Adult glyburide ingestions reported to Texas poison control centers, 1998—2005

2007 ◽  
Vol 26 (7) ◽  
pp. 563-571 ◽  
Author(s):  
MB Forrester
Keyword(s):  
Health Care ◽  
Statistical Significance ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Poison Control ◽  
Poison Control Center ◽  
Limited Information ◽  
Control Center ◽  
Poison Control Centers

Limited information exists on potentially adverse adult glyburide ingestions reported to poison control centers. Using adult glyburide ingestions reported to Texas poison control centers during 1998—2005, the proportion of cases involving serious outcomes was determined for selected variables and evaluated for statistical significance by calculating the rate ratio (RR) and 95% confidence interval (CI). Of 126 cases identified, 49 (39%) involved serious outcomes. Serious outcomes were significantly more likely to occur with a maximum dose > 24 mg (RR 4.74, 95% CI 1.74—14.90) or >4 tablets (RR 3.27, CI 1.57—7.31), where the circumstances of the exposures involved self-harm or malicious intent (RR 2.44, CI 1.33—4.46), or the patient was already at or en route to a health care facility when the poison control center was contacted (RR 12.89, CI 4.00—66.12) or referred to a health care facility by the poison control center (RR 12.21, CI 3.53—65.01). The severity of the outcome associated with adult glyburide ingestions depended on the dose and the circumstances of the ingestion. The management of patients with severe outcomes was more likely to involve health care facilities. Such information is useful for creating triage guidelines for the management of adult glyburide ingestions. Human & Experimental Toxicology (2007) 26: 563—571.

Adult lisinopril ingestions reported to Texas poison control centers, 1998—2005

2007 ◽  
Vol 26 (6) ◽  
pp. 483-489 ◽  
Author(s):  
Mathias B. Forrester
Keyword(s):  
Health Care ◽  
Statistical Significance ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Poison Control ◽  
Poison Control Center ◽  
Limited Information ◽  
Control Center ◽  
Poison Control Centers

There is limited information on potentially adverse lisinopril ingestions reported to poison control centers. Using adult lisinopril ingestions reported to Texas poison control centers during 1998—2005, the proportion of cases involving serious outcomes was determined for selected variables and evaluated for statistical significance by calculating the rate ratio (RR) and 95% confidence interval (CI). Of 468 cases identified, 43 (9%) involved serious outcomes. The severity of the outcome associated with adult lisinopril ingestions depended on the dose and the circumstances of the ingestion. Thus, serious outcomes were significantly more likely to occur with a maximum dose >80 mg (RR 5.69, CI 2.43—13.33) or, if the dose was unknown, ≥3 tablets (RR 9.57, CI 2.39—54.97), where the circumstances of the exposures involved self-harm or malicious intent (RR 6.96, CI 3.65—13.31), or the patient was already at or en route to a health care facility when the poison control center was contacted (RR 7.33, CI 3.09—17.85) or referred to a health care facility by the poison control center (RR 23.76, CI 10.62—55.67). The management of patients with severe outcomes was more likely to involve health care facilities. Such information is useful for creating of triage guidelines for the management of adult lisinopril ingestions. Human & Experimental Toxicology (2007) 26, 483—489

Escitalopram ingestions reported to Texas poison control centers, 2002—2005

2007 ◽  
Vol 26 (6) ◽  
pp. 473-482 ◽  
Author(s):  
M.B. Forrester
Keyword(s):  
Health Care ◽  
Statistical Significance ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Poison Control ◽  
Poison Control Center ◽  
Limited Information ◽  
Control Center ◽  
Poison Control Centers

Limited information exists on potentially adverse escitalopram ingestions reported to poison control centers. Using isolated escitalopram ingestions reported to Texas poison control centers during 2002—2005, the proportion of cases involving serious medical outcomes was determined for selected variables and evaluated for statistical significance by calculating the rate ratio (RR) and 95% confidence interval (CI). Of 1179 cases identified, 234 (20%) involved serious outcomes. Serious outcomes were significantly more likely to occur with a maximum dose of >100 mg (RR 4.69, CI 2.52—9.29) or >5 tablets (RR 4.96, CI 2.94—8.93), where the circumstances of the exposures involved self-harm or malicious intent (RR 3.21, CI 2.42—4.29), or when the patient was already at or en route to a health care facility when the poison control center was contacted (RR 7.88, CI 4.31—15.79) or referred to a health care facility by the poison control center (RR 15.91, CI 8.78—31.64). The severity of the outcome associated with isolated escitalopram ingestions depended on the dose and the circumstances of the ingestion. The management of patients with serious outcomes were more likely to involve health care facilities. Such information is useful for creating triage guidelines for the management of escitalopram ingestions. Human & Experimental Toxicology (2007) 26 , 473—482

Pediatric lisinopril ingestions reported to Texas poison control centers

2007 ◽  
Vol 26 (2) ◽  
pp. 83-89 ◽  
Author(s):  
M.B. Forrester
Keyword(s):  
Health Care ◽  
Statistical Significance ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Poison Control ◽  
Medical Outcomes ◽  
Poison Control Centers ◽  
Factors Associated ◽  
Care Facilities

Lisinopril is not recommended for use by young children. This study attempted to identify factors associated with serious outcomes in pediatric lisinopril ingestions. Cases for this study were lisinopril ingestions by children age ≤5 years reported to Texas poison control centers during 1998- 2005. The percentage of cases involving serious medical outcomes was identified for selected variables and evaluated for statistical significance by calculating the rate ratio (RR) and 95% confidence interval (CI). Of 691 total cases, 26 (3.8%) involved a serious outcome. Higher serious outcome rates were found with a max imum dose of >4 mg/kg (RR: 2.54, CI: 0.05-25.62), or > 80 mg (RR: 7.85; CI: 1.73-29.29),or five or more tablets (RR: 8.18; CI: 2.73-22.54), or the patient was already at or en route to a health care facility when the poison control center was contacted (RR: 13.93; CI: 3.68-77.78),or referred to a health care facility by the poison control center (RR: 33.49; CI: 9.04-194.94). The management of patients with severe outcomes was more likely to involve health care facilities. This information is useful for drafting triage guidelines for the management of pediatric lisinopril ingestions. Human & Experimental Toxicology (2007) 26 , 83- 89

Pattern of ziprasidone exposures reported to Texas poison centers, 2001–2005

2008 ◽  
Vol 27 (4) ◽  
pp. 355-361 ◽  
Author(s):  
MB Forrester
Keyword(s):  
Health Care ◽  
Age Distribution ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Poison Control ◽  
Clinical Effects ◽  
Poison Control Centers ◽  
Poison Centers ◽  
The Mean

Information on potentially adverse exposures to the atypical antipsychotic drug ziprasidone is limited. This study described the pattern of exposures involving only ziprasidone (isolated exposures) reported to Texas poison control centers during 2001–2005. The mean dose was 666 mg. The patient age distribution was ≤5 years (11%), 6–19 years (30%), and ≥20 years (60%). The exposures were intentional in 53% of the cases. Seventy-five percent of the exposures were managed at health care facilities. The final medical outcome was classified as no effect for 39% of the cases and minor effects for 40% of the cases. Adverse clinical effects were listed for 53% of the patients; the most frequently reported being neurological (42%), cardiovascular (13%), and gastrointestinal (5%). The most frequently listed treatment was decontamination by charcoal (34%) or cathartic (28%). Potentially adverse ziprasidone exposures reported to poison control centers are likely to involve management at a health care facility and involve some sort of adverse clinical effect. With proper treatment, the outcomes of such exposures are generally favorable.

Adult metaxalone ingestions reported to Texas poison control centers, 2000-2006

2009 ◽  
Vol 29 (1) ◽  
pp. 55-62 ◽  
Author(s):  
Mathias B Forrester
Keyword(s):  
Health Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Poison Control ◽  
Minor Effect ◽  
Clinical Effects ◽  
Medical Outcome ◽  
Poison Control Centers ◽  
Few Data

Few data exist on potentially adverse metaxalone (Skelaxin®) ingestions in adults. All metaxalone ingestions involving patients aged ≥20 years during 2000-2006 were retrieved from Texas poison control centers. Exclusion criteria were lack of follow-up or multiple substance ingestion. Cases were analyzed for selected demographic and clinical factors. Of the 142 patients, 66.2% were female. Dose ingested was reported for 61 patients. Of those cases with a reported dose, distribution by management site was 29.5% on-site, 59.0% already at/en route to health care facility, and 11.5% referred to health care facility. Final medical outcome was ‘no effect’ for 50.8% cases, ‘minor effect’ for 31.1%, and ‘moderate effect’ for 18.0%. The more common adverse clinical effects reported were drowsiness (27.9%), tachycardia (6.6%), agitation (6.6%), nausea (4.9%), dizziness (4.9%), slurred speech (4.9%), and tremor (4.9%). A moderate medical outcome occurred in 13.6% of ingestions of ≤2400 mg and 20.5% of ingestions of >2400 mg. Management involved a health care facility in 18.2% of ingestions of ≤2400 mg and 100.0% of ingestions of >2400 mg. This study found that adult ingestions of higher doses of metaxalone, particularly >2400 mg, were associated with more serious medical outcomes and were managed at health care facilities. This study also proposes triage guidelines for when ingestions can be safely managed at home.

Adult metformin ingestions reported to Texas poison control centers, 2000–2006

2008 ◽  
Vol 27 (7) ◽  
pp. 575-583 ◽  
Author(s):  
MB Forrester
Keyword(s):  
Health Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Poison Control ◽  
Medical Outcome ◽  
Limited Information ◽  
Poison Control Centers ◽  
Hypoglycemic Agent ◽  
The Mean

Metformin is an oral hypoglycemic agent used in the management of type 2 diabetes mellitus. Limited information exists on adult metformin ingestions reported to poison control centers. The distribution of adult metformin ingestions reported to Texas poison control centers during 2000–2006 was determined for various factors. In addition, triage guidelines for the management of isolated ingestions were drafted. Of 1528 total metformin ingestions, 58% involved coingestants. Of the 264 ingestions of metformin alone, where the final medical outcome was known, dose ingested was reported for 66%. The mean reported dose was 4739 mg (range 500–60,000 mg). Ingestions of ≤2500 mg and >5000 mg reported doses differed with respect to the proportion involving suspected attempted suicide (6% versus 81%), serious final medical outcome (3% versus 19%), and referral to a health care facility (3% versus 83%). Using 5000 mg as a threshold dose for referral to a health care facility, 91% of cases not already at or en route to a health care facility were managed according drafted triage guidelines.

scholarly journals 2016 Annual Report of the University of Kansas Health System Poison Control Center

2019 ◽  
Vol 11 (2) ◽  
pp. 24-33
Author(s):  
Stephen L. Thornton ◽  
Lisa Oller ◽  
Doyle M. Coons
Keyword(s):  
Health Care ◽  
Health System ◽  
Human Exposure ◽  
Annual Report ◽  
Poison Control ◽  
Poison Control Center ◽  
University Of Kansas ◽  
Control Center ◽  
Poison Control Centers ◽  
The University

Introduction. This is the 2016 Annual Report of the University ofKansas Health System Poison Control Center (PCC). The PCC is oneof 55 certified poison control centers in the United States and servesthe state of Kansas 24 hours a day, 365 days a year, with certified specialistsin poison information and medical toxicologists. The PCCreceives calls from the public, law enforcement, health care professionals,and public health agencies. All calls to the PCC are recordedelectronically in the Toxicall® data management system and uploadedin near real-time to the National Poison Data System (NPDS), whichis the data repository for all poison control centers in the U.S. Methods. All encounters reported to the PCC from January 1, 2016to December 31, 2016 were analyzed. Data recorded for each exposureincludes caller location, age, weight, gender, substance exposedto, nature of exposure, route of exposure, interventions, medicaloutcome, disposition and location of care. Encounters were classifiedfurther as human exposure, animal exposure, confirmed non-exposure,or information call (no exposure reported). Results. The PCC logged 21,965 total encounters in 2016, including20,713 human exposure cases. The PCC received calls from everycounty in Kansas. The majority of human exposure cases (50.4%, n =10,174) were female. Approximately 67% (n = 13,903) of human exposuresinvolved a child (defined as 19 years or less). Most encountersoccurred at a residence (94.0%, n = 19,476) and most calls (72.3%, n= 14,964) originated from a residence. The majority of human exposures(n = 18,233) were acute cases (exposures occurring over eighthours or less). Ingestion was the most common route of exposuredocumented (86.3%, n = 17,882). The most common reported substancein pediatric encounters was cosmetics/personal care products(n = 1,362), followed by household cleaning products (n = 1,301). Foradult encounters, sedatives/hypnotics/antipsychotics (n = 1,130) andanalgesics (n = 1,103) were the most frequently involved substances.Unintentional exposures were the most common reason for exposures(81.3%, n = 16,836). Most encounters (71.1%, n = 14,732) weremanaged in a non-healthcare facility (i.e., a residence). Among humanexposures, 14,679 involved exposures to pharmaceutical agents while10,176 involved exposure to non-pharmaceuticals. Medical outcomeswere 32% (n = 6,582) no effect, 19% (n = 3,911) minor effect, 8% (n =1,623) moderate effect, and 2% (n = 348) major effects. There were 15deaths in 2016 reported to the PCC. Number of exposures, calls fromhealthcare facilities, cases with moderate or major medical outcomes,and deaths all increased in 2016 compared to 2015. Conclusions. The results of the 2016 University of Kansas HealthSystem Poison Control annual report demonstrates that the centerreceives calls from the entire state of Kansas totaling over 20,000human exposures per year. While pediatric exposures remain themost common, there is an increasing number of calls from healthcarefacilities and for cases with serious outcomes. The experience of thePCC is similar to national data. This report supports the continuedvalue of the PCC to both public and acute health care in the state ofKansas. Kans J Med 2018;11(2):24-33.

Immediate- and controlled-release zolpidem ingestions reported to Texas poison centers

2009 ◽  
Vol 28 (8) ◽  
pp. 505-509 ◽  
Author(s):  
Mathias B Forrester
Keyword(s):  
Controlled Release ◽  
Care Facility ◽  
Health Care Facility ◽  
Immediate Release ◽  
Poison Control ◽  
Clinical Effects ◽  
Control Center ◽  
Poison Control Centers ◽  
Poison Centers ◽  
The Mean

Zolpidem is available in immediate-release (IR) and controlled-release (CR) formulations. This investigation examined whether there were differences in zolpidem IR and CR ingestions reported to poison control centers. Zolpidem ingestions that did not involve coingestants reported to Texas poison control centers during 2005-2008 were identified. The ingestions were grouped by IR and CR formulations and compared with respect to demographic and clinical factors. There were 734 IR and 163 CR ingestions. The mean dose ingested was 92.9 mg and 104.6 mg, respectively. IR and CR cases were, respectively, 56.9% and 58.3% male, 54.6% and 49.7% age >19 years, 65.0% and 65.0% already at or en route to a health care facility when the poison control center was contacted, and 30.1% and 39.3% involved no effect. The most frequently reported adverse clinical effects were, for IR and CR, respectively, drowsiness (54.4% vs 42.3%), tachycardia (10.6% vs 11.7%), ataxia (6.3% vs 11.7%), slurred speech (6.3% vs 6.7%), vomiting (5.0% vs 5.5%) and hallucinations/delusions (4.9% vs 3.1%). The distribution of zolpidem IR and CR ingestions reported to Texas poison control centers were similar. However, zolpidem CR ingestions appeared less likely to result in drowsiness and hallucinations but more likely to result in ataxia.

Non-health care facility anticonvulsant medication errors in the United States

2017 ◽  
Vol 37 (6) ◽  
pp. 561-570
Author(s):  
Emily A DeDonato ◽  
Henry A Spiller ◽  
Marcel J Casavant ◽  
Thitphalak Chounthirath ◽  
Nichole L Hodges ◽  
...  
Keyword(s):  
Health Care ◽  
Medication Errors ◽  
Care Facility ◽  
Health Care Facility ◽  
The United States ◽  
Anticonvulsant Drugs ◽  
Poison Control ◽  
Medical Outcomes ◽  
Poison Control Centers ◽  
Anticonvulsant Medication

Introduction: This study provides an epidemiological description of non-health care facility medication errors involving anticonvulsant drugs. Methods: A retrospective analysis of National Poison Data System data was conducted on non-health care facility medication errors involving anticonvulsant drugs reported to US Poison Control Centers from 2000 through 2012. Results: During the study period, 108,446 non-health care facility medication errors involving anticonvulsant pharmaceuticals were reported to US Poison Control Centers, averaging 8342 exposures annually. The annual frequency and rate of errors increased significantly over the study period, by 96.6 and 76.7%, respectively. The rate of exposures resulting in health care facility use increased by 83.3% and the rate of exposures resulting in serious medical outcomes increased by 62.3%. In 2012, newer anticonvulsants, including felbamate, gabapentin, lamotrigine, levetiracetam, other anticonvulsants (excluding barbiturates), other types of gamma aminobutyric acid, oxcarbazepine, topiramate, and zonisamide, accounted for 67.1% of all exposures. Conclusions: The rate of non-health care facility anticonvulsant medication errors reported to Poison Control Centers increased during 2000–2012, resulting in more frequent health care facility use and serious medical outcomes. Newer anticonvulsants, although often considered safer and more easily tolerated, were responsible for much of this trend and should still be administered with caution.

scholarly journals Characteristics of Laboratory Confirmed Ethylene Glycol and Methanol Exposures Reported to a Regional Poison Control Center

2019 ◽  
Vol 11 (3) ◽  
pp. 67-69
Author(s):  
Robert C. Tung ◽  
Stephen L. Thornton
Keyword(s):  
Ethylene Glycol ◽  
Care Facility ◽  
Health Care Facility ◽  
Serum Levels ◽  
Anion Gap ◽  
Poison Control ◽  
Poison Control Center ◽  
Laboratory Findings ◽  
Control Center ◽  
Average Maximum

Introduction. Ethylene glycol (EG) and methanol (MET) exposuresare rare but can cause significant morbidity and mortality.Though frequently treated similarly, EG and MET exposures havecharacteristics that are not well differentiated in the literature. Wesought to describe the clinical characteristics of EG and MET exposures,confirmed with quantitative serum levels. Methods. An IRB-approved retrospective review of the Universityof Kansas Health System Poison Control Center database from July2005 to July 2015 identified all EG/MET exposures evaluated ata health care facility. Initial measurements were EG/MET levels,serum pH, serum creatinine, anion gap, serum ethanol level, maxanion gap, max osmolar gap, therapy performed (hemodialysis,fomepizole, ethanol) and death. Results. The search identified 75 cases, with 59 cases having onlydetectable EG levels and 15 cases having only detectable MET levels.The average EG level was 126 mg/dL (range 5 - 834). The averagedetectable methanol level was 78 mg/dL (range 5 - 396). The averagemaximum anion gap of the EG positive group was 20 mEq/L (range8 - 35). The average maximum anion gap of the MET positive groupwas 14 mEq/L (range 6 - 34). One death was reported in the EG positivegroup, with an initial level of 266 mg/dL. Conclusions. In this study of EG/MET exposures, EG exposureswere more common than MET exposures, but they had similardemographics, laboratory findings, and interventions. Continuedstudies are warranted to characterize these uncommon exposuresfurther. Kans J Med 2018;11(3):67-69.

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