Halloween Safety: Remind Kids That Medicine is Not Candy

Halloween SafetyHalloween is approaching and with it, the customary bags of candy. Children anticipate sweet treats this time of year, which may cause them to mistake medication, not properly stored, for candy. CHOC Children’s pharmacists warn parents to be particularly vigilant this time of year, helping ensure treats don’t turn into “tricks” for little ghosts and goblins.

Adults should follow these simple medication safety tips:

  • Use the word “medicine,” not “candy,” when talking about medications
  • Store medicine out of the reach of children
  • Do not leave handbags, containing medicine or other potential hazards, on the floor where children can find them
  • Properly close medicine caps on tamper-resistant bottles
  • Read the label before taking or giving medicine
  • Take medicine out of the sight of children, who learn by copying adults
  • Properly dispose of medication. Even expired medications can have harmful effects when taken inappropriately

More than 50 percent of poison exposures involve medications.

In any case of possible ingested poison, call the Poison Control Center at (800) 222-1222 and be ready to provide responses to the following:

  • Who took the medicine?
  • What did they take?
  • How much did they take?
  • How long has it been?
  • How are they behaving?

Call 911 if the person has difficulty breathing or is unresponsive.

For more information, visit the California Poison Control System website.

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The Dangers of Acetaminophen for Children

CHOC Children's PharmacyAcetaminophen is a safe, popular pain reliever and fever reducer, but it can have devastating consequences for children if not taken properly, a CHOC Children’s pharmacist cautions.

Better known as Tylenol, acetaminophen is the medication most commonly given to American children, with 11 percent of children nationwide using the drug each week, says Ron Snyder, Pharm.D.

“It’s found in many over-the-counter prescription products, including cough and cold remedies and narcotic pain relievers,” Ron says. “The drug is generally considered safe, but can be toxic if taken in high doses or in certain situations.”

Acetaminophen can be toxic to the liver and is one of the most common causes of unintentional and intentional poisoning in the United States, he says.

Incidences of acetaminophen-related toxicity have increased over the past decade, Ron says. Each year, acetaminophen-associated overdoses account for approximately 56,000 emergency department visits, 26,000 hospitalizations and more than 450 deaths.

Here’s what parents can do to ensure their children use acetaminophen safely:

Read the product labels carefully.

Dosing can be confusing, so read labels carefully and ask for help in determining the correct dose. Parents should also limit the amount of acetaminophen taken per dose and limit the amount taken daily.

Be wary of acetaminophen availability from multiple sources.

If taking multiple medicines, be sure to check that child won’t “double dip” on acetaminophen. A big culprit behind overdoses is unknowingly taking acetaminophen from multiple sources, Ron says.

For example, someone with the flu may take Tylenol for a headache, as well as a cough medicine with acetaminophen. This can be extremely dangerous.

Double check what kind of concentrated liquid acetaminophen you have at home.

Liquid acetaminophen used to come in varying strengths for infants and children. The U.S. Food and Drug Administration found that confusion over these types led to overdoses that made infants seriously ill or die from liver failure.

Because of this, the industry has changed to one liquid strength of acetaminophen. However, older and stronger concentrations of acetaminophen once marketed for infants may still be available or in medicine cabinets. Again, read labels to know what you have and how much to give to a child.

Use the dosing device included with the medicine.

Kitchen spoons aren’t all the same, and a teaspoon and tablespoon used for cooking won’t measure the same amount as the dosing device. Rely on what’s included with the product to ensure proper dosing.

Early symptoms of acetaminophen overdose include vomiting, nausea, stomach pain, paleness and tiredness. If a parent suspects their child has overdosed on acetaminophen, call poison control immediately at 800-222-1222.

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Medication Safety FAQs Every Parent and Caregiver Should Know

To help keep your little ones safe from common medication mishaps, check out the answers to some of the most frequently asked questions about medications, medication safetyprovided by Shannon Bertagnoli, pharmacy safety coordinator at CHOC Children’s.

Why does my child’s medication look different?

A: If your child’s medication looks different in color, shape or size from the last time, make sure to review this with your pharmacist – you should have all your questions answered before going home. Sometimes there are multiple brands for the same medication that can look different, but it’s always good to double check. Some pharmacies are open 24 hours so if you get home and have additional questions, you should be able to reach someone even if it’s a different location where you filled your prescription.

Can I use a teaspoon or tablespoon to measure my child’s medication?

A: Never use a household teaspoon or tablespoon to measure the dose as these can vary in different households. When you are picking up a new prescription or over the counter medication read back the directions to the pharmacist. For example: I will give my child 10 mL of amoxicillin three times a day. If it is a liquid, demonstrate how you will use the dispensing device to your pharmacist. If you are unclear if your child’s medicine comes with a measuring device or a dosing cup, ask your pharmacist to recommend an oral syringe to use.

What should I ask my pharmacist when I pick up a new prescription?

A: Remember to tell your pharmacist if your child has any allergies even if you have already told your doctor. Ask your pharmacist what are the most common side effects of the medication, or if there is anything you should monitor for.

Is the bathroom medicine cabinet the best place to store my medications?

A: This is not the best place to store medications because the heat and humidity from the bathroom can break down the medicines and make them less effective. Instead, select a single and secure location in a cool, dry place that is up, away, and out of reach of children. Avoid storing in purses or drawers that children have access to.

Why does my child need to take multiple tablets to make up one dose?

A: It’s important to know that it’s uncommon to need more than two or three tablets, vials or syringes for a single dose of medication for a child. Before administering more than two or three of anything to your child, first verify with a pharmacist. Explain your concerns and have them double check the dose based on your child’s age and weight.

My youngest child is having symptoms similar to my older child. Is it ok to share medication if they have the same condition?

A: Your child’s individual medical condition and tolerance to the medication may vary. Children’s medication dose also varies based on age and weight. You should never share your children’s medication. It’s important to consult your child’s doctor if you have any questions about this.

Who should you call if you have a question about a potential poisoning?

A: A great suggestion is to keep the Poison Center Hotline readily accessible: 1-800-222-1222. Poison centers provide immediate, expert advice, 24 hours a day, seven days a week. Seek immediate medical attention if advised by the Poison Center or if you have any concerns about your child’s safety.

What should I do if I drop a pill on the floor and cannot find it?

A: Stop and look everywhere until the pill is located. If you don’t find it, your child or pet is likely to. Depending on the medication, we know that even one pill can cause significant harm to a small child or pet.

For additional medication safety guidelines, visit http://www.consumermedsafety.org/.

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CHOC Pharmacy’s Med-to-Bed – One Less Thing Before You Go

Bringing a child home from CHOC Children’s just became easier. Beginning this month, our patients, and their parents, will be discharged with home medications already in hand. That’s right — no more stopping by a pharmacy thanks to a new program that improves patient safety and helps prevent hospital readmissions.

Following a successful pilot program in the CHOC Children’s Medical/Surgical units recently, the CHOC Med-to-Bed care program returns and expands services to all patients, Monday through Friday.

The family-centered care program brings an outpatient pharmacist to each patient’s bedside before discharge. There, the pharmacist provides the discharge medications to take home, discusses instructions and side effects, and provides hands-on teaching as needed.

This convenient, one-on-one service offers several advantages:
• Improves patient safety by ensuring patients go home with the medications they need.
• Reduces the possibility of errors and medication-related hospital readmissions by ensuring parents know how to correctly use the medication and manage any side effects.
• Builds patient and parent confidence through hands-on teaching for related medical equipment, including syringes and inhalers.
• Resolves any potential barriers in filling prescriptions caused by transportation, insurance authorization or payment issues.

According to medical literature, medication management errors are some leading factors in hospital readmissions. While the “med-to-bed” concept is becoming popular in hospitals across the country, CHOC is one of the first hospitals in the region to implement this program.

CHOC Pharmacy Director Grace Magedman said the pilot program was tested on the hospital’s medical/surgical units because of their high patient volume.

“Our team found the one-on-one time with patients and their parents right before discharge to be very rewarding,” she said. “We could answer questions, discuss possible side effects, and provide hands-on teaching. This helps ensure that patients are taking their medication correctly at home — and avoids a trip back to CHOC.”

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Medication Safety in the Home

Every 10 minutes in the United States, there’s a child under the age of 6 taken to an emergency department for medication poisoning. Most of the incidents occur in the home, a CHOC pharmacist tells CHOC Radio.

In podcast No. 23, Dr. Shannon Bertagnoli offers tips to help prevent children from getting into medications:

  • where to store medicine;
  • what to do with visitors; and
  • how to take medication

She also offers online resources for caregivers interested in learning more.


CHOC Radio theme music by Pat Jacobs.