|
Poison Links:
|
|
One Pill Can Kill
A whole bottleful of just about any medicine can cause serious illness, if not kill a small child.
But it may not be well known that some commonly prescribed medications are so potent that just one or two pills (or a teaspoon or two if it’s a liquid) can have the same deadly consequences?
And it’s not just pills that grandma might carry in her purse, but medicines you or another one of your children may be taking. Some over-the-counter medications can also be toxic to children in small doses.
The following is a review of some of the most important medicines that could cause serious harm or death to a child if taken in very small amounts.
Recognition of these drugs is the first step in the prevention of childhood exposure and subsequent poisoning.
Lomotil Use: an antidiarrhea medicine
Toxic dose: one tab or one teaspoon
Minimal potential fatal dose = 4 tabs
Clinical signs and symptoms: - onset of symptoms generally 2 – 4 hours after ingestion
- red skin (flushing), dilated pupils, fever, fast heart beat
- coma and respiratory depression may be delayed up to 24 hours and
recurrence may occur 12 – 24 hours after ingestion!
Observation: Patients will be admitted for a 24 hour observation period
Oral Hypoglycemic Agents (sulfonylureas)
Use: type 2 (non-insulin dependent) diabetes
Drug Names: Glyburide, Tolbutamide, Glipizide
Toxicity: smallest toxic dose = one 5 mg tab of glipizide / one 2.5 mg of glyburide
Clinical signs and symptoms:
Hypoglycemia = confusion, lethargy, tachycardia, seizures, coma
Symptoms may be delayed up to 24 hours and relapses may occur!
Observation period: Patients will be admitted for 24 hours to have their blood sugar monitored closely
Clonidine
Uses: antihypertensive, smoking withdrawal, ADDH, Tourette syndrome
Toxicity: Smallest toxic dose: one 0.1 mg tablet
Clinical signs and symptoms: - symptoms appear quickly (75% of patients within 1 hour)
- Central nervous system effects: lethargy, weakness, pinpoint pupils, low temperature, respiratory depression, apnea (stop breathing)
- Cardiac: high blood pressure early then low blood pressure, slow heart beat
Nose sprays and eyedrops. These products (e.g., Visine, Afrin) contain a medication that’s related to Clonidine and can cause the same problems if ingested.
Toxicity: Visine ½ tsp. = serious symptoms Methanol
Uses: glass cleaners, windshield wiper fluid, paint stripper
Toxicity: 4 cc of 100% methanol can lead to blindness
Minimal lethal dose of 40% methanol in adults = 15-30 mL
Clinical signs and symptoms:
Central nervous system problems intially (i.e. lethargy) then may feel better for up to a day then vomiting, abdominal pain, headache, visual disturbances, seizures and/or coma may occur
Methyl Salicylate
Uses: Ben Gay lotion (15%), Icy-Hot balm (30%)
Oil of wintergreen (99%): one teaspoon = 22 adult aspirin tablets (see photo)
Toxicity: minimal fatal dose of oil of wintergreen = 4 mL
Clinical signs and symptoms:
- vomiting, breathing fast, confusion, ringing in the ears, fever, seizures
Benzocaine
Uses: over-the-counter products: Baby Oragel (7.5%), Lanacane spray (20%)
Toxicity: 1 teaspoon of Baby Oragel has produced toxicity in infants can affect the blood’s ability to carry oxygen, causing a child to turn blue.
Clinical signs and symptoms: - cyanosis (turning blue), fatigue, breathing fast, seizures
Tricyclic Antidepressants
Uses: treat depression Drug names: Tofranil, Desipramine and Amytriptyline Toxicity: minimal lethal dose = one 150 mg tab of imipramine in a 1 year old child
Clinical signs and symptoms: toxicity within 4 hours of ingestion Central nervous system problems: agitation, sedation, coma, seizures, fever
Cardiac: fast heat beat, arrythmias, low blood pressure
Camphor
Uses: Products containing camphor include camphorated oil, Vicks VapoRub, Camphophenique
*Products containing camphor are meant for topical (skin) use only!
Toxicity: minimal lethal dose = 1 gram of camphor
5 cc of camphorated oil (20% camphor)
10 cc of Campho-phenique (11%)
21 cc of Vicks Vaporub (5%)
Clinical signs and symptoms: Gastrointestinal: burning mouth/throat, vomiting, hepatitis
Central nervous system problems: agitation, headache, facial twitching, seizures (prolonged)
Chloroquine
Uses: anti-malarial agent, connective tissue diseases
Toxicity: lowest fatal dose = one 300 mg tab in a one year old child
Clinical signs and symptoms: Gastrointestinal: vomiting, abdominal pain
Central nervous system problems: lethargy, coma, seizures
Cardiac: low blood pressure, low heart rate, arrythmias
Other: very low potassium levels
Methadone Uses: narcotic addiction
Toxicity: lowest potential fatal dose = 1 teaspoon
Clinical signs and symptoms:
- apnea (stop breathing), severe lethargy, coma
Lindane (Kwell) Uses: to treat scabies (should be applied to skin only)
Toxicity: 2 teaspoons
Clinical signs and symptoms: seizures
Beta blockers Uses: heart medicines designed to slow the heart rate Drug names: propranolol, atenolol, metoprolol Toxicity: Potential fatal exposure to maximum dose = 1-2 tabs Clinical signs and symptoms: - very low blood pressure and slow heartbeats in kids
- low blood sugar
- seizures
Calcium channel blockers
Uses: heart disease Drug names: verapamil, diltiazem, nifedipine Toxicity: Potential fatal exposure to maximum dose = 1-2 tabs Clinical signs and symptoms: - low blood pressure and slow heartbeats in kids
Other Substances Toxic to Children in Small Dosages
Acetonitrile
Uses: a chemical found in some artificial nail removers
The chemical is broken down to cyanide in the body after being swallowed
Toxicity: smallest lethal dose ingested = 1 teaspoon
Clinical signs and symptoms:
Central nervous system problems – anxiety, headache, coma, seizures
Cardiac – blood pressure and heart rate changes, arrhythmias
Ammonium Fluoride
Uses: high percentage of fluoride found in de-rusting and wheel cleaning products
- Armoral Quick Silver Wheel (17%) (see photo)
- Rust Bust’R (30%)
Toxicity: 2 mL can be fatal of 17% solution
Clinical signs and symptoms:
Gastrointestinal: vomiting, diarrhea
Cardiac: arrythmias
Metabolic: low calcium, high potassium levels
Central nervous system problems: headache, visual disturbances, seizures
Selenious acid
Uses: gun blueing compounds (for gun maintanance) (see photo)
Toxic dose: 15 mls has resulted in a pediatric death
Clinical signs and symptoms:
- corrosive to upper GI tract (drooling, trouble swallowing)
- garlic-breath odor
Cardiac: low blood pressure, arrythmias
Phenothiazines
Uses: antipsychotics
Toxic dose: Minimal potential fatal dose
Thorazine 1 – 2 tabs
Mellaril 1 tablet
Clinical signs and symptoms: - lethargy, coma, seizures, dystonia (stiffening), arrhythmias, low blood pressure
|
|
Printer
Friendly Page
