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Accidental dextromethorphan ingestions in children less than 5 years old.

Author(s): LoVecchio F, Pizon A, Matesick L, O'Patry S

Affiliation(s): Department of Medical Toxicology, Banner Good Samaritan Medical Center, Phoenix, AZ 85006, USA. Frank.LoVecchio@bannerhealth.com

Publication date & source: 2008-12, J Med Toxicol., 4(4):251-3.

INTRODUCTION: The purpose of this study is to evaluate the clinical presentation of accidental dextromethorphan (DXM) ingestions in children <5 years old. Two consecutive years of poison center patient encounters were reviewed. Data including age, outcomes, amount of DXM ingested, co-ingestions, vital signs, clinical manifestations, hospital admissions, and mortality were abstracted. Data were analyzed using descriptive statistics. DISCUSSION: A total of 304 cases were identified with a mean age of 28.2 months (72% were > or =23 months). All cases co-ingested other products of over-the-counter cough and cold medications (i.e., acetaminophen, pseudoephedrine, guaifenesin, ibuprofen, various H1 receptor antagonists, and very infrequently ethanol). The mean DXM dose ingested was 35.0 mg (2.64 mg/kg). Of the patients, 62 (20.4%) experienced lethargy as the sole neurological sign and no patient had any cardiovascular abnormalities. Only 1 (13-monthold) patient, who ingested 3.2 mg/kg and presented with lethargy, was hospitalized and subsequently discharged 14 hours later. No deaths were recorded. CONCLUSION: As demonstrated in our patient population, accidental ingestions of DXM in the pediatric patient did well with supportive care alone and rarely required inpatient treatment.

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