Accidental ingestion of sustained release calcium channel blockers in children.
We examined the effects of small ingestions of sustained release calcium channel blockers (SR-CCBs) in young children and characterized current recommendations regarding monitoring after a suspected ingestion. A 2-part study was performed of pediatric calcium channel blocker (CCB) ingestion: first a telephone survey of 33 randomly selected Poison Control Centers (PCCs) from around the US concerning their recommended management of a small ingestion of sustained release calcium channel blocker in a child, and then a 5-y retrospective review of local cases of CCB ingestions in children under 4 y-of-age. The number of hours of medical observation recommended by the PCCs varied from > or = 24 h (n = 15, 45%) to < 6 h (n = 6, 18%). The retrospective chart review revealed that 19 of 29 local cases involved a SR-CCB, and 6 of these were thought to have ingested only 1 tablet. Observation time varied from > 24 h to < 6 h in the 17 cases seen in an emergency department. No symptoms or vital sign abnormalities were reported in any case. Recommendations regarding duration of observation varied from < 6 h to 24 h. Ingestion of a few SR-CCB tablets was not associated with symptoms, suggesting that admission and 24-h monitoring may not be necessary under those circumstances.
Brayer
A F
AF
Department of Emergency Medicine, University of Rochester Medical Center, NY 14642, USA.
Wax
P
P
D000061:Accidents, Home; D000931:Antidotes / Q000008:administration & dosage / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000009:adverse effects*; D002606:Charcoal / Q000008:administration & dosage / Q000627:therapeutic use; D002675:Child, Preschool; D003692:Delayed-Action Preparations / Q000009:adverse effects; D004338:Drug Combinations; D004639:Emetics / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007486:Ipecac / Q000008:administration & dosage / Q000627:therapeutic use; D011039:Poison Control Centers; D011041:Poisoning / Q000188:drug therapy; D012189:Retrospective Studies; D014481:United States
D000931:Antidotes; D002121:Calcium Channel Blockers; D003692:Delayed-Action Preparations; D004338:Drug Combinations; D004639:Emetics; D002606:Charcoal; D007486:Ipecac