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Measuring device alert for over-the-counter liquid meds

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In the runny-nosed winters of my childhood, one of the highlights of getting sick was being dosed with a soup spoon of grape-flavored Dimetapp. When I asked for more (as I invariably did - that sickly-sweet, super-fake grape taste appealed immensely to my preschool palate) my mother would remind me of my little friend Tiffy, whose name rarely came up without the preface "holy terror," in part because she once drank an entire bottle of Dimetapp on the sly and had to be rushed to the hospital to have her stomach pumped.

Since those bad old days, doctors and medication packages have frequently remonstrated against using non-standard measures (like my mom's flower-patterned soup spoons) for dosing kids with over-the-counter liquid medications. Caregivers should dole out medicine only in the measuring devices that come with the package, they have said. Otherwise, kids could be headed for Emergency Department visits like Tiffy's.

But a study published today in the Journal of the American Medical Association shows those little plastic dispensers are almost always hopelessly confusing. From a press release:

Among the findings of the researchers, a standardized measuring device was provided for 148 products (74.0 percent). Within these 148 products, nearly all examined (98.6 percent) contained 1 or more inconsistencies between the labeled directions and the accompanying device with respect to doses listed or marked on the device, or text used for unit of measurement. Almost a quarter of products (24.3 percent) lacked necessary markings.

“Among the measuring devices, 81.1 percent included 1 or more superfluous markings. The text used for units of measurement was inconsistent between the product's label and the enclosed device in 89 percent of products. A total of 11 products (5.5 percent) used nonstandard units of measurement, such as drams, cubic centimeters, or fluid ounces, as part of the doses listed,” the authors write.

An accompanying editorial discusses the researchers' recommendations for fixing the situation:

Ensure a standardized measuring device is present with all liquid medication packaging, ensure consistency between the label dosing instructions and the markings on the measuring device, and choose standard measurement units and abbreviations. The first 2 suggestions are obvious, and it is difficult to understand how they are not already implemented. The third suggestion raises an important consideration for the FDA and the pharmaceutical industry. Can the FDA and industry agree on using 1 type of unit across all liquid medications and measurement devices? Any reference to using a teaspoon to measure volume can only increase the possibility of using an imprecise measurement tool obtained from a nearby kitchen drawer.

I hope this isn't the last we hear about this issue - I don't want to resort to dosing the next generation of little ones with my own soup spoons.

Photo credit: Melanie Holtsman

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