Over-the-counter analgesic-related exposure and toxicity in pediatrics

Abstract

Background

Analgesics are one of the most commonly purchased and used over-the-counter (OTC) medication classes from pharmacies in the United States. Drug toxicity is a leading cause of injury death in the United States. Limited studies, if any, have examined the impact of specific OTC medication toxicities in the pediatric population.

Objective

To examine the toxicity arising from the use of OTC analgesic medications in pediatric patients in Ohio.

Methods

Data from National Poison Data System for Ohio were obtained for the past 5 years. This data were processed to focus on target populations; pediatrics defined as ages 0–17 years experiencing toxicities related to OTC analgesic medications. The data were categorized into 3 groups: 0–6 year old, 7–12 year old, and 13–17 year old, and reported toxicity was studied based on medications used/given, reasoning for toxicity, and medical outcomes.

Results

Patients aged 0–6 years mainly experienced toxicities from acetaminophen (35%) and ibuprofen (52.7%), due to unintentional exposure (general misuse and therapeutic error; 74.2% and 25.4%, respectively), causing primarily minimal clinical effect (48.4%). Ages 7–12 experienced toxicities from acetaminophen (38.5%) and ibuprofen (44.9%) due to unintentional exposure therapeutic error (44.8%) and intentional suspected suicides (30.1%), causing mainly minimal clinical effects (35.5%) and no effect (23.4%). Pediatric ages 13–17 experienced toxicities due to ibuprofen (36.3%) and acetaminophen (38.9%), with primary reasoning of intentional suspected suicide (81.3%), causing medical outcomes of minor effect and no effect (38.2% and 31.2%, respectively). A chi-square test was performed to analyze correlation between case intention (unintentional or intentional) and age group. Proportion of intentional exposures differed by age [X² (2, N = 18,766) = 14,672, P < 0.0001].

Conclusion

Observations from this study underscore the importance of raising awareness about OTC analgesic toxicities which remain prominent in Ohio.