As you already know because this is the kind of thing we all pay attention to, there is a serious shortage of children’s medications right now. Parents of young children may also be aware because it’s a topic they would discuss at work or school meetings. But they probably don’t give much thought to it until it affects their children.
And then they are going to be scared and upset.
Because they, and we, have been conditioned to believe that they are essential.
But pediatric medications aren’t essential. They are convenient. Their most important function is in precisely dosing the medicine for children based on age and weight (assuming the parent measures accurately). Almost equally important is that they add flavor and are in liquid form for children to easily swallow.
There’s nothing to prevent physicians from doing the math for parents so that they can make their own pediatric dosages for their children. And it’s something that will definitely happen in the not-so-distant future. (Physicians currently advise against parents doing the math themselves for fear the parents will miscalculate and overdose the child.) With antibiotics, it’s already happening.
To be sure, this is something you don’t want to do unless you absolutely have to. Problems lie in getting the dose precise, the pills split evenly, the drug suspended uniformly in the syrup, and making the syrup in small enough doses so that medicine isn’t wasted or that child isn’t under- or overdosed. It’s not an issue to be taken lightly. As pharmacists and physicians all know, and which we should as well, the difference between medicine and poison is the dose.
DIYing pediatric dosages is something you don’t want to get involved in unless you’re approaching the level of serious illness. Rather than risk overdosing an infant with Tylenol (acetaminophen) to reduce a low fever, I’d choose to pass on DIY infant Tylenol. If faced with the risk of my grandchild developing a high fever and there were no commercial preparations and no licensed medical care, I’d DIY the infant Tylenol. Sometimes there are no good choices. (And that’s why we prepare—so that we can have good options. But that’s not something to point out to panicking parents right now.)
For reference, here’s the dosing chart for Tylenol:
Oral administration
Parents facing the possible need for making their own pediatric medicines will need the following supplies:
- Pill splitter
- Mortar and pestle for powdering tablets
- Medicine dropper with measurements in milligrams
In addition, you might want a calculator and you definitely want someone to check your math.
Unfortunately, just reducing the dosage isn’t all that is needed. Infants and most young children can’t swallow pills. The medicine needs to be put in liquid form for easiest administration. You’ve got a couple of options:
Applesauce. Make sure to mix the medicine into just a tablespoon of applesauce, the smallest amount you are sure your child will consume. Of course, if you don’t use enough applesauce, the nasty taste of the medicine will come through. Pudding or ice cream may also work. (Do not mix tetracycline or any –cycline antibiotics into milk or other dairy products.)
Syrup. Make a simple syrup with sugar and water. Add a little candy oil flavoring. The LorAnn oils are very good, strong flavors used in candy making and mask the nasty taste of antibiotics well. (Amoxicillin and Augmentin are particularly nasty.) Grape and cherry are the most commonly used for flavoring children’s medications. LorAnn oils are available wherever candy making supplies are sold, on Amazon, and through the LorAnn website. Depending on how many children you have, you’ll want at least a 1-ounce or 4-ounce bottle. A dram is not enough.
Other means of administration
What if you don’t have a way to mask the flavor of the antibiotic? What if your child has already had one or two doses of the nasty medicine and refuses to have another? You can’t risk having your child waste the antibiotic by spitting it out. And you know your child is doing better because she took the first dose or two. How are you going to get it in her? What if you are dealing with an infant not eating solid foods yet? If all else fails, it goes up the bum.
Make a pediatric suppository.
- Mix the powdered dosage into a very little coconut oil, about ¼- ½ teaspoon.
- Form this into a pellet with a pointed end for easier insertion.
- As coconut oil melts at 77°F and it may warm up as you mix it, you may need to put it in the refrigerator or freezer to harden it before insertion. And then it goes up the bum. ;)
Expired liquid medications
What about out-of-date liquid medications? We know that most medicines in dry form, as long as they have been properly stored, are effective well beyond the date stamped on the package. However, the same does not hold true for liquid medications. They may be effective only a few months past the date. What is the danger in using them? The only risk is that antibiotics may lose efficacy and thus not eradicate the bacterial infection. There is no potential for toxicity. The same holds true for pain relievers—they just may not reduce pain or fever as well.
Prepare now
Recognize that the time is coming when antibiotics will be in such short supply that ear infections and strep throat will not be treated with them because those are not life-threatening illnesses. If parents want those drugs for their children with those illnesses, they will have to acquire their own supply of them. And if the parent seems open to the ideas you’ve shared, suggest that what they see happening with their children’s medicines will soon be happening with their children’s food. They need to prepare now.
Caution. Augmentin doses should never be doubled or halved. Augmentin is amoxicillin + clavulanic acid. The amoxicillin component may be safely and easily changed, but the clavulanic acid cannot be.
For confused adults, a pill crusher, some orange juice, and a syringe work well to give in drips, think 1 mL at a time to prevent choking. Check if the med will work from just getting onto mouth surfaces vs swallowed.
ReplyDelete