Q How often are over-the-counter medications improperly administered? What are the effects of misdosing for the child?

A 39.4 percent of parents made an error in measurement of the intended dose of their child's medication (citation: Pediatrics. 2014 Aug;134(2): e354-61. doi: 10.1542/peds. 2014-0395. Epub 2014 Jul. 14 ). Effects of misdosing the child depends upon the medication being given. Overdosing a child with certain cough and cold medications may increase the child's heart rate or cause breathing problems. Giving too much ibuprofen may cause stomach problems.

Q What medications are most commonly misused?

A The most common misused medications are cough and cold products since these often contain multiple active ingredients.

Q What are some common errors in misdosing over-the-counter medications?

A Some of the common errors in misdosing over-the-counter medications include lack of knowledge about the product by the parent or caregiver, and not enough training on how to use the medication delivery device, whether it be a cup, an oral syringe or a dosing spoon. If the dose of a medication for a child is one mL (milliliter), but the dose measured was one teaspoonful (5mL), the child will get too much medication. It's important to know what type of units the delivery device is measuring. Using an oral syringe with milliliter markings is the preferred and most accurate method of oral liquid medication delivery in children.

Q When should acetaminophen and ibuprofen be used? Can they be used together?

A Acetaminophen and ibuprofen are indicated for relief of pain and fever. They can be used together, but not given together. Some doctors recommend alternating the dosing of them for better pain and fever control in children.

QHow should the dosing amount be determined: by age or weight?

A Most over the counter medications for children have dosing recommendations based on both weight and age. To determine the most correct dose, it should be determined by weight.

QOver-the-counter cold remedies include medications for pain and fever; cough and cold; and allergy. How does a parent decide on the right medications without accidentally giving an overdose?

A I always recommend parents speak with their pediatrician or a pharmacist to discuss which product is right for their child. The cough and cold medications often contain multiple active ingredients, which may not be necessary for the child, or might be necessary which means nothing else should be given except that product. For example, Triaminic® Multi-Symptom Fever and Cold contains four active ingredients, one of them being acetaminophen. If this product is chosen, the child may not need additional acetaminophen. If too much acetaminophen is given, it can be toxic to the liver.

QIf a parent thinks they may have accidentally administered the improper amount, what should they do?

A They should call their pediatrician or pharmacist immediately for guidance. They can also call the local poison control center. The phone number to the poison control center is 1-800-222-1222.

Lauren Grantz, Pharm. D. is the manager of Health Spectrum Pharmacy Services, Lehigh Valley Health Network.