Medication safety: Put the cap on

Oops! This medication bottle has been left out with the cap off
Oops! A member of the NNEPC team came home to find this scene
while their spouse was giving medicine to one of the kids.
Medication with the cap on
That’s better! For safety, put the cap back on your medication
bottle as soon as possible.

Where do you store your medication?

If you answered up high and out of children’s reach, congratulations! You are off to a great start with medication safety.

But what do you do with medication while you are using it?

The NNEPC receives many calls about young children who get into medication that has just been used, but left out, often with the cap off. A study from Safe Kids looking at poison center calls and emergency department visits also found that this is a common scenario.

To help keep children from getting into medication, always put the cap back on as soon as you are finished with the medication, and put it away, up high and out of reach, as soon as possible.

If a child does get into medication, call the poison center at 1-800-222-1222 or chat online. Most of these cases can be safely managed with fast, expert help from the poison center, helping you avoid a visit to the emergency room.

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What happens when you call the poison center?

Concerned parentMany people who call the poison center are understandably worried, but the good news is nearly 9 out of every 10 calls from home can be safely managed with fast, expert help from our poison specialists, without needing to go to the hospital or doctor’s office.

When you get on the phone with a poison specialist, there are a few things they will want to know to help you:

  • How old is the patient?
  • About how much does the patient weigh?
  • What is the name of the product or substance involved? Be as specific as you can—it can help to have the bottle or packaging with you on the phone. Poison experts use a database that contains detailed information on thousands of products.
  • How much of the substance did the patient swallow, breathe in or get on their skin? If you don’t know, the poison specialist will help you estimate.

The Dose Makes the PoisonBased on this information, the poison specialist will tell you what you need to do. It could be as simple as drinking some water or eating a popsicle. In rare circumstances, they may need to send you to the hospital. If so, they will ask which hospital you are closest to and call ahead to let them know you are coming.

You may be placed on hold at some point during your call to the poison center. Don’t worry—the poison specialist will be right back with you.

The poison center will also collect a little bit of personal information from you for your medical chart—your first name, the patient’s first name, your phone number and the zip code you are calling from. This information is confidential. This information is important because it helps us to find your case if you ever need to call about it again for any reason.

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Have you seen this mushroom?

Amanita MuscariaWe’ve had a number of cases in the last few days of young children getting into amanita muscaria or similar mushrooms in the yard. These can make kids sick.

If your child or pet eats some of a wild mushroom, give us a call at 1-800-222-1222 or chat online.

If you have young children, it’s a good idea to try to remove wild mushrooms from your yard as well.Amanita Muscaria

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Driving and medications don’t always mix

For many of us, driving is part of our everyday routine, whether it’s getting to work, running errands or visiting friends and family. But certain medications can make it unsafe for a person to drive because they can cause side effects or reactions.

These effects can be most pronounced when you are starting a new medication or changing the dosage of a medication you already take. Side effects can also happen when you stop taking a medication. Talk to your doctor when there are changes in your medications or your health to see how they may affect your driving.

Cars in traffic
Photo by epSos.de, Creative Commons 3.0

Common effects that can make it unsafe to drive include:

  • Sleepiness
  • Blurred vision
  • Dizziness
  • Slowed movements or reactions
  • Fainting
  • Difficulty paying attention
  • Confusion
  • Jitters

The label on your medication may recommend not driving if these side effects or reactions are likely. Common medications that may make it unsafe to drive include:

  • Medications for anxiety, depression or other psychiatric conditions
  • Opioid pain medications or products containing codeine
  • Sleep aids
  • Cold and allergy products
  • Medications for diabetes

It is not safe to drive if you are tired or drowsy, or feel “off.” If you are tired or drowsy, taking a stimulant such as caffeine (NoDoz, Vivarin, etc.), ephedrine or pseudoephedrine does not make it safe to drive.

What if I need to drive, but I’m taking one of these medications?

Talk to your health care provider. They may be able to change the dosage or when you need to take the medication. They may also be able to suggest a medication that is safer to use when driving.

If you have questions about medications, contact the poison center for fast and expert help. Call us at 1-800-222-1222 or chat online.

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How to read an over-the-counter medication label

Whether you are treating a headache or have a cold, it is important to read the label every time you take an over-the-counter (nonprescription) medication. The label will tell you what you need to know to safely take your medication and avoid a medication error or poisoning.

The FDA requires that the same information be listed in the same way on all nonprescription medications, from toothpaste to pain relievers, using the Drug Facts label. There is an example below. Note that dietary supplements are not required to use this label.

The Drug Facts label gives the following information:

  • Active ingredient: The active ingredient is the ingredient in the product that has a medical effect. Some products have more than one active ingredient. This section shows:
       
      Medication label - chlorpheniramine
      Drug Facts label for chlorpheniramine, an antihistamine
    Image courtesy of the FDA – Click to see a larger version
    • The name of the active ingredient
    • How much of the ingredient is in each unit of measure. The unit might be 1 tablet, 30 milliliters of liquid, etc.
  • Purpose: This section says what the product does and its drug category, such as antacid or pain reliever.
  • Uses: This section lists the symptoms or medical condition the product is meant to prevent or treat.
  • Warnings: Not every medication is right for every person. This section lists:
    • Situations in which you should not take the medication
    • Possible interactions with other medications or food
    • When to stop taking the product
    • When to call the doctor
    • Safety information, such as to keep the medication out of the reach of children
  • Directions: In many cases there is more than one set of directions, based on age or weight. The directions give instructions on:
    • How to take the medication
    • How much of the medication to take
    • How often to take the medication
    • How long to take it (for example, how many days)
  • Inactive ingredients: This section lists substances that do not have a medical effect. They include substances that add flavor or color, or that hold the medication together (binding agents).
  • Other information: This section often includes information on how to store the medication. It may have additional important notes not included in the other sections.

 

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How to avoid some common medication errors

According to a 2015 study, every 8 minutes a child under 6 in the United States gets the wrong medication or the wrong dose of their medication. There are a number of ways medication errors can happen with children. Here are some of the most common:

  • The child gets the medication twice. It’s easy for this to happen. Maybe Dad gives the child their medication at 4 p.m., but doesn’t mention it to Mom, who gives the child medication again at 5 p.m.
  • The child gets the incorrect dose. This can happen because of confusion about units (how many milliliters are in a teaspoon?) or from using imprecise measuring tools, like a spoon from the silverware drawer instead of a medication measuring cup or oral syringe.
  • The child gets the wrong medication. This often happens because the caregiver grabs a medication without carefully reading the label to make sure it is the right one.

Everyone makes mistakes, but there are easy steps to take to help prevent medication errors:

Medication measuring cup

A medication measuring cup

  • Read the label every time. Make sure you are giving the right medication, and double check the dose you need to give.
  • Use a medication measuring cup or syringe. Always use a precise measuring tool, not a kitchen spoon. Most children’s medications these days come with an oral syringe or measuring cup for you to use.
  • Keep track of doses. Write down the date and time when you give your child medication, or track it in an app on your smartphone. Make sure all caregivers have access to the information to avoid double dosing.
  • Know the poison center number. Keep a poison center magnet on your refrigerator and store 1-800-222-1222 in your phone so that you can get quick, expert help if a mistake happens.
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Take these steps to help prevent poisonings in your home

How safe is your home? We all try to keep our homes safe for kids, pets, visitors, and ourselves, but it’s easy to miss things. Let’s take a look at some steps you can take to help prevent poisonings.

HousePoison Center Number

Do you have the poison center number handy? You never know when a poisoning will happen, so be prepared.

Medications

Medications are the top cause of poisonings among all age groups.

  • Keep medications in their original containers, or in a child-resistant pill reminder box.
  • Keep medications up high, out of the reach of children and pets, preferably in a locked cabinet.
  • Go through your medications at least twice a year, and get rid of ones that have expired or that you no longer need.

Carbon Monoxide

Carbon monoxide is a gas that can make you sick, or even kill you. You can’t see or smell it, which makes it especially dangerous.

  • Install carbon monoxide alarms in your home, and test them regularly to make sure they are in working order. There should be at least one alarm on each floor, and at least one alarm near each sleeping area.
  • Have your heating equipment (furnace, etc.) tested by a heating professional before you turn it on in the fall.

Cleaning Products

There is a wide variety of cleaning products out there—everything from toilet bowl cleaner to furniture polish to dish soap.

  • Keep all cleaning products up high, out of the reach of children and pets.
  • Store cleaning products in their original containers.
  • Store cleaning products separately from food and personal care products.

Plants

Certain plants can be harmful if they are eaten by people or pets.

  • Know what plants you have in your house. If you’re not sure, take samples to a local nursery, which may be able to identify them for you.
  • Once you know what you have, call the poison center at 1-800-222-1222 or chat online to find out if the plants in your home can be poisonous.

If you have any questions about possibly poisonous products, you can always call the poison center at 1-800-222-1222, or chat online. We’re here 24/7 to help.

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How much nicotine?

Cigarettes and other nicotine products vary widely in how much nicotine they contain. Below is a rough guide to the total amount found in some common products. It’s also important to note that the amount of nicotine in a product can be different from how much a person absorbs from normal use. A person will typically absorb 1-2 milligrams from smoking a cigarette, while nicotine replacement products (gum, patches, nasal sprays, etc.) are usually designed to deliver 1-4 mg per hour.

Cigarette: Up to 30 mg, but usually much less than that

Nasal spray/inhaler cartridge/oral liquid: Up to 10 mg per bottle

Patch: Up to 21 mg per patch

Electronic cigarette: Up to 24 mg per e-cigaratte or e-cigarette refill cartridge

E-cigarette liquid: Up to 240 mg per bottle

An electronic cigarette

An electronic cigarette con contain up to 24 mg of nicotine.

For information on the effects of nicotine, see our nicotine page.

For information on electronic cigarettes, and how they can be harmful to children, see our corresponding blog post.

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Liquid nicotine: Dangerous to children

A bottle of liquid nicotine.The death in December 2014 of a 1-year-old boy in upstate New York has brought further attention to electronic cigarettes and the liquid nicotine used to refill them. The boy reportedly swallowed some liquid nicotine, which was sold in a bottle that did not have a child-resistant cap.

If you’ve been to a convenience store in the past year, you’ve probably seen these products—Blu, NJoy and VaporFi are some of the most common brands. E-cigarettes are rapidly gaining popularity, especially among younger people, and many view them as safer than traditional cigarettes.

E-cigarettes work by heating the liquid and turning it into a vapor that the smoker breathes in. This is where the slang term “vaping” comes from. E-cigarette liquid is available in a wide variety of flavors, including chocolate and cotton candy, and with different levels of nicotine.

While some liquid refills are nicotine-free, others contain as much as 240 milligrams of nicotine in a 10 milliliter bottle. That’s a very large amount of nicotine in a small bottle, and it means that just a taste could be enough to cause symptoms in a young child, and a large sip could be fatal. See our corresponding post, “How much nicotine?” for a comparison of the nicotine content of various products.

Because of this, even before the death in New York state, many lawmakers were pushing to require child-resistant caps for e-cigarette liquid. While some members of Congress are working on a national law, Vermont became one of the first states to require child-resistant caps—its law went into effect on January 1, 2015.

Adults should not rely on child-resistant caps alone. If you use e-cigarettes or any other nicotine products, be sure to always keep them out of the reach of children, in a locked cabinet if possible.

If a child does get into a nicotine product, don’t wait for symptoms—call the poison center right away at 1-800-222-1222 or chat live with a poison specialist.

For more information about nicotine and its poisoning effects, see our nicotine page.

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Clear your outdoor vents to avoid carbon monoxide poisoning

With so much snowfall in the last week, the Northern New England Poison Center has seen 30 cases of people exposed to carbon monoxide. This number is much higher than usual, even for this time of year. The NNEPC averaged about 8 carbon monoxide cases per week in January and February from 2012-2014.

Here are some tips to help avoid this potentially deadly poisoning:

  • Have a working carbon monoxide alarm. You cannot see or smell carbon monoxide, so an alarm is essential to make sure you can get out of the building before a poisoning becomes serious. You should have at least one alarm on each floor, and an alarm in each part of the building where there are bedrooms. Test the alarm to make sure the batteries are working. If you do not own an alarm, you can purchase one at most hardware and department stores.
  • Keep outside heating vents clear. With more than 2 feet of snowfall in many areas over the last week, it is easy for these vents to become blocked up. If your heating system cannot vent properly, carbon monoxide can build up inside your home.
  • Use generators outside only. Many Northern New England residents turn to a generator when the power goes out. It’s important to only use generators, as well as other outdoor equipment, like grills and gas-powered tools, outside. Your generator should be at least 15 feet away from any houses, with the exhaust facing away from houses.
  • Clear your vehicle’s tailpipe. If snow is blocking the tailpipe, carbon monoxide can build up in the vehicle.
  • Do not leave your car running in the garage.

If you think there is carbon monoxide in your home, get to fresh air right away. Call 911 or your local fire department, and then call the poison center at 1-800-222-1222.
 
The poison center is available 24/7 to answer any questions you have about carbon monoxide — 1-800-222-1222 or chat online.

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