Proper dosage can be a matter of timing


September 13, 1994|By Dr. Modena Wilson and Dr. Alain Joffe | Dr. Modena Wilson and Dr. Alain Joffe,Special to The Sun

Q: Over the summer my son was started on a medication he is supposed to take three times a day. I am worried he'll conveniently forget to take it at school, because he'll find it embarrassing. Does he have to take it during school?

A: We can't answer your question directly without more information. What is the medication? Why is he taking it? How old is your son? What are his school hours? Let's discuss his specific situation.

Medication dosing schedules are designed to regulate the level of the medicine in the body. The aim may be for a steady amount DTC of medicine in body and organs. If so, it is important to give doses close enough together that the next dose of medicine is absorbed before the last is completely gone.

Sometimes the proper interval between doses (four or six hours are common ones) is shorter than the school day. When that is the case and a steady level of medicine is important to a child's health, a dose must be given at school.

On the other hand, a number medicines need not be given so precisely. Many medicines prescribed in "three times a day" dosages do not have to ge given at strict eight-hour intervals. Check with your child's doctor. Doses before and after school and at bedtime might be perfectly acceptable.

Alternatively, if you must stay with an every-eight-hours schedule and are giving a dose during school hours, the schedule might be slowly rotated until it avoids school hours altogether.

If, in the end, your son needs to take medicine at school, you need to know that most school systems require medication supervision by the school nurse or another member of the school staff. You, your son, your son's doctor and school personnel can work together to arrange a time and place for your son to take his medicine with the least possible risk of embarrassment.

It is normal for children to be sensitive about indications that they are "different" from their classmates; however, it sounds although your son may be quite troubled about the health problem which requires medication.

Give him an opportunity to talk with you about it, and think about ways in which he might learn that other children have similar problems and must take medication, too.

Dr. Wilson is director of general pediatrics at Johns Hopkins Children's Center; Dr. Joffe is director of adolescent medicine.

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