For these medicines that require divided doses, many parents think that they can simply break the tablets in half. It doesn't matter if they have more or less. They often rely on their feelings to "guess the dosage and break the medicine."

Author: Zhao Yijia, Sun Yat-sen Memorial Hospital, Sun Yat-sen University

Review: Qiu Kaifeng, Sun Yat-sen Memorial Hospital, Sun Yat-sen University

The lack of special drugs for children has always been a long-standing pain point in the field of pediatric medication in my country. In the face of the pediatric population, clinical needs are based on the individual conditions of the children. Dosage control. However, due to the lack of suitable dosage forms and specifications for children, the problem of divided dosage of pediatric drugs has become prominent.

divided dose medication, that is, it is impossible to administer the entire tablet, whole pill, and whole tube, and some measures need to be taken to split it. For these medicines that require divided doses, many parents think that they can simply break the tablets in half. It doesn't matter if they have more or less. They often rely on their feelings to "guess the dosage and break the medicine." As everyone knows, the accuracy and uniformity of dose distribution may affect the clinical efficacy of the drug and even increase the risk of adverse drug reactions. So it’s important to master the correct dosing methods and techniques!

1. Liquid medicine divided dosage method

Solutions and syrups are the most commonly used dosage forms for children. Some medicine packaging boxes will be equipped with small measuring cups or rubber-tipped straws to ensure the measured volume of the liquid. precise. If the medicine itself is not equipped, parents can purchase "children's medicine measuring cups" and "children's medicine straws" on their own (please pay attention to regular pharmacies or other channels and do not purchase three-no products).

2. The divided dosage method of granular drug

granules and powder try to choose the specifications suitable for children. If you need to take 1/2 packet, you can spread the granules evenly in the medicine bag and then fold it in half; or pour the granules on a clean white paper and divide it in half. However, if you need to take a smaller dose, such as 1/4 bag, 1/5 bag, etc., you can dissolve the entire package of medicine in water, stir evenly, and then use a measuring cup or a rubber-tipped straw to take 1/4 or 1/5 Just wait. However, it should be noted that the remaining medicine should be sealed and stored according to the instructions, and it is recommended to use it up as soon as possible. Once abnormalities such as deliquescence, granulation, discoloration, and taste change are found, it can no longer be taken. Medications that have been brewed should be discarded if left for more than one day and should not be taken any further.

3. The divided dosage method of capsule drug

capsules are usually not recommended for divided dosage, because the capsule shell has the functions of masking the bad smell of the drug, improving drug stability, delaying or directional release, etc. When it is necessary to divide the dose, it is best not to discard the capsule shell. The contents should be poured out and divided into doses before repacking it into the capsule shell for consumption. If the child cannot swallow it, he can drink it with warm water after consulting the pharmacist. The remaining contents of the capsule are best discarded for safety reasons.

4. The divided dosage method of in tablet dosage form.

tablet is the most commonly used and most diverse pharmaceutical dosage form. After receiving the medicine, parents must consult a doctor or pharmacist to confirm whether the medicine can be divided into doses. Sustained-release tablets, controlled-release tablets, enteric-coated tablets, sublingual tablets , sugar-coated tablets , etc. generally do not require divided doses. Tablets with irregular shapes or containing compound ingredients are generally not recommended for divided doses. Common tablet dosage forms of drugs dosing methods are introduced as follows:

1, split tablet method

Commonly used tools include bare hands, scissors, knives, medicine cutters, etc. Breaking the tablets directly with bare hands is suitable for medicines with scratches on the surface of the tablets. However, it is difficult to break hard medicines with bare hands. Tools such as scissors and knives can easily lead to uneven doses and easily cause injuries. Consider using a medicine cutter. The accuracy of divided doses is relatively high, but it is still difficult to deal with irregular divided doses such as 1/3 and 1/5. In addition, attention should be paid to hand hygiene and tool cleanliness when splitting tablets.

2, grinding method

grinding method is more suitable for those who have grinding tools and should be used with electronic balance . Do not measure the dosage visually, otherwise the weight will be uneven. The grinding method can handle irregular doses such as 1/3, 1/5, etc.However, this method may destroy the integrity of the original dosage form of the drug and change the release and absorption process of the drug in the body; if the powder after divided doses is exposed to the air for a long time, it may also cause the drug to absorb moisture and deteriorate; improper operation may even cause Risk of cross-contamination. The grinding method should be carried out by professional doctors or pharmacists, and parents should not use this method to divide doses.

3. Solid drug liquefaction

Grind the tablets or pills into powder and put them into a certain volume of liquid, completely dissolve them, and then use tools such as measuring cups, plastic tip straws, etc. to measure the corresponding volume. This method can be divided into any dosage, and is suitable for dividing doses of very small doses of medicines, but it is not suitable for medicines that are difficult to dissolve or insoluble in water, and the remaining liquid medicine is inconvenient to store and can easily cause waste.

4, automation equipment

automation equipment, automatic powder dispensing machine and 3D printer can improve the accuracy and efficiency of dispensing. The automatic powder packaging machine automatically seals the packaging bag containing drug powder with good sealing, preventing the drug from getting damp and deteriorating, and increasing the stability of the drug; 3D printing technology can produce drugs of any specification and achieve individualized medication. However, the use of automated equipment for dose distribution is still in its infancy, and only a few large medical institutions provide this service.

Tips:

1. Before dividing the dosage, you should consult your doctor or pharmacist whether the operation and method of dividing the dosage are possible;

2. Do not split all the medicines at once. Just split them before taking them to avoid deterioration of the medicines;

3. Medicines dissolved in water or brewed granules should be discarded if left for more than one day. Do not save on medicines that may lead to reduced efficacy or even adverse reactions.