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CLOSE THIS BOOKWhere There Is No Doctor - A Village Health Care Handbook (Hesperian Foundation, 1993, 516 p.)
Chapter 8 - HOW TO MEASURE AND GIVE MEDICINE
VIEW THE DOCUMENT(introduction...)
VIEW THE DOCUMENTMedicine in Liquid Form
VIEW THE DOCUMENTHow to Give Medicines to Small Children
VIEW THE DOCUMENTHow to Take Medicines
VIEW THE DOCUMENTDosage Instructions for Persons Who Cannot Read

Where There Is No Doctor - A Village Health Care Handbook (Hesperian Foundation, 1993, 516 p.)

Chapter 8 - HOW TO MEASURE AND GIVE MEDICINE

SYMBOLS:

= means:

is equal to or


Figure


is the same as





+ means:

and or plus


HOW FRACTIONS ARE SOMETIMES WRITTEN:

1 tablet = one whole tablet =

1/2 tablet = half of a tablet =

1 1/2 tablet = one and one-half tablets =

1/4 tablet = one quarter or one-fourth of a tablet =

1/8 tablet = one-eighth of a tablet (dividing it into 8 equal pieces and taking 1 piece) =

MEASURING

Medicine is usually weighed in grams (gm.) and milligrams (mg.).

1000 mg. = 1 gm. (one thousand milligrams make one gram)
1 mg. =.001 gm. (one milligram is one one-thousandth part of a gram)

Examples:

One adult aspirin tablet contains 300 milligrams of aspirin.

.3 gm.
0.3 gm.
0.300 gm.
300 mg.

All these are different ways of saying 300 milligrams.

One baby aspirin contains 75 milligrams of aspirin.

.075 gm.
0.075 gm.
75.0 mg.
75 mg.

All these are different ways of saying 75 milligrams.

Note: In some countries some medicines are still weighed in grains; gr. = grain and 1 gr. = 65 mg. This means a 5 gr. aspirin tablet weighs about 300 mg.

Many times it is important to know how many grams or milligrams are in a medicine.

For example, if you want to give a small piece of adult aspirin to a child, instead of baby aspirin, but you do not know how big a piece to give...

read the small print on the labels of each. It says aspirin: acetylsalicylic acid .3 gm. (acetylsalicylic acid = aspirin)


Figure

.3 gm. = 300 mg. and .075 gm. = 75 mg. So, you can see that one adult aspirin weighs 4 times as much as one baby aspirin.

75 mg.


75 mg.

4 baby aspirin

75 mg.


75 mg.

add up to

300 mg.

1 regular aspirin

If you cut the adult aspirin into 4 equal pieces, each quarter = one baby aspirin


Figure


Figure

So if you cut an adult aspirin into 4 pieces, you can give the child 1 piece in place of a baby aspirin. Both are equal, and the piece of adult aspirin costs less.

CAUTION: Many medicines, especially the antibiotics, come in different weights and sizes. For example, tetracycline may come in 3 sizes of capsules:


Figure

Be careful to only give medicine in the recommended amounts. It is very important to check how many grams or milligrams the medicine contains.

For example: if the prescription says: Take tetracycline, 1 capsule of 250 mg. 4 times a day, and you have only 50 mg. capsules, you have to take five 50 mg. capsules 4 times a day (20 capsules a day).


Figure

MEASURING PENICILLIN

Penicillin is often measured in units.

U. = unit

1,600,000 U. = 1 gm. or 1,000 mg.

Many forms of penicillin (pills and injections) come in doses of 400,000 U.

400,000 U. = 250 mg.

Medicine in Liquid Form

Syrups, suspensions, tonics, and other liquid medicines are measured in milliliters:

ml. = milliliter

liter = 1000 ml.

Often liquid medicines are prescribed in tablespoons or teaspoons:


Figure

When instructions for a medicine say: Take 1 tsp., this means take 5 ml.

Many of the 'teaspoons' people use hold as much as 8 ml. or as little as 3 ml. When using a teaspoon to give medicine, it is important that it measure 5 ml. - No more. No less.

How to Make Sure that the Teaspoon Used for Medicine Measures 5 ml.

1. Buy a 5 ml. measuring spoon.


Figure


Figure

2. Buy a medicine that comes with a plastic spoon. This measures 5 ml. when it is full and may also have a line that shows when it is half full (2,5 ml.). Save this spoon and use it to measure other medicines.

3. Fill any small spoon that you have at home with 5 ml. of water, using a syringe or something else to measure, and make a mark on the spoon at the level of the liquid.


Figure

How to Give Medicines to Small Children

Many medicines that come as pills or capsules also come in syrups or suspensions (special liquid form) for children. If you compare the amount of medicine you get, the syrups are usually more expensive than pills or capsules. You can save money by making your own syrup in the following way:


Grind up the pill very well

and mix the powder with boiled water (that has cooled) and sugar or honey.


You must add lots of sugar or honey when the medicine is very bitter (tetracycline or chloroquine).


or open the capsule



When making syrups for children from pills or capsules, be very careful not to give too much medicine.

CAUTION: To prevent choking, do not give medicines to a child while she is lying on her back, or if her head is pressed back. Always make sure she is sitting up or that her head is lifted forward. Never give medicines by mouth to a child while she is having a fit, or while she is asleep or unconscious.

HOW MUCH MEDICINE SHOULD YOU GIVE TO CHILDREN WHEN YOU ONLY HAVE THE INSTRUCTIONS FOR ADULTS?

Generally, the smaller the child, the less medicine he needs. Giving more than needed can be dangerous. If you have information about the doses for children, follow it carefully. If you do not know the dose, figure it out by using the weight or age of the child. Children should generally be given the following portions of the adult dose:

1 kilogram (kg.) = 2.2 pounds (lb.)


Adults: 1 dose


Children 8 to 13 years: 1/2 dose


Children 4 to 7 years: 1/4 dose


Children 1 to 3 years: 1/8 dose


Give a child under 1 year old the dose for a child of 1 year, but ask medical advice when possible.

How to Take Medicines

It is important to take medicines more or less at the time recommended. Some medicines should be taken only once a day, but others must be taken more often. If you do not have a clock, it does not matter. If the directions say '1 pill every 8 hours', take 3 a day: one in the morning, one in the afternoon, and one at night. If they say '1 pill every 6 hours', take 4 each day: one in the morning, one at midday, one in the afternoon, and one at night. If the directions are '1 every 4 hours', take 6 a day, allowing more or less the same time between pills.


Figure

Whenever you give a medicine to someone else, it is a good idea to write the instructions and also to have the person repeat to you how and when to take the medicine. Make very sure he understands.

Dosage Instructions for Persons Who Cannot Read

To remind people who cannot read when to take their medicine, you can give them a note like this (1)

In the blanks at the bottom draw the amount of medicine they should take and carefully explain what it means. (2)


Figure

For example:

This means 1 tablet 4 times a day, 1 at sunrise (3), 1 at noon, 1 at sunset, and 1 in the middle of the night.


Figure


This means 1/2 tablet 4 times a day.


This means 1 capsule 3 times a day.


This means 1/4 tablet twice a day.


This means 2 teaspoons twice a day.

WHEN YOU GIVE MEDICINES TO ANYONE...

Always write all the following information on the note with the medicine - even if the person cannot read:

· the person's name (1)
· the name of the medicine (2)
· what it is for (3)
· the dosage (4)


This information can be put on the same note as the drawing for dosage.

A page of these dosage blanks is included at the end of the book. Cut them out and use them as needed. When you run out, you can make more yourself.

When you give medicine to someone, it is a good idea to keep a record of this same information. If possible, keep a complete Patient Report.

TAKING MEDICINES ON A FULL OR EMPTY STOMACH

Some medicines work best when you take them when the stomach is empty - that is, one hour before meals.

Other medicines are less likely to cause upset stomach or heartburn (chest pain) when taken along with a meal or right afterwards.

Take these medicines
1 hour before meals:

· penicillin
· ampicillin
· tetracycline

It is better not to drink milk an hour before or after taking tetracycline.

Take these medicines together with or soon after meals (or with a lot of water):

· aspirin and medicine that contains aspirin
· iron (ferrous sulfate)
· vitamins

· erythromycin

Antacids do the most good if you take them when the stomach is empty, 1 or 2 hours after meals and at bedtime.

Note: It is best to take medicines while you are standing or sitting up. Also, try to drink a glass of water each time you take a medicine. If you are taking a sulfa medicine, it is important to drink lots of water, at least 8 glasses a day, to prevent harm to the kidneys.

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