Each year we hear about children who've received accidental overdoses of acetaminophen (Tylenol, Panatol, APAP, and other names). Although most children recover, too much acetaminophen can damage the liver. That's what happened to a 2-year-old boy who was taken to the emergency room with a high lever.
While there, the child received one dose of Concentrated Tylenol Infants' Drops. When the child was ready to leave, the doctor told the boy's mother to give him 1 teaspoon of Children's Tylenol Suspension Liquid every 4 hours for his fever.
But the boy's mother had noticed that the nurse gave her son the concentrated infants' drops. Believing she was supposed to do the same, she gave her son one teaspoon of the concentrated infants' drops at home. He grew very tired and started to vomit, so his mother took him back to the hospital. He was treated for liver damage from the accidental overdose of acetaminophen. Sadly, on rare occasions, children have died from accidental overdoses.
The problem is the concentrated infants' drops are about three times stronger than the children's liquid. The infants' medicine is more concentrated so babies can get the right amount of acetaminophen in just a small amount of liquid. But it's easy to confuse the two strengths.
You could accidentally pick up the wrong strength when shopping. Or, if you have several children of different ages and keep both strengths on hand, you could mistakenly give an older child the concentrated infants' drops instead of the children's liquid.
The company that makes Tylenol (MeNeil) has taken steps to help avoid these mistakes, Concentrated Tylenol Infants' Drops come in a bottle with a Safe-TY-Lock opening that makes it hard to pour the drops out of the bottle. The drops can only be withdrawn using the dropper that comes with the medicine. Other brands of acetaminophen may not have the Safe-TY-Lock opening.
Acetaminophen overdoses can occur in other ways, too, Busy parents may forget to tell each other when they've given acetaminophen to their child. So the other parent may give the child another dose. Or you may not notice that you're giving your child two medicines that contain acetaminophen--one for fever and another for a stuffy nose. Many cough and cold medicines contain acetaminophen.
It's quite safe to give your child acetaminophen. But to avoid mistakes, you have to exercise care and caution.
Preventing Acetaminophen Overdoses
Follow these rules when you give your child acetaminophen.
* During each check-up, confirm with your child's doctor that you know the right dose of acetaminophen to give your child. Tell the doctor whether you'll be using infants' drops, children's liquid, or chewable tablets. Also ask your pharmacist if you have questions.
* Never give concentrated infants' drops to children over 3 years of age. Discard the infants' drops as your child becomes older, and use children's liquid or chewable tablets.
* Read the label when shopping for children's cold medicines to see if they contain acetaminophen. Words like "non-aspirin formula" are clues that the medicine might contain acetaminophen. Do not give your child additional doses of acetaminophen if it's already in his cold, cough, or flu medicine.
* To measure the right dose, use the dropper that comes with the infants' drops, or the cup that comes with the children's liquid. Never use a spoon.
* Do hot substitute aspirin for acetaminophen if your child has a fever or other signs of a virus infection, especially the flu or chickenpox. (Taking aspirin for these conditions could cause a serious illness, Reye's syndrome.)
This article is reprinted with permission from the September/October 2003 issue of Safe Medicine, a newsletter for consumers published by The Institute for Safe Medication Practices (ISMP). For more information and resources on safe medication use and medication error prevention, visit ISMP on the Web at www.ismp.org or write to ISMP, 1800 Byberry Road, Suite 810, Huntingdon Valley, PA 19006.
COPYRIGHT 2003 Pediatrics for Parents, Inc.
COPYRIGHT 2004 Gale Group
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