The growing impact of pediatric pharmaceutical poisoning

J Pediatr. 2012 Feb;160(2):265-270.e1. doi: 10.1016/j.jpeds.2011.07.042. Epub 2011 Sep 13.

Abstract

Objective: To understand which medications, under which circumstances, are responsible for the noted increase in pediatric medication poisonings, resource use, and morbidity.

Study design: Patient records from 2001-2008 were obtained from the National Poison Data System of the American Association of Poison Control Centers for children aged ≤5 years evaluated in a health care facility following exposure to a potentially toxic dose of a pharmaceutical agent. Pharmaceutical agents were classified as over-the-counter or prescription and by functional category. Exposures were classified as child self-ingested the medication or as therapeutic error. For the 8-year period, emergency visits, admissions, significant injuries, and trends in these events were calculated for each substance category.

Results: We evaluated 453 559 children for ingestion of a single pharmaceutical product. Child self-exposure was responsible for 95% of visits. Child self-exposure to prescription products dominated the health care impact with 248 023 of the visits (55%), 41 847 admissions (76%), and 18 191 significant injuries (71%). The greatest resource use and morbidity followed self-ingestion of prescription products, particularly opioids, sedative-hypnotics, and cardiovascular agents.

Conclusions: Prevention efforts have proved to be inadequate in the face of rising availability of prescription medications, particularly more dangerous medications.

MeSH terms

  • Administration, Oral
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / adverse effects
  • Cardiovascular Agents / administration & dosage
  • Cardiovascular Agents / adverse effects
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Hospitalization / statistics & numerical data*
  • Humans
  • Hypnotics and Sedatives / administration & dosage
  • Hypnotics and Sedatives / adverse effects
  • Infant
  • Infant, Newborn
  • Male
  • Nonprescription Drugs / administration & dosage
  • Nonprescription Drugs / adverse effects
  • Pharmaceutical Preparations / administration & dosage
  • Poison Control Centers / organization & administration
  • Poison Control Centers / statistics & numerical data
  • Prescription Drugs / administration & dosage*
  • Prescription Drugs / adverse effects*
  • Risk Factors
  • United States

Substances

  • Analgesics, Opioid
  • Cardiovascular Agents
  • Hypnotics and Sedatives
  • Nonprescription Drugs
  • Pharmaceutical Preparations
  • Prescription Drugs