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26-09-2011 | General practice | Article

Pediatric medication poisoning ‘getting worse’

Abstract

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MedWire News: Pharmaceutical poisoning is now the most common reason for young children to attend the emergency department (ED), report US researchers who have identified a significant increase in such cases in recent years.

"The problem of pediatric medication poisoning is getting worse, not better," said lead author G Randall Bond (Cincinnati Children's Hospital Medical Center, Ohio).

"More children are exposed, more are seen in EDs, more are admitted to hospitals, and more are harmed each year."

The team examined data from the National Poison Data System for the American Association of Poison Control Centers for all children aged 5 years or under who were examined at a healthcare facility following exposure to a potentially toxic medication between 2001 and 2008.

In all, 453,559 children were treated following ingestion of a single pharmaceutical agent, with 95% of cases due to self-exposure.

Of concern, rates of injury, admission, ED use following single agent poisoning, and exposure all showed significantly greater increases over the study period than the accompanying increase in the US population of children (43, 36, 28, and 22 vs 8%).

Ingested agents were most commonly prescription drugs (55%), and these were responsible for the majority of admissions (76%) and significant injuries (71%).

Prescribed opioid analgesics, sedative-hypnotics, and cardiovascular drugs were especially common poisons and were associated with a high rate of both admissions and injuries, the researchers report in the Journal of Pediatrics.

Therapeutic poisoning from errors in giving over-the-counter acetaminophen or cough and cold medicines made up less than 2% of ED visits and admissions, and injuries. There was a 71% rise in acetaminophen-related errors over the study period but this was not seen for cough and cold medicines.

"Education interventions should readdress home storage of all medications, repackaging of medications-particularly grandparents' medications in 'pill minders,' and the fact that older siblings may not be as careful as parents when opening containers or taking medications," Bond et al write.

"Storage devices and child-resistant closures may need to improve. Additionally, mechanical barriers to ingestion such as blister packs may be required for more substances."

They add: "Preventive efforts should also address appropriate prescribing and society's problem with opioid and sedative abuse."

By Lynda Williams

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