Dr C P Ravikumar

Giving medicines the right way!

Does making your child take medicine stress you out? Maybe this stress also forces errors in giving medicine.

So, let’s learn a few things about medicines and a few tricks to help you as well.

Medicines come in different shapes, sizes and forms. A brief introduction on each is below:

1. Syrup – medicine is in a liquid form, usually sugar content high to make it tasty. A simple analogy is dissolving sugar (drug) in water = syrup.

e.g: Paracetamol, Valparin

It can be mixed in yogurt, curds, jelly, fruit juices to mask and facilitate intake.

2. Suspension – This is nothing but a medicine suspended in a liquid solution; sugar content is high. But, the drug usually remains at the bottom of the bottle. Hence, it is IMPORTANT to shake the bottle thoroughly to ensure the drug is well distributed. A simple analogy is Sand (drug) dissolved in water = Suspension.

e.g: Tegrital (carbamazepine)

It can be mixed in yogurt, curds, jelly, fruit juices to mask and facilitate intake.

3. Tablets : As simple as it sounds, this category is self-explanatory. A tablet can be crushed and mixed in yogurt, curds, jelly, fruit juices to facilitate intake.

4. Modified Release (Controlled release): These are regular tablets with a punch of technology! It is hence relatively expensive compared to the standard tablets. This medicine is coated with layers, so each layer dissolves and releases medicine slowly. The advantage is it avoids peaks (high) and troughs (low) meaning very high or low levels in the blood. Crushing these tablets will nullify the reason why they were made, if you need to crush and administer medicine, then use a standard tablet.

  • Extended-release – The drug is released slowly, so the frequency of dosage can be reduced.
  • Delayed-release – The tablet is coated with a gastric resistant coating, so the drug is not released until it crosses the stomach.
  • Dispersible Tablet – This dissolves in the mouth, making it easier to administer in children, they need to stay in the mouth for a few seconds.

4. Capsules : Drug granules in a small cylindrical container. In children, you can empty contents in yogurt, curds, jelly, fruit juices to mask and facilitate intake.

5. Enema / Suppository : In this, a medical preparation is inserted into the Rectum, Vagina, or urethra. It is not very pleasant to insert and can be painful; however, it is helpful in children who are vomiting or not swallowing medicines with the best of effort.

Common examples would be Paracetamol, Diazepam, Dulcolax for constipation.

6. Inhalers : These are used for administering medicines to the respiratory system, local administration which gives maximum dosage to where it is required.

7. Nasal Sprays : Once again, here the medicine is used to treat local disease processes (e.g: Steroid spray for allergy) or sometimes administer the drug for fast absorption (e.g: Midazolam for controlling seizure).

8. Drops : These are liquids used for eye and ear local treatment.

PLEASE NOTE : THERE ARE SPECIFIC MEDICINES THAT ARE NOT TO BE GIVEN WITH FOOD. IT IS DIFFICULT TO LIST THEM HERE. PLEASE CHECK WITH YOUR DOCTOR OR THE DRUG INFORMATION SHEET THAT IS PROVIDED WITH THE PARTICULAR MEDICINE YOU ARE TO TAKE.

Tips & Tricks: A guide for parentsAfter all, what’s parenthood without challenges?

There is no simple trick that would make the life of a parent easy, it is all about being a parent! Here are a few suggestions below for you to try the next time your kids trouble you with taking medicines!

  • Giving your child the responsibility to take his/her medicines
  • Visual feedback: Reward charts/ stars, for older children, can work really well.
  • Taste: It’s all in the tongue…. please check if a different flavored syrup is available which will make it more palatable for your child.
  • Mix with yogurt, jelly, dark-colored juice that will mask the taste of the medicine.
  • Use a syringe and spurt into the cheeks and give them something to drink immediately.
  • Give them control, let them choose where they will take medicine, in the balcony, bedroom. Where will they sit? Who will give medicine? It sorts of makes the child feel he/she is in control.
  • Play Doctor (Role Play): Ask your child to give medicine to his/her favorite toy and then it’s his/her turn to take medicine.
  • Being honest and not really giving an option about taking medicine.
  • Set a time limit, giving medicine should not become a drag. Use a timer on your phone. Both you and your child should know the endpoint, this should not become a traumatizing process.
  • If none works, then use the following trick: Then one parent should hold the child, and the other push medicine into the cheek using a syringe.

Here are some don’t do’s:

  • Children should not be lying when giving medicine.
  • Don’t force medicine down the throat, it can lead to choking or aspiration.
  • Avoid too many people around the child.

Syringes example: https://www.amazon.in/Ezy-Dose-Calibrated-Medicine-Syringe/dp/B000VCF6FG

Additional Tip: Wrapping a toddler or baby in a towel as below, will stop them kicking you or pushing the syringe away from their hands.

givingmedicine 1

If you still find it difficult to deal with your child, make sure to seek help from a professional to discover ways to deal with the situation better by working around the communication between you and your child.

References :

  1. IAP Drug Formulary Web Update 2020(3) Edition 58, https://www.iapdrugformulary.com/Home
  2. Consumer Medicines Information (CMI), https://www.tga.gov.au/consumer-medicines-information-cmi
  3. British National Formulary for Children (BNFC)
  4. Food and Drug Administration, USA https://www.fda.gov

Disclaimer:

Medical information is simplified to make it easy for a layman to understand, hence it cannot be comprehensive, it cannot address individual needs. No website content can replace expertise of a doctor; hence this information should NEVER be taken as a replacement for medical consultation. It is possible the information may not be accurate and may even mislead in some cases. It is hence advised to seek medical consultation without delay for any queries.

Dr C P Ravikumar

Dr C P Ravikumar

CONSULTANT – PEDIATRIC NEUROLOGY
Aster CMI Hospital, Bangalore