Making Medications Easier

Medications!  Mercy!  My world sometimes seems to be ruled by medications.  It is the first thing I did in the morning and the last thing I did for Maddie before she went to bed.  When Maddie came to me, she did not have one medication.  The first week two were added.  By the time she was a year old she was on a handful and every year more were added.  That is not unusual for medically fragile children (or adults for that matter).

 I, however, was not good at the whole process.  I wasn’t even good at remembering to take an antibiotic when I needed.  I failed on birth control pills because I could not get the hang of taking them every day.  With Maddie, it was imperative that I get it right every time. 

It required me, who am extremely organizationally challenged, to develop some organizational skills.  Over the years I discovered how important it was and became very efficient about all of it.  Here are a few things that were helpful to me.

1.  Keep all medications in the same place.  Pick a place with adequate safe storage and near a water facet.  If there are a number of medications given at different times of the day, place them in order of time given.

2.  Try to encourage the medical team to add medications to times when meds are already scheduled.  Ideally all meds could be given at two or three times a day otherwise the whole day is spent doing medical things.

3.  Order refills in a timely fashion.  Most pharmacies and insurance companies allow medications to be refilled 7 days before running out.  Thursday is a very good day to check all medications and place orders.  That way if there is a problem it can be resolved Thursday afternoon or Friday.  It is much harder to resolve problems on Friday afternoon or over the weekend when doctors’ offices are closed. 

4.  Be consistent with the times meds are given.  It does not have to get in the way of other things in life.  I have been known to give medications in restaurants, in the back of the van, in the dugout of a baseball field, and at rest stops.  In my estimation this is one of most important things to our kids.  Set a timer or arrange for someone to call with a reminder until it becomes second nature.

5. If a child goes to day care or school, send only medication for one day at a time.  It may seem inconvenient but it allows you to make sure medications are given.  In situations with other children, it is easy for medications to be overlooked or forgotten.  One quick look will confirm that the medication has been given in the correct dosage.

6.  Never send medications in something other than a correctly labeled container.  A while back a child died because a mom gave a nurse a syringe label as heparin with a medication the mom had intended to be given through the g-button.  The nurse gave it through the child’s central line.  *** Please note: Medical professionals who are competent will never give a medication mixed up or drawn up by someone else.  It may seem inconvenient and rather parental but it is really to protect our children.

7.  A computer generated medications sheet saves a lot of time.  Every doctor visit, clinic appointment, and emergency room admission begins with a communication of current medications.  It is very annoying and frustrating!  Although I am pretty good at remember the names and the purpose of the medications, there is no way I will remember the concentrations.  If there are not too many it is not a problem to gather the med bottles on the way out the door.  However, if there are a number of them a med sheet is so much easier.   It needs to include the name of the drug, concentration of medication, amount given, route delivered, and time given.  It needs to be frequently up dated.  At the bottom of the page is one of Maddie’s old ones.  I always kept a copy on Maddie’s wheelchair and one in my purse.


Medication sheet example:

March 2011                                                                             Allergies:

Madeleine (Maddie) Halla Gillett                           Demerol: seizures             Codine: vomiting

DOB: 5-22-96                                                            Morphine:Apnea              Macrodantin: vomiting     
                                                                                   Albuterol: heart rate increase 
                                                                                   Plastic tape: rash and sores    

Morning Medications:                                                                                               

Medication	Strength	Amount	Delivery Mode
Prevacid	3mg/ml liquid	5 ml	G-tube.   Keep refrigerated.
Raglan or Metoclopramide	5mg/5 ml liquid	6cc	G-tube
Synthoid	100mcg/tab	1 tablet	J-tube
Cortef	5mg/ tab	2 tablets	J-tube
Neurontin	300 mg capsules	4 Capsules	J-tube
Trileptal	300mg/tab	1 1/2  tablets	J-tube
Keppra	500mg/tab	2 tablets	J-tube
Provigil	100mg/ tab	1 1/2 tablet	J-tube
Vitamin/iron		1 tablet	J-tube
Vitamin D	1000IU	1 tablet	J-tube
Flow Vent	100mcg	1 puff	mouth
Fluticasone	50mcg/puff	1 puff/each	nose
Glycopyrolate	2mg/tab	1 tablet	J-tube

Evening Medications:

Medication	Strength and form	Amount	Delivery Mode
Prevacid	3mg/ml liquid	5cc	G-tube.   Keep refrigerated.
Raglan or Metoclopramide	5mg/5 ml liquid	6cc	G-tube
Cortef	5mg/tablet	1 tab	J-tube
Glycopyrrolate	2mg	1 tablet	J-tube
Neurontin	300 mg capsules	4 Capsules	J-tube
Trileptal	300mg	2  tablets	J-tube
Keppra	500mg	2 tablets	J-tube

Formula: 24 hours recipe for 2000 ml

Mix:     420 ml (14 ounces) Peptamen AF
       360 ml Pedialyte
       1220 ml Water  (hot)
       1/4 teaspoon salt
       2 packets Benefiber
       2 Scoops Beneprotein
       ½-1 cap Mirlax 17/cap

Divide in 2 containers pour 700ml  formula mix to the day bag. Add 3 K-phos (Phospha) tablets crushed and
7.5 ml Potassium Chloride  (20% 40Meq/15 ml).

 Add 10 ml Calcium Carbonate to night bag, place in fridge

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