Cases of pediatric ingestion of celecoxib reported to Texas poison control centers in 2000–2007

2009 ◽  
Vol 28 (4) ◽  
pp. 191-194 ◽  
Author(s):  
MB Forrester
Keyword(s):  
Abdominal Pain ◽  
Healthcare Facility ◽  
Poison Control ◽  
Minor Effect ◽  
Clinical Effects ◽  
Medical Outcome ◽  
Clinical Factors ◽  
Poison Control Centers

Little data exist regarding pediatric celecoxib ingestions. This study described the pattern of pediatric celecoxib ingestions reported to poison control centers. Cases were isolated celecoxib ingestions by patients aged 0–5 years during 2000–2007 reported to Texas poison control centers. The distribution of cases was described with respect to demographic and clinical factors. Of the 177 total patients, dose ingested in milligrams was reported for 92 patients. Mean reported dose was 305.5 mg (range 10–2300 mg). Of those 92 cases, distribution by management site was 89.1% on site, 6.5% already at/en route to healthcare facility and 4.3% referred to healthcare facility. Final medical outcome was no effect for 95.7% cases and minor effect for 4.3% cases. Specific clinical effects reported (in only one case each) were rash, abdominal pain, vomiting, agitation/irritability, and drowsiness. All of the pediatric celecoxib ingestions reported to Texas poison control centers resulted in no or minor effect.

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.

Toxicity of Polysaccharide–Iron Complex Exposures Reported to Poison Control Centers

2000 ◽  
Vol 34 (2) ◽  
pp. 165-169 ◽  
Author(s):  
Wendy Klein-Schwartz
Keyword(s):  
Healthcare Facility ◽  
Iron Complex ◽  
Facility Management ◽  
Poison Control ◽  
Minor Effect ◽  
Poison Center ◽  
Clinical Effects ◽  
Serious Adverse Events ◽  
Poison Control Centers ◽  
Toxic Exposures

OBJECTIVE: To evaluate the toxicity of polysaccharide–iron complex (PIC) exposures reported to poison centers in the US. DESIGN: A retrospective analysis of potentially toxic exposures to PIC without concomitant substances reported to the American Association of Poison Control Centers (AAPCC) Toxic Exposure Surveillance System from 1990 to 1998 was performed. RESULTS: Of 810 potentially toxic exposures to PIC, 55.9% occurred in females, 43.8% in males; in 0.3%, gender was unknown. The majority of exposures (74.4%) involved children under six years of age. The reasons for exposure were: 86.7% unintentional, 11.6% intentional, and 1.6% adverse reaction. The most frequently reported clinical effects attributed to PIC were vomiting (n = 23), diarrhea (10), nausea (11), abdominal pain (10), and lethargy/drowsiness (7). While the majority of exposures were managed outside a healthcare facility, management site varied depending on age (management in non-healthcare facility in 71.8% of exposures in children under six years of age vs. 44.9% in adolescents and adults). The majority of outcomes (95.6%) were no effect, minor effect, unrelated effect, not followed since nontoxic, or not followed since only minimal toxicity possible. Of two cases coded as moderate effect, it could not be determined whether the symptoms were related to PIC in one, and in the second case inspection of the poison center record revealed that the actual outcome was minor effect. There were no major effects or deaths. CONCLUSIONS: There were no serious adverse events following PIC exposure reported to the AAPCC. Although more data are needed, these findings suggest reduced toxicity for PIC relative to other forms of iron.

Eszopiclone ingestions reported to Texas poison control centers, 2005—2006

2007 ◽  
Vol 26 (10) ◽  
pp. 795-800 ◽  
Author(s):  
Mathias B. Forrester
Keyword(s):  
Attempted Suicide ◽  
Healthcare Facility ◽  
Threshold Dose ◽  
Poison Control ◽  
Medical Outcome ◽  
Limited Information ◽  
Poison Control Centers ◽  
Experimental Toxicology ◽  
The Mean ◽  
Moderate Effect

Eszopiclone is a nonbenzodiazepine hypnotic for the treatment of insomnia and classified as schedule IV controlled substance. Limited information exists on eszopiclone ingestions reported to poison control centers. The distribution of eszopiclone ingestions reported to Texas poison control centers during 2005—2006 was determined for various factors. In addition, triage guidelines for the management of such ingestions were drafted. Of 525 total eszopiclone ingestions, 259 involved coingestants. Of coingestant cases, 78.8% involved suspected attempted suicide and 90.7% were managed at a healthcare facility. Of 266 ingestions of eszopiclone alone, 40.2% were suspected attempted suicide and 62.0% were managed at a healthcare facility. A final medical outcome and dose ingested were known for 60 ingestions of eszopiclone alone. The mean dose was 28.3 mg (range 0.3—210 mg). Ingestions of eszopiclone alone of ≤6 and >6 mg differed with respect to the proportion involving suspected attempted suicide (0.0% versus 64.7%), final medical outcome of minor or moderate effect (38.5% versus 67.6%) and management at a healthcare facility (34.6% versus 91.2%). Using 6 mg as a threshold dose for referral to a healthcare facility, 78% of cases not already at/en route to a healthcare facility were managed according drafted triage guidelines. Human & Experimental Toxicology (2007) 26, 795— 800

Celecoxib exposures reported to Texas poison control centers from 1999 to 2004

2006 ◽  
Vol 25 (5) ◽  
pp. 261-266 ◽  
Author(s):  
M B Forrester
Keyword(s):  
Health Care ◽  
Age Distribution ◽  
Health Care Facilities ◽  
Poison Control ◽  
Clinical Effects ◽  
Medical Outcome ◽  
Patient Age ◽  
Poison Control Centers ◽  
Care Facilities ◽  
The Mean

Concerns have been raised about the safety of celecoxib. This study described the pattern of exposures involving only celecoxib (isolated exposures) reported to Texas poison control centers from 1999 to 2004. The mean dose was 701 mg. The patient age distribution was 5 / 5 years (48%), 6 / 19 years (8%), and 20 years (44%). In 78% of cases, exposure was unintentional. Of the exposures, 74% were managed outside of health care facilities. The final medical outcome was classified as no effect for 82% of the cases, and minor effects for 12% of the cases. Adverse clinical effects were listed for 5% of the patients, the most frequently reported being rash (3%), drowsiness (3%), pruritis (2%), and vomiting (2%). The most frequently listed treatment was decontamination by dilution (43%) or food (32%). The majority of isolated celecoxib exposures could be managed outside of health care facilities, and the outcome was generally favorable.

Comparison of Immediate-Release and Controlled-Release Paroxetine Ingestions Reported to Texas Poison Control Centers between 2002 and 2008

2009 ◽  
Vol 25 (3) ◽  
pp. 169-175
Author(s):  
Mathias B Forrester
Keyword(s):  
Controlled Release ◽  
Immediate Release ◽  
Healthcare Facility ◽  
Poison Control ◽  
Medical Outcome ◽  
Limited Information ◽  
Medical Outcomes ◽  
Control Center ◽  
Poison Control Centers ◽  
Therapeutic Benefits

Background: Controlled-release (CR) paroxetine was created to improve the tolerability of immediate-release (IR) paroxetine while maintaining therapeutic benefits. There is limited information comparing the toxicity of the 2 paroxetine formulations. Objective: To compare the toxicity and management of paroxetine IR and paroxetine CR ingestions reported to poison control centers. Methods: Cases of ingestion of paroxetine that were reported to Texas poison control centers between 2002 and 2008, in which the final medical outcome and dose were known, were retrospectively reviewed. The rates for selected variables were determined for paroxetine IR and paroxetine CR and comparisons between the 2 were made by calculating the ratio of the drug's CR rate to the IR rate and 95% confidence interval. Compliance with simplified algorithms of triage management guidelines was determined for both formulations. Results: Included in the analysis were 405 cases of paroxetine IR ingestion and 169 cases of paroxetine CR ingestion for which a reported dose and final medical outcome were known. There were no statistically significant differences between the paroxetine CR and paroxetine IR formulations with respect to serious medical outcomes (ratio 0.69, 95% CI 0.34 to 1.31), self-harm or malicious intent (ratio 0.82, 95% CI 0.60 to 1.12), or referral to a healthcare facility (ratio 1.18, 95% CI 0.76 to 1.83). The rate of compliance with the triage algorithm for cases not already en route to or at a healthcare facility when the poison control center was contacted was 87% for paroxetine IR and 89% for paroxetine CR. Conclusions: The toxicity and management of paroxetine IR and paroxetine CR ingestions reported to Texas poison control centers were similar after adjusting for differences in dosage.

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.

Evaluation of Centrally Acting Cholinesterase Inhibitor Exposures in Adults

2007 ◽  
Vol 41 (10) ◽  
pp. 1632-1637 ◽  
Author(s):  
Keith R McCain ◽  
Tama S Sawyer ◽  
Henry A Spiller
Keyword(s):  
Healthcare Facility ◽  
Poison Control ◽  
Clinical Effects ◽  
Toxic Exposure ◽  
Lack Of Information ◽  
Number Of Patients ◽  
The Us ◽  
Poison Centers ◽  
Life Threatening ◽  
Toxic Exposure Surveillance System

Background: There are 4 centrally acting cholinesterase inhibitors (CA-ChEI) available in the US: tacrine, galantamina, rivastigmine, and donepezil. Documented clinical experience involving exposure to these agents is limited. The lack of information makes decisions involving excessive or unintended CA-ChEI exposure difficult. Objective: TO assess the effects, demographics, and outcomes of CA-ChEI exposures reported to US poison centers. Methods: A retrospective review of the Toxic Exposure Surveillance System of the American Association of Poison Control Centers data of acute and acute-on-chrontc exposures involving only a CA-ChEI in patients 19 years of age or older with documented medical outcomes from 2000–2005 was performed. Results: There were 1026 records that met criteria for this study. Patients aged 70–89 years made up 73% of reports; 69% of the patients were female. Moderate (197) and major outcomes (20) accounted for 21% of exposures. There were no deaths. Clinical effects that occurred in 5% or more of patients included vomiting (34%), nausea (28%), diarrhea (12%), dizziness/vertigo (9.9%), drowsiness/lethargy (7.7%), diaphoresis (7.4%), tremor (5.2%), and bradycardia (5%). Patients were admitted to the hospital in 19% of all exposures. Of those patients, 42% were admitted to a critical care unit. The majority (65%) of exposures were attributed to unintentional therapeutic error. Patients received at least one form of therapy In 47% of exposures, including intravenous fluid (111), antiemetic (46), atropine (17), benzodiazepine (15), oxygen (14), antihypertensive (4), pralidoxime (4), intubation (3), antihistamine (2), antiarrhythmic (1), anticonvulsant (1), and pacemaker (1). Conclusions: The majority of patients evaluated in this retrospective study experienced no or mild effect; however, significant or life-threatening effects were observed in a small group of patients and an appreciable number of patients were admitted to a healthcare facility.

Epidemiology and Toxicity of Pediatric Guanfacine Exposures

2002 ◽  
Vol 36 (11) ◽  
pp. 1698-1703 ◽  
Author(s):  
Jean C McGrath ◽  
Wendy Klein-Schwartz
Keyword(s):  
Children And Adolescents ◽  
Surveillance System ◽  
American Association ◽  
Healthcare Facility ◽  
Poison Control ◽  
Toxic Exposure ◽  
Inclusion Criteria ◽  
Poison Control Centers ◽  
Toxic Exposure Surveillance System

OBJECTIVE: To examine the epidemiology and toxicity of guanfacine exposures in children and adolescents reported to poison control centers. METHODS: Guanfacine exposures reported to the American Association of Poison Control Centers Toxic Exposure Surveillance System from 1993 to 1999 in children and adolescents <19 years of age were analyzed. RESULTS: There were 870 cases that met the inclusion criteria: 478 (54.9%) were children <6 years old, 304 (34.9%) were 6–12 years old, and 88 (10.1%) were adolescents 13–18 years old. The number of cases increased eight-fold over the 7-year period, with the largest increase in children <13 years of age. Analysis showed 29.7% of exposures were managed on site (non-healthcare facility) and 68.3% were managed in a healthcare facility. There were no symptoms in 546 (62.8%) children. In 324 symptomatic children, the most common symptoms were drowsiness/lethargy (76.8%), bradycardia (30.0%), and hypotension (25.8%). The majority of cases were acute (77.5%), 182 (20.9%) were acute-on-chronic, and 14 (1.6%) were chronic. Children aged 6–12 years represented the majority of the acute-on-chronic and chronic exposures with (n = 118). Overall, there were 195 (22.4%) exposures coded as minor, 121 (13.9%) as moderate, and 8 (0.9%) as major effects. CONCLUSIONS: These data demonstrated a trend of increasing numbers of guanfacine exposures annually. Although the majority of children experienced minimal or no toxicity, serious toxicity can occur.

An 11-year retrospective review of venlafaxine ingestion in children from the California Poison Control System

2015 ◽  
Vol 35 (7) ◽  
pp. 767-774 ◽  
Author(s):  
S Doroudgar ◽  
PJ Perry ◽  
GD Lackey ◽  
NG Veselova ◽  
HM Chuang ◽  
...  
Keyword(s):  
Health Care ◽  
Control System ◽  
Care Facility ◽  
Health Care Facility ◽  
Altered Mental Status ◽  
The United States ◽  
Poison Control ◽  
Minor Effect ◽  
Clinical Effects ◽  
Phone Calls

Venlafaxine is commonly used in the United States for approved and non-Food and Drug Administration–approved indications in adults. It is used off-label to treat children for psychiatric diagnoses. The aim of the study was to describe venlafaxine toxicities in children and to identify the venlafaxine dose per weight that correlates with toxicities. An 11-year retrospective study of venlafaxine ingestion in children was performed using the California Poison Control System (CPCS) database. Data was extracted from phone calls received by CPCS clinicians and follow-up phone calls made to assess the patient’s progress in a health-care setting. Inclusion criteria were venlafaxine ingestion cases reported to CPCS between January 2001 and December 2011, children aged 20 years and under, venlafaxine as the only ingested substance, managed in a health-care facility, and followed to a known outcome. Two hundred sixty-two cases met the study criteria. Common presentations included gastrointestinal (14.9%), altered mental status (13.7%), and tachycardia (13.4%). The majority of the cases resulted in no effect (51.5%) or minor effect (19.9%). The average estimated dose per weight was 18.3 mg/kg in all patients and 64.5 mg/kg in those experiencing moderate-to-severe adverse effects. Seizures occurred in only 4 of the 262 cases at doses ranging from 1500 to 7500 mg. Although the estimated dose per weight exceeded 10 mg/kg for the majority of the cases, only 12 cases resulted in moderate or severe outcomes. The majority of venlafaxine ingestion cases in children resulted in either no clinical effects or minor clinical effects.

scholarly journals A Retrospective Study of Clinical Effects of Powdered Caffeine Exposures Reported to Three US Poison Control Centers

2016 ◽  
Vol 12 (3) ◽  
pp. 295-300 ◽  
Author(s):  
Gillian A. Beauchamp ◽  
Amberly R. Johnson ◽  
Barbara I. Crouch ◽  
Matthew Valento ◽  
B. Zane Horowitz ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Poison Control ◽  
Clinical Effects ◽  
Poison Control Centers
Sign in / Sign up

Export Citation Format

Share Document