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Medication Safety

Parents play an important role in protecting their children from various illnesses and injuries, including poisoning. Dr. Megan Brennard is a physician in the emergency department at Children’s of Alabama. She says poisoning and ingestions are common reasons why children visit the emergency department. “The most common poisoning we see in a child is medication poisoning,”she says.

It’s important for parents to keep all medicines up high and out of reach of children. But sometimes the danger may be brought in by someone else. “Sometimes the most dangerous medicine in your house was brought in by a grandparent,” Brennard says. “They may keep their purse on the floor and not even realize it’s a risk for the child.”

Often adults store medicine in pill boxes or organizers, but parents need to remember these are not child-proof. And to a child, medicine may look like candy. It’s important to talk with guests of your home to ensure any medicine they have is kept out of reach of children.

Along the lines of “candy,” Brennard recommends parents never call medicine “candy.” “Sometimes parents do that to encourage their child to take medicine, but it’s never a good idea to confuse the two,” she says.

All teaspoons and tablespoons are not equal

It’s also important that all medicine be given with the appropriate measuring device as provided by the pharmacist, whether it’s a syringe or measuring cup. Brennard says eating utensils come in various sizes. One teaspoon could range from a half teaspoon to one-and-a-half teaspoons when measured. She also adds that bottle tops for medicine are “child resistant” not “child-proof.” Some children are still able to open them. “It’s a good idea to get a lockbox to store medicine, anything with a code to get in. This adds another layer of protection,” Brennard says.

The Regional Poison Control Center at Children’s of Alabama is always available to answer questions or concerns. The number is 1-800-222-1222. Brennard recommends that parents store this number in their cell phone for easy access. Of course, always call 911 in the event of an emergency.

How Much Caffeine is Too Much?

The consumption of caffeine has become prevalent in adults, teens and children across the country. It is found in soda, coffee, tea, chocolate, energy drinks and several other products we consume every day. Caffeine is defined as a drug because it acts as a stimulant for the central nervous system.

The American Academy of Pediatrics recommends that children should not consume caffeine. If adolescents do drink caffeine, it is recommended that they intake no more than 100 milligrams (mg) per day. Higher doses can cause adverse reactions.

  • 12 oz can of Coca-Cola® = 46 mg
  • 5 oz cup of coffee = 60-180 mg
  • 12 oz glass of iced tea = 67-76 mg

In adults, low doses of caffeine can be used to enhance one’s ability to focus, but any amount over 100 mg actually creates the opposite effect.

Some adverse reactions to caffeine are:

  • Jitters
  • Anxiety
  • Nausea
  • Increased urination (over 500 mg of caffeine)
  • Headaches
  • Insomnia
  • Increased heart rate
  • Tremors
  • Seizures (over 1 gram of caffeine)

“In 2015-2016, the Regional Poison Control Center (RPCC) at Children’s of Alabama received an average of 110 calls per year regarding adverse reactions to caffeine,” said Becky Rozier, MSN, RN, CSPI, RPCC educator. “The highest number of caffeine calls came from parents of 1- to 2-year-olds who had unintentionally consumed caffeine. The second highest came from 13- to 19-year-olds and the third highest came from 6- to 12-year-olds. Both of these groups had intentionally consumed the caffeine.”

Food and Drug Administration regulation:

  • Limits sodas to 71 mg per 12 oz
  • Limits caffeine tablets to 200 mg per tablet
  • Does not regulate energy drinks

“There are true dangers to caffeine,” said Ann Slattery, DrPH, RN, RPh, CSPI, DABAT, RPCC managing director. “Educate your children and teens to closely look at the amount of caffeine listed on the labeling. For example, some energy drinks include herbals that contain caffeine (guarana, kola nut and yerba mate), but are not included in the amount of caffeine listed.”

If your child is experiencing adverse reactions to caffeine or you have a question about toxicity, call the RPCC at 1-800-222-1222. A specialist will calculate the amount of caffeine ingested versus the body weight of the individual. The RPCC is available for all ages, 24/7/365.