Ask a CHOC Doc: Can I Use a Kitchen Spoon to Measure Medicine?

Question: Is it okay to use a kitchen spoon to give my child their medicine?  -Anonymous

Answer:

No! Household spoons are not accurate for measuring the correct dose. Always ask the pharmacist for a syringe or dosing cup. Have the pharmacist show you which line to draw up the volume to make sure your child receives the exact dose prescribed.

 If you’re ever unsure about something regarding your child’s medication, ask your pharmacist! You can call a 24-hour pharmacy any time you need more information about a side effect, how to give your child their medication, or to ask if it should be taken with food.

-Whitney Pittman, clinical pharmacy resident at CHOC Children’s

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Whitney Pittman, clinical pharmacy resident at CHOC Children’s
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Ask a CHOC Doc: Are Heart Palpitations Dangerous?

Question: Sometimes I experience heart palpitations. I want more information on what exactly causes them and if I can do anything to reduce their frequency. At what point should I mention this to my doctor?  –Anonymous

Answer:

A heart palpitation is the feeling of your heart beating too fast, skipping a beat, or fluttering in your throat, chest or neck.

Palpitations, also known as irregular heartbeats, are most likely caused by non-heart-related triggers. Strenuous exercises as well as strong emotions of anxiety or stress, most common among the younger generation, are frequent causes. Consuming caffeine, nicotine, alcohol, certain herbal supplements, cold and cough medication, or asthma medication, which all contain stimulants, as well as illegal drugs such as cocaine are common triggers. Some people report having palpitations after certain heavy meals that contain large doses of carbohydrates, sugars or fat. Sometimes, eating foods with excessive amounts of sodium can bring them on as well. However, some palpitations are caused by actual medical conditions including cardiac arrhythmias, thyroid disease, anemia, low blood pressure, fevers, and dehydration. If palpitations ever occur with chest pain, exercise, or fainting, this could represent a cardiac arrhythmia, and you should notify a physician.

Changing your diet is another key factor in reducing heart irregularities. Cutting back on caffeine intake such as tea, coffee, sodas, and energy drinks can be quite effective.  As a replacement, drink more water. Dehydration can lead to decreased blood pressure which triggers the body’s compensatory response of adrenaline which makes your heart race. Staying hydrated throughout the day can keep your heart rate normal.

If your heart is racing unexpectedly, there are also several things you can try at home to reduce your heart rate. Vagal maneuvers are ways to send anti-adrenaline signals to your heart and blood vessels. These maneuvers include “bearing down,” blowing through a straw, forceful coughing, and placing ice or cold water on your forehead or neck, among others. Sometimes even headstands accomplish the vagal maneuver! These actions stimulate the vagus nerve, which is the nerve that connects your brain to your heart and helps control the rate at which your heart beats. If these maneuvers make your palpitations stop abruptly, that is a good thing, but it also means that you are likely to have a primary cardiac arrhythmia, like supraventricular tachycardia which requires further evaluation and treatment. If palpitations continue despite vagal manuevers, contact your physician or seek medical care.

Palpitations are most likely harmless; however, it is important to know when it is time to see your doctor. When palpitations are accompanied by severe shortness of breath, fainting, chest pain or discomfort, or dizziness seek immediate medical attention. When your heart is beating too fast, it causes your blood pressure to drop which could potentially lead to fainting. Fainting due to low blood pressure can be a possible sign of a heart problem such as a cardiac arrhythmia, congenital heart disease or a heart valve defect. Palpitations accompanied by these other symptoms are also known to have been related to cardiac arrest, strokes, coronary artery disease, heart muscle problems and heart failure.

Here are some helpful questions to keep in mind before seeing your doctor:

  • Is the onset abrupt or gradual?
  • Check your pulse once your heart starts palpitating. Is your heart beating fast or slow? Is it beating at regular intervals or irregularly?
  • During palpitations do you feel dizzy, short of breath, or experience chest pains?
  • How often do your palpitations occur and for how long?
  • What are you doing when they start? Exercise? Calm and relaxed?

Is there anything else unusual about when your palpitations start? Are you sick with fevers, vomiting or diarrhea? Have you consumed less water that day? Are there other stressful and/or unusual events occurring in your life?

anthony-mccanta-choc-childrens
Dr. Anthony McCanta

-Dr. Anthony McCanta, a pediatric cardiac electrophysiology specialist at CHOC Children’s

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Ask a CHOC Doc: Where Should I Store My Child’s Medications?

Question: Where should I store my child’s medications?  –Anonymous

Answer:

Contrary to its name, a medicine cabinet in the bathroom is not the best place to store medications. This is because the steam from showers can change the properties of the medication and it may lose some of its effectiveness. Storing medications in a cabinet near the stove is not ideal for the same reason. All medications should be stored in a cool, dry place away from light. Medications should be stored up and away out of reach of children. If possible, they should be stored in a locked cabinet.

Some medications require refrigeration. The bottle should say “refrigerate” on it. Liquid Augmentin® is a medication that must be kept in the refrigerator. Some medications, like liquid amoxicillin, don’t need to be refrigerated, but taste better if you refrigerate them. Others, like liquid azithromycin for bacterial infections, should not be refrigerated because it can get too thick and your child likely won’t want to take it.

-Whitney Pittman, clinical pharmacy resident at CHOC Children’s

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Whitney Pittman, clinical pharmacy resident at CHOC Children’s

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Ask a CHOC Doc: How Important Is It To Finish An Entire Course of Antibiotics?

Question: Is it really that important for my child to finish their entire prescription of antibiotics?  -Anonymous

Answer:

Yes! Even if your child is feeling better, they should still finish the full course of their prescription as directed by their doctor. Even if, for example, they feel better on day five and their prescription is for 10 days of antibiotics, they need to finish the entire course as prescribed because the bacterial infection might still be present. To really beat the bacterial infection, it is important for your child to finish their entire course. Stopping short could cause your child to get sick again. If your child is experiencing a side effect, contact your pharmacist or pediatrician for more information on how to manage the side effect, such as taking the medication with food to help ease an upset stomach. If your child is having a side effect that they can’t tolerate or an allergic reaction, contact your child’s doctor immediately.

If the pharmacy gave you a full bottle of a liquid antibiotic, you might still have medication left in the bottle. If this is the case, you should always properly dispose of old medicine. It is not a good idea to keep the medication in the refrigerator or cabinet for the next time your child gets sick. Medications expire and they might not work properly or may cause your child to have an unexpected side effect. There is also the possibility that someone might accidentally take the medication.

-Whitney Pittman, clinical pharmacy resident at CHOC Children’s

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Whitney Pittman, clinical pharmacy resident at CHOC Children’s

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Ask a CHOC Doc: How Can I Properly Dispose of Old Prescriptions?

Question: How can I safely dispose of old prescriptions my  family doesn’t need to take anymore? -Anonymous

Answer:

Expired or unused medications should be removed from the home as quickly as possible to help reduce the chance that someone may accidentally take them. There are several ways to get rid of old prescriptions.

  • Medicine take-back options – this is the preferred way to safely dispose of most types of unneeded medications. The US Drug Enforcement Administration (DEA) periodically hosts National Prescription Drug Take-Back events where temporary collection sites are set up in communities for safe disposal of prescription medications. Another option is to drop your medications off in a drop-box at a DEA-registered collector, which safely and securely collects and disposes of medications. For more information, visit National Prescription Drug Take-Back Day or DEA-registered collector to find an event or collection site near you.
  • Disposal in the household trash – If there are no specific instructions in the package insert, you can follow these simple steps to dispose of most medicines in the trash.
    • Pour unwanted or expired medications out of their original containers into a zip baggie.
    • Pour hot water (over 110OF – about as hot as a cup of coffee) into the baggie.
    • Insert kitty litter or another inedible product such as dirt or used coffee grounds into the baggie. Seal baggie. Place in trash bin.
    • Remove all personal information on the prescription label or empty pill bottles. Shred them or use a black marker to cross out label information.
  • Don’t throw unused or expired medications down the drain or toilet.

-Whitney Pittman, clinical pharmacy resident at CHOC Children’s

whitney-pittman-choc-childrens-pharmacy-resident
Whitney Pittman, clinical pharmacy resident at CHOC Children’s

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