title: Paracetamol orodispersible tablets: a risk for severe poisoning in children?
abstract: OBJECTIVE
  Childhood paracetamol (acetaminophen) ingestion with subsequent risk of hepatotoxicity is a major medical problem. The aim of this study was to investigate the risk of high-dose ingestion of orodispersible, fast-disintegrating paracetamol tablets in children.
  
  
  METHODS
  A retrospective single-center case study of all accidental selfadministrations of solid or orodispersible 500-mg paracetamol tablets occurring in children ≤ 6 years, reported to the Swiss Toxicological Information Centre between June 2003 and August 2009.
  
  
  RESULTS
  We found 187 cases with ingestion of solid 500-mg paracetamol tablets and 16 cases with ingestion of orodispersible 500-mg tablets. The mean ingested dose in the orodispersible-tablet group was 59% higher than in the solid-tablet group (p = 0.085). Administration of activated charcoal and/or N-acetylcysteine because of ingestion of a potentially hepatotoxic paracetamol dose ( ≥ 150 mg/kg body weight) was recommended in 32 patients (17.1%) in the solid-tablet group and in five (31%) in the orodispersible-tablet group.
  
  
  CONCLUSIONS
  Orodispersible paracetamol formulations may represent an important risk factor for severe paracetamol poisoning in children. Over-the-counter availability may contribute to increasing the use of this galenic formulation and eventually the number of poisonings in children.
authors.affiliation: Division of Science, Swiss Toxicological Information Centre, Freiestrasse 16, CH-8032, Zurich, Switzerland. Alessandro.Ceschi@usz.ch
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ceschi
authors.forename: Katharina E
authors.initials: KE
authors.lastname: Hofer
authors.forename: Christine
authors.initials: C
authors.lastname: Rauber-Lüthy
authors.forename: Hugo
authors.initials: H
authors.lastname: Kupferschmidt
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage / Q000506:poisoning*; D000111:Acetylcysteine / Q000627:therapeutic use*; D000284:Administration, Oral; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000506:poisoning*; D002675:Child, Preschool; D016208:Databases, Factual; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D012189:Retrospective Studies; D012307:Risk Factors; D013607:Tablets
chemical_list: D018712:Analgesics, Non-Narcotic; D016166:Free Radical Scavengers; D013607:Tablets; D000082:Acetaminophen; D000111:Acetylcysteine