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Pima County Health Department is First Things First’s statewide administrative
entity for Child Care Health Consultation in Arizona.
CCHCs! This site is your opportunity to share ideas, favorite resources, announcements and questions. Also you will find current information regarding health and safety and CCHC projects.
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Who's Who? Contact information for individuals who are part of the CCHC leadership team in Arizona
Kelley Murphy, RN-Senior Policy Specialist, First Things First - contact
Kathi Ford RN, Child Care Health Consultation Systems Coordinator , Pima County Health Department - contact
Tom Ball, MD, MPH-American Academy of Pediatrics, Child Care Contact for Arizona - contact
Pima County Health Department
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Additional CCHC Favorite Resources:
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back to topThe Doctor is In...
Dr. Phan is a Clinical Assistant Professor in Pharmacy Practice and Science at the College of Pharmacy and Assistant Professor in Pediatrics at the College of Medicine. Dr. Phan's current research interests include safety and efficacy of drug therapy, patient education, and adherence in the treatment of cystic fibrosis and asthma.
Nicole Even is a Pediatric Pharmacy Specialty Resident, University of Arizona and Diamond Children's at University Medical Center, Tucson, AZ
Question: What tips can I give to providers about giving liquid medications to children?
Answer:
The Importance of Appropriate Medication Measurement:
Medication error in dosing can occur at any moment in time. In a recent study of parents and caregivers, medication error from dosing liquid medications has been found to occur at a rate of up to 50% (Yin, et al; in Archives of Pediatric and Adolescent Medicine, February 2010). One way to help prevent medication dosing error is by making sure the medication is measured correctly. Use measuring devices provided with products or ones supplied by the pharmacy with milliliter and teaspoon increments properly labeled on the syringe or device. Please make sure to learn how to properly measure the medication using the appropriate device and be careful of the markings on the measuring device and the prescribed dose (e.g., mL or teaspoons). Do not use kitchen spoons or measuring cups that do not accompany the medication. Using an incorrect measuring device will result in too much medication (e.g., overdose) per dose.
Suspensions versus Syrups:
Medication suspensions are a combination of a medication (e.g., crushed tablet) mixed in a liquid, called a drug vehicle (e.g., flavored cherry syrup). This is a very common way medication is made for children that otherwise would need to be given as a tablet or capsule. The drug vehicle can make the medication taste better; however, some bitter aftertaste can result with some medications. Suspensions need to be shaken well to make sure the crushed medication is evenly mixed for appropriate dosing. If a suspension is not mixed well, some of the crushed medication can settle to the bottom of the medication bottle and lead to inconsistent dosing. Some suspensions will need to be stored in the refrigerator (always check the label); but will still need to be shaken well prior to measuring and giving a dose.
Medication syrups or solutions are another common way medications are made for pediatric patients. These are a dissolved mixture of a medication and a liquid drug vehicle (e.g., flavored cherry syrup). Unlike suspensions, medication syrups or solutions to not need to be shaken well and are not typically stored in the refrigerator but at room temperature. However, it is recommended to always check the label to verify appropriate storage.
Masking the "Icky" Taste of Medications:
Some liquid medications can taste bad, which can affect ability to give medications as directed. Avoid giving medications in infant formula, as infants may associate bad taste with feeds and avoid feedings which can affect their weight and growth. Some liquid medications can be given with certain food items to help mask bad taste. For example, chocolate syrup may be used, as a small spoonful before the medication dose, mixed with the medication dose, and a small spoonful after the dose. Chocolate syrup coats the mouth, thus can help reduce the bitter taste of some medications. Items such as applesauce or pudding can be used instead; however, check with your local pharmacist to make sure it does not interact with the medication. Peanut butter should be avoided in children with nut allergies and honey should not be used in children less than one year of age. Always ask families about food allergies before considering using food items to help give medications.
Proper Storage of Medications:
With summer coming up it is important to remember to not to leave medications in direct sun light, high temperatures (e.g., the car), or warm moist areas (e.g., bathrooms), as all of these things can chemically change the medication which could deactivate it or cause it to go bad. Medications should be stored in dry cool areas unless otherwise indicated. Some medications may need to be stored in the refrigerator. Proper storage instructions can usually be found on the medication label. If you cannot locate this information, ask your local pharmacist. It is also very important to look at the expiration date of each medication (also located on the label). Do not use the medication if it is expired and ask your local pharmacist for instructions on proper disposal.
Importance of Medication Lists:
Whether a child is at home with their family, at day care, the babysitter, or at a friend's house, it is very important that each child have a medication list (with medication allergies included) with them at all times in case of emergency. Health care professionals need to be made aware of a child's medications and allergies in case new medications need to be started. With a current medication list and allergies, health care professionals can look for possible drug interactions. A free medication list for printing is available at: http://kidsmeds.info/mymedicationlist/.
Other Reliable Internet-Based, Pediatric Medication Resources:
Archived questions
Submit questions to Kathi Ford.
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Announcements & Events
 For more information about the CCHC training series in Maricopa County contact Barbara Herber (barbaraherber@mail.maricopa.gov).
For information and application For Pima County and the rest of the state contact Kathi Ford (kathi.ford@pima.gov)
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Child Health and Safety Radio
Child Health and Safety Radio is part of BAM Radio Network, the largest education radio network in the world. BAM Radio Network offers programming from the nation's top education organizations and thought leaders, and reaches a wide audience of people committed to quality education. This link is provided by Dr. Charlotte Hendricks of Health Childcare Consultants Inc.
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PIMA COUNTY HEALTH DEPARTMENT | 3950 S. Country Club Road, Ste. 100 Tucson, Arizona 85714
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