High-dose montelukast exposures in a 3-year-old and a 5-year-old child.
The leukotriene receptor antagonists (LTRAs) is a relatively new class of asthma medication with a lack of toxicity for unintentional poisoningsituations. This makes it difficult to determine which exposures require aggressive decontamination or simple monitoring in the home setting: prompting the question, "What LTRA dose is likely to produce significant toxicity?" We report a case of an unintentional poisoning with 80 mg montelukast in a 3-y-o asthmatic child that was managed in the home with observation alone and a second case of untentional 135 mg montelukast poisoning in a 5-y-o asthmatic child managed in an emergency department. In both cases, symptoms were not observed. These cases and available literature suggest that doses < 4.5 mg/kg in children result in minimal toxicity.
Cobb
Douglas B
DB
University of Texas Health Science Center at San Antonio, South Texas Poison Center, 78229-3900, USA.
Abbott
Cynthia L
CL
Watson
William A
WA
Fernández
Miguel C
MC
D000059:Accidents; D000085:Acetates / Q000008:administration & dosage / Q000506:poisoning*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000506:poisoning*; D001249:Asthma / Q000188:drug therapy*; D002675:Child, Preschool; D003521:Cyclopropanes; D004305:Dose-Response Relationship, Drug; D004632:Emergency Medical Services; D006801:Humans; D008297:Male; D011804:Quinolines / Q000008:administration & dosage / Q000506:poisoning*; D013440:Sulfides
D000085:Acetates; D018927:Anti-Asthmatic Agents; D003521:Cyclopropanes; D011804:Quinolines; D013440:Sulfides; C093875:montelukast