Medication Forms: Pills vs. Powders for Children

Q: Medication Forms: Pills vs. Powders for Children

Hello： 1. <br>For a child weighing approximately 21 kilograms at the age of 9, medications should be crushed into powder. <br>When crushing medications, it is important to be aware of potential drug interactions, especially when dealing with adult medications, particularly diabet

Tablets and powders?

Hello Dr.
Hou: My son is 9 years old and weighs about 21 kilograms.
I usually take him to see a pediatrician, and when medications are prescribed, I request tablets, which the pediatrician agrees to.
However, during a visit to an otolaryngologist, the doctor refused and angrily stated that children cannot take tablets due to the risk of overdose, and that the medication must be ground into powder instead.
I am a bit confused, as I would expect that all doctors would avoid prescribing an overdose.
I wonder if this is because otolaryngology medications tend to be stronger (as I feel weak after taking them).
I am somewhat concerned and would like your clarification.
Additionally, does grinding medication into powder reduce its efficacy? Thank you, and have a nice day!

JOJO, 30~39 year old female. Ask Date: 2006/05/31

Dr. Hou Fangmin reply Pharmacology

Hello: 1.
For a child weighing approximately 21 kilograms at the age of 9, medications should be crushed into powder.
When crushing medications, it is important to be aware of potential drug interactions, especially when dealing with adult medications, particularly diabetes medications.
Ensure that the crushing equipment is thoroughly cleaned to avoid cross-contamination of adult medications with those intended for children.
2.
If the child needs to take a pill, they should take 1/4 or 1/3 of it.
To ensure accurate dosing, it is better to use the powdered form, as parents may have difficulty dividing the pill evenly.
3.
Regarding whether crushing medications affects their efficacy, if the medication is an enteric-coated tablet or a film-coated tablet, crushing it will result in loss of effectiveness.
In our hospital, if a medication cannot be crushed, the physician will see a warning on the computer screen when entering the medication.
4.
In otolaryngology, some medications may cause drowsiness or a feeling of weakness due to their antihistamine properties.
Wishing you peace and happiness.

Reply Date: 2006/05/31

More Info

When it comes to administering medication to children, the choice between pills and powders can be a significant concern for parents. Your question highlights an important aspect of pediatric care: the appropriate form of medication for children and the potential implications of each form.

Firstly, it's essential to understand that the choice between pills and powders often depends on the child's age, weight, and ability to swallow. For a 9-year-old child weighing around 21 kg, many pediatricians would consider it appropriate for them to take pills, especially if they are capable of swallowing them without difficulty. However, some healthcare providers may prefer to prescribe powdered forms for various reasons, including ensuring accurate dosing and minimizing the risk of choking.

The concern raised by the ear, nose, and throat (ENT) specialist about the potential for overdose with pills may stem from the fact that certain medications can have a narrow therapeutic index, meaning that the difference between an effective dose and a toxic dose is small. This is particularly true for medications that are potent or have significant side effects. In such cases, the physician may prefer to prescribe a powdered form to allow for more precise dosing, especially if the medication needs to be adjusted based on the child's response.

Regarding the question of whether grinding pills into powder can affect their efficacy, the answer is nuanced. Some medications are designed to be released slowly in the body (extended-release or enteric-coated formulations). Grinding these types of medications can lead to a rapid release of the drug, potentially resulting in increased side effects or reduced effectiveness. Therefore, it is crucial to consult with a pharmacist or healthcare provider before altering the form of any medication. They can provide guidance on whether a specific medication can be safely crushed or ground without compromising its effectiveness.

In addition, when considering the administration of powdered medications, parents should be aware of the potential for interactions with other medications or food. For instance, certain powdered medications may interact with dairy products or other substances, affecting absorption and efficacy. It is always advisable to discuss any changes in medication form with a healthcare provider to ensure safety and effectiveness.

In summary, while both pills and powders can be appropriate for children, the choice should be made based on the individual child's needs, the specific medication, and the guidance of healthcare professionals. If there is any confusion or concern about the prescribed form of medication, it is essential to communicate openly with the prescribing physician or a pharmacist. They can provide clarity on the rationale behind their recommendations and help ensure that your child receives the safest and most effective treatment.

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