors, some pharmacy chains now dole out pediatric prescriptions with milliliter dosing instructions and provide parents with oral syringes to accurately measure each dose, Free said.

Free herself uses milliliter dosing in filling prescriptions for children, and even marks the prescribed dose on the oral syringe so parents don't have to eyeball the right amount each time.

Parents should not be afraid to ask their doctor or pharmacist to make their child's prescription easier to administer, Yin said.

"Parents should ask their doctor or pharmacist to tell them the dose in milliliters instead of teaspoons and tablespoons," she said. "Parents should also make sure to use a dosing device, like an oral syringe, dropper or dosing spoon, rather than a kitchen spoon, to measure out the dose."

Pharmacies have accurate dosing devices on hand and should provide them if asked, Free said.

"If the pharmacist does not provide it, I encourage parents to ask your pharmacist for one of their disposable oral syringes, and make sure they are familiar for how to use it," she said.

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