----- Original Message -----
Sent: Wednesday, August 16, 2006 2:41
PM
Subject: [USMA:37215] Re: Ambiguous
ounces used on TSA web-site.
From your "USMA pharmacist" (grin);
Not entirely true, Scott. For over-the-counter oral liquidsThe trend has
certainly been towards metric, but when the rubber hits the road, it still
comes out to be in fluid ounces in the U.S.. The solution
concentrations are exclusively metric, and the doses recommended in the
professional literature are described in milliliters, but there is a
heinous disconnect once the doctor has his/her prescription pad available and
begins to write. There, the quantity of liquid becomes fluid ounces, and the
dose to be measured is almost always in teaspoonsful and
tablespoonsful. This practice comes from a long-standing tradition in
the U.S. that the prescriber shall write oral liquid in the units with
which the patient is presumed to be familiar. In pharmacy school in the
1970s, I was taught to convert the prescribed 5 mL, or the prescribed one
fluid dram, to one teaspoonful. Another old tradtion, which has been
unaffected by metrication of the U.S. pharmaceutical industry, is that retail
pharmaceuticals are sold in avoirdupois units. I'm not sure about what
maintains this situation (perhaps Ms. Gentry of NIST might know), but maybe
the FPLA metric-only option amendment, once passed, will give the drug
makers pause and let them join Dasani water in making rational metric sizes
of, let's say, 120 mL bottles of Robitussin cough syrup or 250 mL bottles of
NyQuil.
On the Drug Facts panels of most over-the-counter oral liquids, you will
find a "5 mL teaspoonful" mentioned, and even just "5 mL." But, in their gut,
the American people do not yet have a grasp of what just plain old,
unretouched "five milliliters" really is. They don't reach for a measuring
tube to measure oral liquids. Heaven knows what they reach for!! Many people
probably swig Robitussin like they would Cutty Sark.
This tradition of prescribing oral liquid medications has not even
yielded to a 1995 U.S. Pharmacopoeia directive abolishing the apothecary
system of measurement in U.S. healthcare. It must be dealt with by the major
healthcare forces,by the Insitute for Safe Medication Practices (ISMP),
and by a massive public education campaign, and by one pharmacist who has
been shouting in the metrological wilderness for 32 years.
Incidentally, TSA's recent about-face on prescription-only vs.
over-the-counter liquids in carry-ons probably came about
when legions of angry passengers charged the TSA supervisor with the
battle cry, "But, my doctor told me to us this!! I've gotta have it!!"
----- Original Message -----
Sent: 06 Aug 15,Tuesday 21:29
Subject: [USMA:37211] Ambiguous ounces
used on TSA web-site.
Strange that the TSA lists allowed medications in ounces,
when they are dispensed and labeled in metric only (even in the US).
