4.6 Article

The Growing Impact of Pediatric Pharmaceutical Poisoning

Journal

JOURNAL OF PEDIATRICS
Volume 160, Issue 2, Pages 265-U312

Publisher

MOSBY-ELSEVIER
DOI: 10.1016/j.jpeds.2011.07.042

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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. (J Pediatr 2012;160:265-70).

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