General Guidelines

Medication administration to a pediatric patient can be challenging. Prescribers should order dosage forms that are age appropriate for their patients. If a child is unable to take a particular dosage form, ask the pharmacist if another form is available or for other options.

Oral Liquids

Pediatric liquid medicines may be given with plastic medicine cups, oral syringes, oral droppers, or cylindrical dosing spoons. Parents should be taught to use these calibrated devices rather than using household utensils. If a medicine comes with a particular measuring device, do not use it with another product. For young children, it is best to squirt a little of the dose at a time into the side of the cheek away from the bitter taste buds at the back of the tongue.

Eye Drops/Ointments

Tilt the child's head back and gently press the skin under the lower eyelid and pull the lower lid away slightly until a small pouch is visible. Insert the ointment or drop (1 at a time) and close the eye for a few minutes to keep the medicine in the eye.

Ear Drops

Shake otic suspensions well before administration. For children <3 yr, pull the outer ear outward and downward before instilling drops. For children ≥3 yr, pull the outer ear outward and upward. Keep child on side for 2 min and instill a cotton plug into ear.

Nose Drops

Clear nose of secretions prior to use. A nasal aspirator (bulb syringe) may be used in infants and young children. Ask older children to blow their nose. Tilt child's head back over a pillow and squeeze dropper without touching the nostril. Keep child's head back for 2 min.

Suppositories

Keep refrigerated for easier administration. Wearing gloves, moisten the rounded end with water or petroleum jelly prior to insertion. Using your pinky finger for children <3 yr and your index finger for those ≥3 yr, insert the suppository into the rectum about 1 in. beyond the sphincter. If the suppository slides out, insert it a little farther than before. Hold the buttocks together for a few minutes and have the child hold their position for about 20 min, if possible.

Topicals

Clean affected area and dry well prior to application. Apply a thin layer to the skin and rub in gently. Do not apply coverings over the area unless instructed to do so by the prescriber.

Metered-Dose Inhalers

Generally the same principles apply in children as in adults, except the use of spacers is recommended for young children (see Medication Administration Techniques).