Are You Measuring Out The Wrong Dose?

January 13, 2010


If you are suffering from a cough or cold, how do you measure out the dose? If you use a special spoon from the chemist, or the measuring cup that came with the product, then you are on the right track. However, millions of people just reach for a kitchen spoon and that could be a serious mistake – particularly where children are involved.

In a study published in this month’s Annals of Internal Medicine, Cornell University researchers asked 195 university students to pour out 1 tsp. (5 ml) of cold medicine into kitchen spoons of various sizes. Consistently, they got it wrong and on average poured out either 8% too little or 12% too much, depending on the size of the spoon they chose. If they picked a medium-size tablespoon they erred on the side of caution and tended to underdose, but if they used a large tablespoon, they overcompensated and overdosed which is potentially a real problem. Even worse is not using a spoon but drinking straight from the bottle which runs a double risk of both the wrong dose and spreading germs..

Twelve percent over the recommended dose may not sound like a lot, but if you are taking a medicine every four to eight hours for up to four days that is putting you in danger. Medicines for pain and cold can contain acetaminophen which can also put stress on the liver. In the USA there have been an estimated 56,000 emergency-room visits, 26,000 hospitalizations and 458 deaths related to acetaminophen overdoses over a ten year period.

This is a particular problem for two groups of people: drinkers — whose livers may already be compromised — and children. Unlike doses for adults, those for children tend to be very precise, right down to the milligram, which means even a single, small overdose is something to be avoided. Adding to the problem is the fact that the formulation of a drug for infants can differ from that for an older child: the infant’s version can actually be stronger since it is often administered in tiny amounts with a medicine dropper.

According to studies done by Dr. Benard Dreyer, a professor of paediatrics at New York University, they have done studies that show that 50% of the time, parents give the wrong dose and they recommend parents don’t use spoons at all but only the measure supplied with the medicine.

I know a lot of over-the-counter medications come with dosing cups, but many people lose them, don’t like them or don’t know how to use them and simply feel more comfortable with a spoon. Plus the fact that the level markers are not always clearly visible and you have a problem on your hands. The problem is all to do with our perception, because 5 ml on a teaspoon pretty much covers the entire surface area of the spoon and so looks like a lot to us but the same 5 ml on a large spoon somehow appears to be less, and as a result we add more.


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