ADULT ESOL LESSON PLAN

LOW INTERMEDIATE HIGH INTERMEDIATE

.
ESOL COMPETENCIES: Health and Nutrition
Read and interpret medicine labels.

Classroom Procedure:
1. Assess prior knowledge by asking: Why is it important to read and
interpret medicine labels? ) i.e. to take the proper dosage, to use the
product correctly).
2. Elicit and list students responses, focusing on the vocabulary
words.
3. Share a variety of medicine labels. Demonstrate how to read and
interpret medicine labels.
4. Have students bring in prescription and over the counter medication.
Read and interpret the medicine labels.
5. In pairs have students read, discuss and complete Activity Sheet
58.05
Reading a Medicine Label. Review answers with whole class
6. Discuss the usage of common over the counter medicines. Establish
what medications address various symptoms, i.e. Do you take
aspirin for a stomachache or headache? Do you take Tums for a
backache or an upset stomachache? etc. Review answers as a
group.
7. Summarize by comparing the use, availability and costs of medicine
between the U.S. and students countries.

Cultural Focus:
It is important to learn which foods are good for the body and
which are not.

Grammatical Focus:
Contractions: dont, shouldnt, wont:
Dont drink alcohol when taking
medication.
He shouldnt take too many pills.
I wont drive if I feel drowsy.
Fundamentals English Grammar
pgs. 19, 32, 49, 161

Pronunciation:
Prefix-re- refill, relief
R-controlled vowels- er- allergic
generic
long vowel- i- antibiotic, side effects,
inv

Vocabulary:
label
medicine
medication/drugs
information
prescription
over the counter
pharmacy
shake well
drowsiness/ dizziness
empty/ refill(s)
pharmacist
side effects
pill(s)/ tablet(s)/
capsule(s)
tired/ lightheaded
appetite
teaspoon(s)/
tablespoon(s)
overdose
external use only
emergency
avoid
Take with meals.
Take on an empty
stomach.
Take with a glass of
water.
Do not consume
alcohol. while
taking this
medication.
Finish all this
medication unless
otherwise prescribed.

Text Books:

Materials/Additional Resources:
A variety of medicine labels
Activity Sheet 58.05 Reading a Medicine Label

Evaluation:
Students read and interpret medicine labels.
Students complete Activity Sheets 58.05A and 58.05B.

The New Over-the-Counter Medicine Label: Take a Look

Graphic version in PDF format

Always Read the Label

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Reading the product label is the most important part of taking care of
yourself or your family when using over-the-counter (OTC) medicines
(available without a prescription). This is especially true because many
OTC medicines are taken without seeing a doctor. The OTC medicine
label has always contained important usage and safety information for
consumers, but now that information will be more consistent and even
easier to read and to understand. The U.S. Food and Drug
Administration (FDA) has issued a regulation to make sure the labels on
all OTC medicines (from a tube of fluoride toothpaste to a bottle of
cough syrup) have information listed in the same order; are arranged in
a simpler eye-catching, consistent style; and may contain easier to
understand words. While the new labels on a majority of OTC drug
products will be appearing on store shelves soon, some products and
companies have additional time to comply with the new labeling
regulations. If you read the OTC medicine label and still have questions
about the product, talk to your doctor, pharmacist, or other health care
professional.

Tamper-Evident Packaging: An Important Safety Feature

The makers of OTC medicines widely use tamper-evident packaging for
their products. This is to help protect consumers against possible
criminal tampering. Drug products with tamper-evident packaging have
a statement on the packaging describing this safety feature. It is
always important to inspect the outer packaging before you buy an
OTC drug product and to look at the product again before you take it.

What's On The New Label

Back to top

All nonprescription, over-the-counter (OTC) medicine labels have

detailed usage and warning information so consumers can properly
choose and use the products.
Below is an example of what the new OTC medicine label looks like.

Active Ingredient. Therapeutic substance in product; amount of active ingredient

per unit.
Uses. Symptoms or diseases the product will treat or prevent.
Warnings. When not to use the product; conditions that may
require advice from a doctor before taking the product; possible
interactions or side effects; when to stop taking the product and
when to contact a doctor; if you are pregnant or breastfeeding,
seek guidance from a health care professional; keep product out
of childrens reach.
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Inactive Ingredients. Substances such as colors or flavors.

Purpose. Product action or category (such as antihistamine,
antacid, or cough suppressant.
Directions. Specific age categories, how much to take, how to
take, and how often and how long to take.
Other Information. How to store the product properly and
required information about certain ingredients (such as the
amount of calcium, potassium, or sodium the product contains)

The new Drug Facts labeling requirements do not apply to dietary supplements,
which are regulated as food products, and are labeled with a Supplement Facts
panel.

Back to top

Reading the Label: The Key to Proper Medicine Use

The label tells you what a medicine is supposed to do, who should or should not take it,
and how to use it. But efforts to provide good labeling can't help unless you read and use
the information. It's up to you to be informed and to use OTC drug products wisely and
responsibly.

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The manufacturers of OTC medicines sometimes make changes to their products or

labeling (new ingredients, dosages, or warnings). Make sure to read the label each time
you use the product. Always look for special "flags" or "banners" on the front product
label alerting you to such changes. If you read the label and still have questions, ask your
doctor, pharmacist, or other health care professional for advice.

The Label Also Tells You...

The expiration date, when applicable (date after which you should not use the
product).
Lot or batch code (manufacturer information to help identify the product).

Name and address of manufacturer, packer, or distributor.

Net quantity of contents (how much of the product is in each package).

What to do if an overdose occurs.

Many OTC medicines are sold in containers with child safety closures. Use them
properly. Rememberkeep all medicines out of the sight and reach of children.
FDA
U.S. Food and Drug Administration
Phone: 1-888-INFO-FDA (1-888-463-6332)
CHPA

Drug Facts

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Active ingredients
Active ingredients are the specific chemical ingredients that make a drug work.
This section also shows the amount of active ingredient in each dose.

Purpose
Explains the class of drug. For example, you might see the word antihistamine
under "purpose" on a label for an allergy medication.
Uses
What you should use the drug for. Make sure you find a medication that relieves
only the symptoms you need it to. Ask your healthcare provider or pharmacist for
help in choosing the right medications for your symptoms.
Warnings

Do not use...
Lists when the product should not be used under any circumstances
Ask a Doctor before use if you have...
Some labels have warnings for people with chronic health problems such as high
blood pressure, heart disease, glaucoma, asthma, or diabetes. People older than 65
or younger than two may not be able to take some OTCs. This section explains
who should consult a health care provider before taking the medications.
Ask a Doctor or pharmacist before use if you are...
Sometimes the food you eat, other medicines you take, or tobacco can interact
with medications. On this portion of the label, companies will list foods or
beverages to avoid while taking the medication. Talk to your healthcare provider
or pharmacist about all the medications you take, both prescription and over-thecounter. Don't forget to mention any dietary supplements too; interact with
medications.
When using this product...
For most people OTCs are safe, effective, and without complications. But some
people do experience side effects. The most common side effects are listed on the
label. If you have a side effect to an OTC, re-read the label. Most side effects are
minor nuisances, but should be discussed with your doctor. If the side effect is
severe or continues, you should stop taking the medication and call your
healthcare professional.
This part of the label will also describe substances or activities to avoid while
taking the medication. Two warnings commonly found on OTCs are:
a. Do not drink alcoholic beverages while taking this medicine
People also ignore or forget this common warning when taking OTCs, but mixing
alcohol and medications can cause serious problems. For example, combining
alcohol and certain OTC medications for colds, coughs, and allergies can cause
excessive sleepiness, mental confusion, or breathing difficulty. Sometimes the
combination makes the medicine less effective.

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b. Do not drive or operate heavy machinery

Many people ignore this warning on some OTC medications. Driving after taking
some nonprescription medicines such as cold, cough, and allergy or sleep aids can
cause impaired judgment and reaction time. Use the medications only as
recommended. Remember that medications may affect people differently. It may
take 2 or 3 doses before you know how a medication will affect you.
Stop use and ask a doctor if...
When side effects are severe or continue, you should stop taking the medication
and call your healthcare professional. This section will explain the serious side
effects that warrant an immediate call to your doctor.
Pregnancy/breastfeeding warning
If you are pregnant or breastfeeding, you should always consult a doctor before
taking any medication.

Keep out of reach of children

This warning explains what to do incase of an overdose.
Directions
This is where you?ll find out how much of the medication to take, when, how and
how often. Do not use medications longer than the time listed on the label. The
label will tell you when to consult your healthcare provider if you have not had
relief from your symptoms. Persistent symptoms may signal a serious problem
that requires attention and treatment by your health care provider.
Other Information
This area will include information, as necessary, on how to store the medication.
Inactive ingredients
This is the list of ingredients that are only used as additives for color, flavor,
binding, or bulk.

Use Medicine Safely

When you don't feel well, medicines can help you get better. But they can hurt you if you
don't take them according to instructions from your doctor or pharmacist. Before using
any medicine, read the label!

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There are two kinds of medicine:

Over-the-Counter (OTC) Medicine--Medicine you can buy without a doctor's
prescription.
Prescription Medicine--Your doctor writes a prescription that tells the pharmacist what
you need. You pick up the medicine at a pharmacy.
Your doctor or pharmacist can help you take medicine safely.
Medicine labels may be hard to read. Make sure you ask questions so you know how and
when to take the medicine.
Taking more than one medicine without telling the doctor might hurt you.

When you talk to your doctor and pharmacist:

tell them which medicines you are taking now
tell them if you have ever had problems with medicine
make a list of your medicines to show them, or bring your medicine with you
tell them if you are allergic to any foods or medicines.

Protect yourself and your baby. Medicine may hurt your baby. Tell the doctor or
pharmacist if:

You are pregnant.

You are nursing a baby.

Before you take any kind of medicine, make sure you know:

What it is.
Why you should take it.
If it could make you feel sleepy or cause some other problem for you.
When to take it.
How much to take.
How long to take it.

You also need to know what you should not have while taking your medicine. Some
foods and drinks can make medicine work too fast. Some can make it work too slow or
not at all. Smoking cigarettes can change the way your medicines work. And drinking
alcohol when you are taking some medicines can be very dangerous.
Some medicines may cause problems if you take them with other medicines. This is why
it's important to tell your doctor and pharmacist about all the medicines you are taking.
And some medicines can cause problems, even if you take them correctly. Call your
doctor or pharmacist if you think your medicine is making you feel worse.

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Three Safety Ideas

1. When you buy medicine, make sure no one has already opened it. At the store,
check to see if the package was opened. If it was, tell a person working in the
store.
2. Never take someone else's prescription medicine.
3. Keep all medicines away from children. A locked cabinet is best.
Do you have questions about your medicine? The FDA (Food and Drug Administration)
may have an office near you. Look for their number in the blue pages of the phone book.
Or check online at www.fda.gov/cder/

Medicines and Older Adults

The Food and Drug Administration, or FDA, is a United States government agency that
makes sure medicines are safe and accurately labeled.

Be More Careful With Medicines

While everyone needs to be careful about taking medicines, older adults need to be even
more careful. This is because:

Older people often take more medicines than younger people

Older people may react differently to medicine.

This brochure will tell you what older adults need to know about the medicines they take.

Problems
Two of the biggest problems older people have with medicines are:

Reactions from mixing two or more drugs in the body, called "drug interactions."
A drug interaction can cause bad effects (usually called side effects), such as a
rash, stomach upset or sleepiness.
Getting too much of one medicine, called "drug overdose." This, too, can cause
side effects.

Older people are more likely to have side effects from drug interactions or drug
overdosages because:

They are more likely to take a number of different drugs.

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Their bodies use food and drugs slowly. This means that it may take longer for a
drug to start working. Drugs also may stay in their bodies longer. This can cause
too much of the medicine to be in the body.

Common side effects of drugs are:

upset stomach, such as diarrhea or constipation

blurred vision
dizziness
mood changes
skin rash

"Start low and go slow" is good advice for older people when taking medicines. This
means starting at the lowest dosage, and if this isn't effective, increasing the dosage
slowly.

How to Prevent Drug Side Effects

Take a drug only if you really need it. Ask your doctor if there is another way to
treat a problem before taking prescription or over-the-counter drugs.
Tell your doctor about all the drugs, vitamins, herbs and other pills you take.
Make sure to include both prescription drugs (ones you get from the pharmacist
with a doctor's prescription) and over-the-counter drugs (ones you can buy
yourself without a prescription). If you have several doctors, make sure they all
know what the others are prescribing.
Ask one doctor, such as in internist or family medicine doctor, to track all your
medicines. Put all your medicines in a bag. Take them to your next doctor's
appointment. This is the best way to let your doctor know what medicines,
vitamins and other pills you are taking.
If you need drugs to treat more than one condition, ask your doctor if there is one
drug that can treat both. For example, some blood pressure medicines also treat
migraine headaches.
If you have side effects, write them down. Write down when they happened. Also
write down any new problems you have, even if you think they are not related to
the drug. Tell your doctor about these side effects. Ask the doctor if there is
another drug that may be better for you to take.
Learn about the drugs you are taking. Ask the pharmacist and doctor questions.
Read the information that comes with the medicine. Or, ask a family member or
friend to read it for you.
Follow directions. Read the label. Understand when you should take the medicine
and how much you should take.
Always take your medicine when you should.

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Easy Ways to Take Medicine

You may have problems that make it hard for you to take medicine. Many older adults
can't see well, can't use their hands well, or forget things easily. Here are some ways to
make it easy for you to take medicine:

Ask the pharmacist to put your medicines in big bottles that are easy to open.
Ask for bottles with labels printed in large letters or use a magnifying glass, and
read the label under bright light.
Find ways to remind you to take your medicine. One way is to take medicines at
the same time every day. For example, at meals or before you go to bed. Use
charts and calendars. Or put all the drugs you need to take for one day -- or one
week -- in a small container, like a pillbox. You can buy pillboxes at drug stores.
If you forget easily, you also might want to ask a family member or a nurse or
other health worker to remind you when and how much medicine you need to
take.
Ask your doctor to set easy dosing times for you.

Questions to Ask Your Doctor or Pharmacist

What is the name of the drug? Is this the brand name or a copy of the brand-name
drug? Copies of brand-name drugs are called "generic drugs." They usually cost
less than brand-name drugs, but they work the same.
If the prescription is written for a brand name, is it OK for the pharmacist to give
me the generic version of this drug?
What does the drug do?
When should I take the drug? How often?
Does it matter if I take it with food?
Are there any foods I should stop eating while I'm on this drug?
Is it safe to drink alcohol, such as beer or wine, while I'm on this drug?
How long will I need to take this drug?
What should I do if I forget to take the medicine?
What are common side effects?
How will I know if this drug is working?
Where should I keep this drug?

How to Save Money on Medicines

When trying a drug for the first time, ask your doctor for free samples. Or ask the
pharmacist for just a few pills before getting the whole prescription filled. That
way, you can see if you have problems with the medicine before paying for a
whole bottle.
For drugs you take all the time, buy larger amounts at a time so that the price for
each pill is cheaper. But before you do this make sure you will be able to use all
the medicine within at least a year. Holding on to medicines for a long time may
cause the drug to lose its ability to work.
Call around to see which store has the lowest price.
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If you are an older person ask about a senior citizen's discount.

Ask your doctor if it's OK to take a generic drug instead of the brand-name drug.
If it is OK, tell the pharmacist you want the generic version of the medicine.
For drugs bought over the counter, buy the store-brand or discount brand. The
pharmacist can help you choose.
Call or write to the local chapter of the American Association for Retired Persons
(AARP) or a local chapter of a health organization, such as the American Diabetes
Association or the American Heart Association. You may be able to buy drugs
through them at lower prices.

Do You Have Other Questions About Medicines?

FDA may have an office near you. Look for the number in the blue pages of the phone
book.
Or, call FDA's toll-free number, 1-888-INFO-FDA (1-888-463-6332). Or, on the World
Wide Web at www.fda.gov

How to Give Medicine to Children

Do You Know How To Give Medicine To Children?
If you are caring for a child who needs medicine, it's important that you know how to
give the medicine the right way.

Over-the-Counter Drugs
Over-the-counter drugs are also called OTC drugs. They are medications you can buy
without a doctor's prescription. You usually find them on drugstore shelves, or in
supermarkets and other stores. OTC drugs have information on the bottle or box. Always
read this information before using the medicine. This information tells you:

how much to give

how often to give it
what is in the medication
warnings about using the drug
if the drug is safe for children. If no dose is given on the bottle or package for
children under 12 years old, ask your doctor or pharmacist:
o Is it OK to give the medicine to my child?
o How much should I give my child and when?

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If the medicine has alcohol in it, as some cough and cold syrups do, you may want to ask
the doctor if it's OK for your child to take it.
Before buying the product, make sure the safety seal is not broken. If it's broken or torn,
buy another box or bottle with an unbroken seal. Show the product with the broken seal
to the pharmacist or sales person.
If your child has a cold, flu, or chickenpox, do not give your child any product with
aspirin or similar drugs called salicylates unless your doctor tells you to. Aspirin and
other salicylates given to children with symptoms of cold, flu, or chickenpox can cause a
rare but sometimes deadly condition called Reye syndrome. Instead of aspirin or other
salicylates, you can give your child acetaminophen (sold as Tylenol, Datril, and other
brands).

When The Doctor Prescribes The Medicine

If a doctor prescribes a drug for your child, before you leave the doctor's office ask any
questions you have about the drug. Some of these questions may be:

What is the drug and what is it for?

Will this drug cause a problem with other drugs my child is taking?
How often does my child need to take this medicine?
How many days or weeks does my child need to take this medicine?
What if I miss giving my child a dose?
How soon will the drug start working?
What side effects does it have?
What should I do if my child gets any of these side effects?
Should I stop giving the medicine when my child gets better?
Is there a less expensive generic version that I can use?

When you get the medicine, check to see if it's the color and size you expected from the
doctor's description. If not, ask the pharmacist about it. When filling a prescription, the
pharmacist will often give you printed information with the medicine. If you don't
understand the information, or if you have questions, ask the pharmacist. If you still have
questions, call your doctor.

How To Measure
Liquid medicines usually come with a cup, spoon, or syringe to help measure the right
dose. Be sure to use it. The devices that come with the medicine are better for measuring
than kitchen spoons because the amount of medicine kitchen spoons hold can differ a lot.
For example, one kitchen teaspoon could hold nearly twice as much as another.
The numbers on the side of measuring instruments are usually small, so read them
carefully. Here are the most common types of dosing instruments and tips for using them:

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Dosage cups
For children who can drink from a cup without spilling. Look closely at the numbers on
the side to make sure you get the dose right. Measure out the liquid with the cup at eye
level on a flat surface.

Cylindrical dosing spoons

For children who can drink from a cup but are likely to spill. The spoon looks like a wide
straw with a small spoon at the top. Measure the liquid in the spoon at eye level. Have the
child sip the medicine from the spoon.

Droppers
For children who can't drink from a cup. Put the medicine into the dropper and measure
at eye level. Give to the child quickly before the medicine drips out.

Syringes
For children who can't drink from a cup. You can squirt the medicine into the back of the
child's mouth where it's less likely to spill out. Some syringes come with caps to prevent
the medicine from leaking out. Be sure to remove these caps before giving the medicine
to the child, or the child could choke on the cap. Throw away the cap or place it out of
reach of children. You can fill a syringe with the right dose and leave it capped for a
babysitter to give to your child later. Make sure you tell the sitter to remove the cap
before giving the medicine to your child. It's best to use syringes specially made to give
medicines to children. But if you find you have to use a hypodermic syringe, always
remove the needle first.

Do You Have More Questions?

If you're not sure about the medicine or how to give it to your child, ask your pharmacist
or doctor. Or ask the FDA.
The FDA may have an office near you. Look for the number in the blue pages of your
phone book. You can also call the FDA on its toll-free number: (888) INFO-FDA (4636332).
Or you can find the FDA on the Internet at www.fda.gov

How to Give Medicine to Children

by Rebecca D. Williams
"Open wide ... here comes the choo-choo."
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When it comes to giving children medicine, a little imagination never hurts.

But what's more important is vigilance: giving the medicine at the right time at the right
dose, avoiding interactions between drugs, watching out for tampering, and asking your
child's doctor or the pharmacist about any concerns you may have.
Whether it's a prescription or over-the-counter (OTC) drug, dispensing medicine properly
to children is important. Given incorrectly, drugs may be ineffective or harmful.
Read the Label
"The most important thing for parents is to know what the drug is, how to use it, and
what reactions to look for," says Paula Botstein, M.D., pediatrician and acting director of
the Food and Drug Administration's Office of Drug Evaluation III. She recommends that
a parent should ask the doctor or pharmacist a number of questions before accepting any
prescription:

What is the drug and what is it for?

Will there be a problem with other drugs my child is taking?
How often and for how long does my child need to take it?
What if my child misses a dose?
What side effects does it have and how soon will it start working?

It's also a good idea to check the prescription after it has been filled. Does it look right? Is
it the color and size you were expecting? If not, ask the pharmacist to explain.
Check for signs of tampering in any OTC product. The safety seal should be intact before
opening. Also, parents should be extra careful to read the label of over-the-counter
medicines.
"Read the label, and read it thoroughly," says Debra Bowen, M.D., an internist and
director of FDA's medical review staff in the Office of OTC Drugs. "There are many
warnings on there, and they were written for a reason. Don't use the product until you
understand what's on the label."
Make sure the drug is safe for children. This information will be on the label. If the label
doesn't contain a pediatric dose, don't assume it's safe for anyone under 12 years old. If
you still have questions, ask the doctor or pharmacist.
Children are more sensitive than adults to many drugs. Antihistamines and alcohol, for
example, two common ingredients in cold medications, can have adverse effects on
young patients, causing excitability or excessive drowsiness. Some drugs, like aspirin,
can cause serious illness or even death in children with chickenpox or flu symptoms.
Both alcohol and aspirin are present in some children's medications and are listed on the
labels.

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Younger and Trickier

The younger the child, the trickier using medicine is. Children under 2 years shouldn't be
given any over-the-counter drug without a doctor's OK. Your pediatrician can tell you
how much of a common drug, like acetaminophen (Tylenol), is safe for babies.
Prescription drugs, also, can work differently in children than adults. Some barbiturates,
for example, which make adults feel sluggish, will make a child hyperactive.
Amphetamines, which stimulate adults, can calm children.
When giving any drug to a child, watch closely for side effects.
"If you're not happy with what's happening with your child, don't assume that
everything's OK," says Botstein. "Always be suspicious. It's better to make the extra calls
to the doctor or nurse practitioner than to have a bad reaction to a drug."
And before parents dole out OTC drugs, they should consider whether they're truly
necessary, Botstein says.
Americans love to medicate--perhaps too much. A study published in the October 1994
issue of the Journal of the American Medical Association found that more than half of all
mothers surveyed had given their 3-year-olds an OTC medication in the previous month.
Not every cold needs medicine. Common viruses run their course in seven to 10 days
with or without medication. While some OTC medications can sometimes make children
more comfortable and help them eat and rest better, others may trigger allergic reactions
or changes for the worse in sleeping, eating and behavior. Antibiotics, available by
prescription, don't work at all on cold viruses.
"There's not a medicine to cure everything or to make every symptom go away," says
Botstein. "Just because your child is miserable and your heart aches to see her that way,
doesn't mean she needs drugs."
Dosing Dilemmas
The first rule of safety for any medicine is to give the right dose at the right time interval.
Prescription drugs come with precise instructions from the doctor, and parents should
follow them carefully. OTC drugs also have dosing instruction on their labels. Getting the
dosage right for an OTC drug is just as important as it is for a prescription drug.
Reactions and overdosing can happen with OTC products, especially if parents don't
understand the label or fail to measure the medicine correctly. Similar problems can also
occur when parents give children several different kinds of medicine with duplicate
ingredients.

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"People should exercise some caution about taking a bunch of

medicines and loading them onto a kid," Botstein says.
Pediatric liquid medicines can be given with a variety of dosing
instruments: plastic medicine cups, hypodermic syringes without
needles, oral syringes, oral droppers, and cylindrical dosing spoons.
Whether they measure teaspoons, tablespoons, ounces, or milliliters,
these devices are preferable to using regular tableware to give
medicines because one type of teaspoon may be twice the size of
another. If a product comes with a particular measuring device, it's best
to use it instead of a device from another product.
It's also important to read measuring instruments carefully. The
numbers on the sides of the dosing instruments are sometimes small
and difficult to read. In at least one case, they were inaccurate. In 1992,
FDA received a report of a child who had been given two tablespoons
of acetaminophen rather than two teaspoons because the cup had
confusing measurements printed on it. The incident prompted a
nationwide recall of medicines with dosage cups.
The following are some tips for using common dosing instruments:
Syringes: Syringes are convenient for infants who can't drink
from a cup. A parent can squirt the medicine in the back of the
child's mouth where it's less likely to spill out. Syringes are also
convenient for storing a dose. The parent can measure it out for
a babysitter to use later. Some syringes come with caps to
prevent medicine from leaking out. These caps are usually
small and are choking hazards. Parents who provide a syringe
with a cap to a babysitter for later use should caution the sitter
to remove the cap before giving the medicine to the child. The
cap should be discarded or placed where the child can't get at it.
There are two kinds of syringes: oral syringes made specifically for administering
medicine by mouth, and hypodermic syringes (for injections), which can be used
for oral medication if the needles are removed. For safety, parents should remove
the needle from a hypodermic syringe.Always remove the cap before
administering the medication into the child's mouth.

The illustration at right shows a standard hypodermic syringe with protective

plastic cap on (top left) and off (top right) the device: When in place, the cap
appears to be an integral, yet inconspicuous, part of the syringe.
The syringe can be loaded with cap in place: The plastic cap is simply intended
to be a protective barrier to the syringe's nozzle.Figure A shows how a liquid
medication can be drawn up into a hypodermic syringe without removing the cap.

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Liquid can easily enter the syringe nozzle through clearance around the
cap.Figure B shows liquid medication being poured into the barrel of the syringe
after removing the plunger, with the cap still in place. In either case, the potential
exists for administering liquid medication without first removing the cap.
Potential hazard of using capped syringe when administering liquid
medication: If left on a loaded hypodermic syringe, the cap could pop off in the
child's mouth and could choke the child. FDA is working with manufacturers to
eliminate the safety hazards posed by the caps. Until then, parents must be extra
cautious when using capped syringes.
Always remove the cap before administering the medicine. Throw it away or
place it out of the reach of children.

Droppers: These are safe and easy to use with infants and children too young to
drink from a cup. Be sure to measure at eye level and administer quickly, because
droppers tend to drip.
Cylindrical dosing spoons: These are convenient for children who can drink from
a cup but are likely to spill. The spoon looks like a test tube with a spoon formed
at the top end. Small children can hold the long handle easily, and the small spoon
fits easily in their mouths.
Dosage cups: These are convenient for children who can drink from a cup without
spilling. Be sure to check the numbers carefully on the side, and measure out
liquid medicine with the cup at eye level on a flat surface.

FDA Proposes New Regulations

FDA is working on changing the labels of over-the-counter medications to make them
more eye-catching, easier to read, and consumer-friendly. One such label appears on the
recently approved OTC version of children's Motrin.
For prescription drugs, FDA took measures in December 1994 to provide more
information to health-care providers about use of those products in children. This rule
was final in January 1995.
The agency now lets prescription drug manufacturers base pediatric labeling on data
extrapolated from adequate and well-controlled adult studies, together with other
information about safety and dosing in children. This is allowed as long as the agency
concludes that the course of the disease and the drug's effects are sufficiently similar in
children and adults.
Presently, most prescription drugs do not contain pediatric doses on their labels. A 1979
regulation required full clinical trials in children as the basis for pediatric labeling.
Doctors who need to prescribe those drugs to children do so based on their own
experience and reports in medical literature. The new regulations will give health-care
providers more information to prescribe medicine for children safely.

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In addition, FDA is taking steps to increase the numbers of drugs being tested in children,
and the agency is working closely with the National Institute of Child Health and Human
Development to conduct pediatric studies.
The goal of FDA's changes is to help ensure that whenever a child receives medication, it
is as safe and effective as possible.
Rebecca D. Williams is a writer in Oak Ridge, Tenn.

Aspirin and Children

Remember those orange-flavored baby aspirin tablets? They're not usually for kids
anymore.
Children and teenagers should never take aspirin, or products containing aspirin or other
salicylates, if they have chickenpox or flu symptoms or are recovering from these or
other viral illnesses. Such aspirin use has been associated with Reye syndrome, a rare but
serious condition that can cause death.
"The incidence of Reye syndrome has dropped dramatically," says Debbie Lumpkins, an
FDA microbiologist in the Office of OTC Drugs, "but that doesn't mean it can't still
happen."
FDA has proposed adding a more descriptive warning label on aspirin and other products
containing salicylates. The label would describe symptoms of Reye syndrome in more
detail than it does now.
To reduce fever safely in children, use acetaminophen or ibuprofen products.
--R.D.W.
Publication No. (FDA) 96-3223

You and Your Medicine

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Medicine is the most common treatment for many of the

problems associated with aging. Medicine treats and cures
diseases, prevents life threatening illnesses, relieves pain,
and helps terminally ill patients. Often, people have a better
quality of life and live longer because of the medicine they
take.
However, medicine can sometimes be a double-edged sword
for the aging person. If prescription medications, over-thecounter medications, and herbals and supplements are not
taken properly, there can be devastating results.
Taking medication improperly can lead to unnecessary visits to the emergency room, hospitalization, or
admission to a nursing home.
Changes in your body
Aging causes a change in the body's processes. These changes create a need for a different dose strength of
some medications that are taken by the elderly. In some instances, a medicine can be most effective in a child's
dose. It is important that your doctor, nurse, and pharmacist know your age so the right dosage and dose
strength is prescribed. Overdoses can occur in aging adults because of the body's inability to handle the
medication. During routine visits to your doctor, be sure to discuss any new symptoms that you may have
experienced since your last visit (Table 1).
Age-related problems associated with
taking medicine can be easily
overcome if you discuss them with
your doctor (Table 2).
Problems remembering to take
medication, being able to read the
labels, and being able to open the
bottles are just a few of the everyday
problems that should be discussed
with your physician. There are
solutions available to help you
overcome these types of problems.
For example, inexpensive electronic
devices that beep to remind you when
to take your medicine are available. You can ask that instructions and labels be printed in large print to make it
easier to read. Getting a printout of instructions also helps if you have difficulty hearing your physician or
remembering what he said.

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When your doctor prescribes

medication, don't be afraid to ask
questions about it. You should always
know what you are taking and why.
Ask your doctor if the medication is
necessary and if it is the best medicine
for your condition. Also, be sure to ask
if the new medication will affect other
medicines that you are taking. Ask if
you are taking the right dose, although,
often, the dose has to be adjusted a
time or two to get it just right for you.
Ask what side effects you may have
while taking the medication. After you
begin taking a medication be sure to let
your doctor know if you experience
any problems such as feeling drowsy,
confused, or depressed. Let him or her
know if you can't sleep, feel shaky, or
are not steady when you walk. All of
these symptoms are important
considerations in prescribing the right medication and the right dosage.
Just because the label of an over-the-counter herbal supplement says "natural" does not always mean it's safe.
You should keep in mind that herbals can interact with your prescribed medicine. The Food and Drug
Administration (FDA) does not regulate herbals so companies don't have to demonstrate if their herbal is
effective, safe to use, or if it has an adverse effect on other medicines. For example, ginkgo biloba and other
herbal supplements used in memory loss can interact with blood thinners, high blood pressure medications,
ibuprofen, and naproxen. Remember, it's important to let your doctor and pharmacist know what kind of
herbals or supplements you are taking.
Keeping a record
The benefits of your medication are at the highest when you take the proper dose at the prescribed intervals. If
you take a medication daily, it is best to take it at the same time each day. Keeping a written record of your
medication schedule is an excellent way to keep up with how much you have taken and when the medication
was taken. A spiral notebook is an inexpensive and convenient way to keep a written record of your
medication schedule. You can show the record to your doctor at each visit. You can also note any new
symptoms or side effects you experience. The record can help pinpoint the cause of any problem. You can also
list the results of any testing your doctor has prescribed for you to do at home, such as the results of testing
your blood pressure or blood-sugar level.

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Taking medications doesn't have to be a double-edged sword. For better health and management of your
medications, talk to your health care professional if you have questions about your medicine. Make sure your
doctor knows everything you take, which includes herbal tea, vitamin supplements, or over-the-counter
medicine. Your medicine should improve your health and well-being rather than contribute to illness, so
always speak up if you have questions, and tell the doctor if you have side effects.
Nancy Chaffee, RPh, MSHA
Columbus, Georgia

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