Availability in Spain of "one pill killers" and other highly toxic drugs in infants
Por:
Martínez-Sánchez L, Aguilar-Salmerón R, Pi-Sala N, Gispert-Ametller MÀ, García-Peláez M, Broto-Sumalla A, Fernández de Gamarra-Martínez E and Nogué-Xarau S
Publicada:
1 dic 2020
Ahead of Print:
10 abr 2020
Categoría:
Pediatrics, perinatology and child health
Resumen:
Objective: To prepare a list of highly toxic drugs in infants (HTDs) marketed in Spain, comparing those that reach the lethal dose in a child of 10 kg with the ingestion of 1 to 3 units.
Method: HTDs are defined as those capable of causing severe or lethal poisoning in children less than 8-year-old. Severe poisoning is considered as that corresponding to Grade 3 in the Poisoning Severity Score classification and to the "major effects" category in publications in the American Association of Poison Control Centers. A literature review was carried out on the annual reports of the American Association of Poison Control Centers, as well as in PubMed, between January 2000 and February 2019 (Keywords "severe", "fatal", "life-threatening", "poisoning", "child", "paediatric", "toxicological emergency"). An observational, retrospective study was also conducted on infants less than 8-year-old that were seen in a Paediatric Emergency Department due to suspected drug poisoning between July 2012 and June 2018.
The active ingredients responsible marketed in Spain were selected, and the lethal or highly toxic doses were determined. The number of units (pills) necessary to reach this dose in children of 10 kg was calculated.
Results: A total of 7 HTD groups were identified: analgesics; psychotropics and other medication used in neurological disorders; catarrh decongestants - cough -antihistamine - asthma drugs; cardiovascular drugs; antibiotics, topical preparations, and other drugs. In 29 active ingredients, the ingestion of a single pill could cause death in 10 kg infant, in another 13, the ingestion of 2 pills could cause death, as well as the ingestion of 3 pills in 10 cases.
Conclusion: There are numerous HTDs marketed in Spain, some of which are available in potentially fatal presentations with few pills. (C) 2020 Asociacion Espanola de Pediatria. Published by Elsevier Espana, S.L.U.
Filiaciones:
Martínez-Sánchez L:
Servicio de Urgencias, Hospital Sant Joan de Déu, Barcelona, España
Grupo de Trabajo Red de Antídotos, Sociedad Española de Farmacia Hospitalaria-Societat Catalana de Farmàcia Clínica, España
Aguilar-Salmerón R:
Grupo de Trabajo Red de Antídotos, Sociedad Española de Farmacia Hospitalaria-Societat Catalana de Farmàcia Clínica, España
Servicio de Farmacia, Hospital Universitari de Girona Doctor Josep Trueta, Girona, España
Pi-Sala N:
Grupo de Trabajo Red de Antídotos, Sociedad Española de Farmacia Hospitalaria-Societat Catalana de Farmàcia Clínica, España
Servicio de Farmacia, Clínica Girona, Girona, España
Gispert-Ametller MÀ:
Grupo de Trabajo Red de Antídotos, Sociedad Española de Farmacia Hospitalaria-Societat Catalana de Farmàcia Clínica, España
Servicio de Urgencias, Hospital Universitari de Girona Doctor Josep Trueta, Girona, España
García-Peláez M:
Grupo de Trabajo Red de Antídotos, Sociedad Española de Farmacia Hospitalaria-Societat Catalana de Farmàcia Clínica, España
Servicio de Farmacia, Hospital ASEPEYO Sant Cugat, Sant Cugat del Vallès, España
Broto-Sumalla A:
Grupo de Trabajo Red de Antídotos, Sociedad Española de Farmacia Hospitalaria-Societat Catalana de Farmàcia Clínica, España
Servicio de Farmacia, Consorci Sanitari de Terrassa, Barcelona, España
Fernández de Gamarra-Martínez E:
Grupo de Trabajo Red de Antídotos, Sociedad Española de Farmacia Hospitalaria-Societat Catalana de Farmàcia Clínica, España
Servicio de Farmacia, Hospital de la Santa Creu i Sant Pau, Barcelona, España
Nogué-Xarau S:
Grupo de Trabajo Red de Antídotos, Sociedad Española de Farmacia Hospitalaria-Societat Catalana de Farmàcia Clínica, España
Unidad de Toxicología Clínica, Servicio de Urgencias, Hospital Clínic, Barcelona, España
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