The Growing Impact of Pediatric Pharmaceutical Poisoning

被引:111
作者
Bond, G. Randall [1 ,2 ,3 ]
Woodward, Randall W. [1 ,2 ]
Ho, Mona [1 ,2 ]
机构
[1] Univ Cincinnati, Div Emergency Med, Cincinnati Childrens Hosp, Med Ctr, Cincinnati, OH USA
[2] Univ Cincinnati, Dept Pediat, Cincinnati Childrens Hosp, Med Ctr, Cincinnati, OH 45221 USA
[3] Univ Cincinnati, Drug & Poison Informat Ctr, Cincinnati Childrens Hosp, Med Ctr, Cincinnati, OH 45221 USA
关键词
AMERICAN ASSOCIATION; MEDICATION USE; INGESTIONS; CHILDREN; RISK;
D O I
10.1016/j.jpeds.2011.07.042
中图分类号
R72 [儿科学];
学科分类号
100202 [儿科学];
摘要
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).
引用
收藏
页码:265 / U312
页数:7
相关论文
共 24 条
[1]
Acetaminophen Hepatotoxicity Working Group Center for Drug Evaluation and Research Food and Drug Administration Department of Health and Human Services, REC FDA INT DECR OCC
[2]
[Anonymous], NPDS ANN REP AM ASS
[3]
2009 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 27th Annual Report [J].
Bronstein, Alvin C. ;
Spyker, Daniel A. ;
Cantilena, Louis R., Jr. ;
Green, Jody L. ;
Rumack, Barry H. ;
Giffin, Sandra L. .
CLINICAL TOXICOLOGY, 2010, 48 (10) :979-1178
[4]
2008 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 26th Annual Report [J].
Bronstein, Alvin C. ;
Spyker, Daniel A. ;
Cantilena, Louis R., Jr. ;
Green, Jody L. ;
Rumack, Barry H. ;
Giffin, Sandra L. .
CLINICAL TOXICOLOGY, 2009, 47 (10) :911-1084
[5]
Cox ER, 2008, PEDIATRICS, V122, pE1053, DOI 10.1542/peds.2008-0214
[6]
Understanding parental motivators and barriers to uptake of child poison safety strategies: a qualitative study [J].
Gibbs, L ;
Waters, E ;
Sherrard, J ;
Ozanne-Smith, J ;
Robinson, J ;
Young, S ;
Hutchinson, A .
INJURY PREVENTION, 2005, 11 (06) :373-377
[7]
Governale L, OTC RX ACCT MARK OV
[8]
Inequalities in hospital admission rates for unintentional poisoning in young children [J].
Groom, L. ;
Kendrick, D. ;
Coupland, C. ;
Patel, B. ;
Hippisley-Cox, J. .
INJURY PREVENTION, 2006, 12 (03) :166-170
[9]
ACCIDENTAL INGESTIONS OF ORAL PRESCRIPTION DRUGS - A MULTICENTER SURVEY [J].
JACOBSON, BJ ;
ROCK, AR ;
COHN, MS ;
LITOVITZ, T .
AMERICAN JOURNAL OF PUBLIC HEALTH, 1989, 79 (07) :853-856
[10]
Recent patterns of medication use in the ambulatory adult population of the United States - The Slone survey [J].
Kaufman, DW ;
Kelly, JP ;
Rosenberg, L ;
Anderson, TE ;
Mitchell, AA .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2002, 287 (03) :337-344