Most people consider their pets as part of the family. But just like you wouldn’t want to take another family member’s medicines by mistake, you don’t want to accidentally take your pet’s medicine either.  Who would ever make that mistake? You’d be surprised how often it happens.

Our colleagues at ISMP in Canada heard from a consumer who reported that an elderly relative had accidently taken the family dog's deworming pills. Someone had placed the dog's pills on a bookcase. Later, the elderly relative moved the dog's pills to a bedside table, where other medicines were being stored. For several days the elderly relative then took the deworming pills, instead of a regularly prescribed medicine. The mistake was discovered when it was time to give the dog a dose of deworming medicine. The family member found the empty container on the bedside table and realized that the elderly relative had taken all of the dog's pills!

When the mistake was discovered, the elderly relative mentioned having felt sick for a few days earlier in the week, without knowing why. Fortunately, no serious harm occurred, but some pet medicines can be harmful if taken by humans.

Also, a person who takes a pet's medicine instead of the medicine that was prescribed will lose the benefit of taking the correct medicine. In a case reported to us, a father told his child’s babysitter to put his son's antibiotic ear drops in his right ear before bed, and the careful babysitter did just that. She found ear drops labelled "put two drops in right ear" in the medicine cabinet, and instilled the ear drops into the child's right ear. But the family's dog also had a bottle of ear drops for ear mites, which were the drops the babysitter used. The son's ear drops were in the refrigerator. Luckily, the child was not harmed by the dog's ear drops but he did miss an important treatment for his ear infection.

Here are a few tips to help prevent mix-ups with pets' medicines in your home:

• Keep in mind that many medicines intended for pets, whether obtained from your veterinarian’s office or the local community pharmacy, are dispensed in prescription vials that may look similar to vials used for human medicines.
• Mix-ups between pet's and children's medicines occur most often when they are stored together in the same place, such as a medicine cabinet. To prevent mix-ups, which could be serious, keep all pet medicines away from human medicines and food. Store them in a separate location from medicines intended for people.
• Keep all medicines out of the reach of children and adults who may become confused. It is best to use safety locks on any cabinets where medicines and hazardous products are stored.
• The Centers for Disease Control and Prevention (CDC) and the Consumer Healthcare Products Association (CHPA) Educational Foundation launched UP and Away and Out of Sight to provide tools to remind everyone of the importance of safe medication storage and keeping medicines and vitamins “Up and Away” and out of every child’s reach and sight. It’s worthwhile taking a few minutes to review this material.
• Whenever you receive a medicine for your pet, check to be sure it is safely packaged. For example, is the pet medicine in a child-proof container? Is the container clearly labeled "For veterinary use only"? If not, ask your veterinarian or pharmacist to change the packaging to reduce the chance of a mix-up or at least mark the container in some way. Make sure the container looks different from human medicine.  

Administering medicines to children is a job that requires some basic knowledge. If you must ask your babysitter or someone else to give medicine to your child, be sure to show them where the medicine is, how much to give, and how to give it. Never assume they will know what to do without your explicit instructions.

Incidentally, medicines intended for humans can also be harmful for pets. Talk to your veterinarian before giving your pet any medicine.

Sixth grade marks the start of middle school for many American 11-year-olds. Research also indicates that it is the age that children begin to self-medicate. With that in mind, Scholastic and the American Association of Poison Control Centers (AAPCC) have launched OTC Literacy, an educational campaign to raise awareness about over-the-counter medicine safety. The program is tailored to 6th graders and emphasizes that while OTC medicines are safe when used properly, it is critical to consult a parent or guardian before taking any medication.

Here’s advice about seemingly harmless over-the-counter eye drops, such as Visine and similar products containing the active ingredients tetrahydrozoline, oxymetazoline, or naphazoline. These drugs are quite dangerous if ingested. Severe side effects have been documented after swallowing as little as a half of teaspoonful.

Most people wouldn’t think twice about the potential for harm when applying over-the-counter creams, lotions, ointments, sprays or patches to the skin. However, we recently received a report about a patient who was hospitalized for burns after using an over-the-counter (OTC) cream for muscle pain. The patient, who was using ICY HOT Medicated Patches, sustained 2^nddegree burns over the area of his chest where the patch had been placed. The size of the burn was reported to be 9 cm by 5.5 cm (about 3 ½ inches by 2 inches). Fortunately, the patient is now fine.

Companies often use color on products to capture attention or differentiate items. For instance, bright colors may draw your attention to a specific word or detail on a label. Companies also use color to distinguish different products within their brand.

With millions of Americans suffering from diabetes, there has been tremendous growth in the use of insulin. For convenience, many insulin dependent diabetics carry their insulin in a prefilled syringe available from drug manufacturers. The device is called an insulin pen because it looks similar to a writing pen and can be carried in your pocket. An insulin pen is designed to give multiple injections of insulin after changing the single use attachable needle.

Patients who keep an EpiPen on hand in case of a severe allergic attack need to know about a potentially dangerous mix-up between the actual pen and a similar looking training pen.

A nurse visited a homebound woman who continued to have high blood sugar levels despite doubling her insulin dose for about 2 weeks. The nurse questioned the woman about factors that may be causing the sudden need for more insulin. The woman had been eating her usual diet. She had no signs of infection or decrease in physical activity. She was sleeping well, and there was no new stress in her life. The technique and materials she used to test her blood sugar were appropriate. Any one of these factors could influence the dose of insulin required to keep her blood sugar under control, but nothing unusual was discovered.

Most pills you need to swallow are available commercially in the dosage strengths commonly prescribed for patients. Or, if need be, a liquid or suspension might be available. But this is not always the case. Occasionally, the exact dose of medication you need is not available commercially, so part of a tablet or capsule may be needed.

Durezol is a steroid eye drop prescribed to reduce swelling and pain after eye surgery. Unbelievably, there’s a wart remover with a very similar name called Durasal. The wart remover is a strong salicylic acid (26%) solution. Both products come in small applicator bottles. You can guess what can happen, especially since patients who undergo eye surgery often have difficulty reading medication labels.