What liquid medication is

Liquid medicines include solutions, syrups and elixirs that are commonly prescribed for children but may also be prescribed for adults and older people who have difficulty swallowing tablet and capsule medicines. In some cases, the medicine is absorbed better in liquid form, so sometimes people who do not have difficulty swallowing might be prescribed liquid medicines.

What needs to be done before supporting with liquid medication

There is often advice to 'shake the bottle well' before use. It is important that the staff always follows this advice as it helps to ensure any particles are evenly dispersed throughout the bottle.

Some liquid medications, for example, antibiotics and oramorph can have a short expiry date. Staff supporting a service user with medication must always check the label on the bottle to ensure the medicine is not used after the expiry date. It is good practice to dispose of liquid medicines 6 months after the date opened regardless of the manufacturer's expiry date. This situation may apply to medications to be taken on a PRN basis (Latin phrase for 'pro re nata') meaning 'when required'. If the date opened has not been written on the bottle, then staff should use the date dispensed on the pharmacy label as a guide.

It is important that staff carefully read and correctly follow instructions on the medication bottle and those recorded on the Medication Administration Record (MAR) before supporting a service user. If instructions and records on the bottle and MAR do not match, then the staff must inform their line manager immediately. The manager must ensure that staff are given clear and correct instructions to enable them to support with the medication correctly by seeking further medical advice where necessary.

How to measure liquid medication

Liquid medicines usually come with their own 'dosing' or 'measuring' devices. If a dosing device does not come with the liquid medication the service user or the staff needs to ask the pharmacist to supply one.

Staff supporting service users to pour a measured dose of liquid medication must use a dosing or measuring device such as a syringe, a dosing cup or measuring spoon and must never use a household measuring device such as a teaspoon, tablespoon or measuring cup to measure liquid medicines and must measure on a flat surface, not while holding the measuring device in one hand. Household measures are inaccurate and may result in the staff supporting the service user to take more or less medicine than prescribed.

What needs to happen after support has been provided with liquid medication

'Dosing' or 'measuring' devices must always be washed and well dried after use. If not, bacteria can grow and cause contamination. Leaving liquid residue on the device can also interfere with dosing accuracy. The bottle of liquid medication must be wiped with a clean damp cloth after use to prevent spillages and drips which could obscure the information label.

Staff must always record on the service users MAR each time they provide support with liquid medications in the same way they must do with any other medication they support with.

Some liquid medications require refrigeration. Staff must always ensure they read the label on the liquid medication bottle carefully and store correctly, according to any instructions.

Further guidance

Managing medicines for adults receiving social care in the community | Guidance | NICE

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