Young children increasingly find and ingest medications on their own

The problem of pediatric medication poisoning is getting worse, according to a study of patient records from 2001 to 2008 from the National Poison Data System of the American Association of Poison Control Centers, and most of the rise in such poisoning is attributable to children's finding and ingesting medications by themselves. Investigators studied the records of more than 453,000 children (aged ≤5 years) who were evaluated in a health care facility after exposure to a potentially toxic dose of a pharmaceutical agent.

Of the children evaluated for ingestion of a single pharmaceutical product, child self-exposure was responsible for 95% of visits to health care facilities, overwhelmingly emergency departments (EDs). Prescription products (not over-the-counter drugs) accounted for the greatest proportion of child self-exposure: 55% of ED visits, 76% of admissions, and 71% of injuries. Oral hypoglycemic agents accounted for the highest admission and injury rates. Opioid analgesics, sedative-hypnotics (such as benzodiazepines, muscle relaxants, and sleep aids), and cardiovascular medications also accounted for a high number of associated total visits and a significant growth in admission or injury rates.

Therapeutic errors were not significant contributors to ED visits, admissions, or injuries, although therapeutic error-related ED visits with acetaminophen did rise 71% during the 8-year period, with a proportional rise in admissions and injuries. Younger children, especially boys, were most at risk for therapeutic errors (Bond GR, et al. J Pediatr. 2012;160[2]:265-270).

Despite years of education as well as advances in tamper-proof packaging, rates of medical visits for ingestions have continued to rise. Part of the reason seems to be an increase in the number of prescription drugs in the home. If that is indeed the reason, the trend will likely continue. Availability of oral hypoglycemics, identified as the cause of a large portion of serious ingestions, will increase with obesity rates. Meanwhile, baby-boomer grandparents are aging into the many chronic conditions that will generate other tempting medications in the home. -Michael Burke, MD