When I was in pharmacy school, which was a long time ago (mid-1970s), I was
taught to convert whatever units of measurement that were in the signa of an
oral liquid prescription to teaspoonsful on the patient label, ostensibly to
allow the patient to measure the liquid in lay terms.  However, I believe
that this practice is now not only outdated but also potentially dangerous.

I have always wondered what instrument the public actually uses to measure
these liquids with.  In this era of medication-error scrutiny, how can we
justify, let's say, dispensing anticonvulsive medications such as Dilantin
Oral Suspension on a teaspoonful-directed basis?

The solution (to the problem) I wish to propose is to drop the practice of
stating anything but milliliters on the labels of these prescriptions (e.g.,
take 5 mL by mouth three times a day) , provide a plastic metric measuring
tube to the patient or his/her family or agent,  and to counsel them on the
use of the tube in measuring. Yes, this will take extra counseling work and
expense (it's never a convenient time to introduce overdue innovations, I
realize), but this would go a long way towards reducing the number of horror
stories of overdoses (or even underdoses) we keep seeing because of
measurement-unit confusion.  This change can also be seen as a public
relations and a business coup, with the name and phone number of the
pharmacy printed on the measuring tube.

Now, some will say, if you label it "5 mL,", they'll take or give five
teaspoonsful by mistake. Not if you explain the milliliter and show them how
to measure, and not when, after a while, milliliters are all they see on
labels.

I'm not making this suggestion in ignorance of reality. I worked retail
pharmacy for 12 years, and this would be added burden to the labor already
on our plate. But, IMHO, The time is long past for teaspoons and tablespoons
as units of measurement in healthcare, and for our patients' sakes, we ought
to work towards ending the deadly confusion.

We ought to consult medicine, nursing, and pharmacy at large before making
this a regular procedure, but that, too, would be worth the effort.