title: Adult prescription drug use and pediatric medication exposures and poisonings.
abstract: OBJECTIVE
  Nontherapeutic medication ingestions continue to be a major pediatric health problem, with recent increases in ingestions despite a number of public health interventions. It is unknown how changes in adult prescription drug use relate to pediatric medication poisonings. The objective of the study was to measure the association between changing adult prescription drug patterns and pediatric medication exposures and poisonings and identify high-risk classes of medications and pediatric age groups.
  
  
  METHODS
  We measured monthly pediatric exposures and poisonings using the National Poison Data System and prescriptions written for adults using the National Ambulatory Medical Care Surveys for 2000 through 2009. Associations between adult prescriptions for oral hypoglycemics, antihyperlipidemics, β-blockers, and opioids and exposures and poisonings among children 0 to 5, 6 to 12, and 13 to 19 years were analyzed by using multiple time-series analysis. Emergency department visits, serious injuries, and hospitalizations stemming from these associations were described.
  
  
  RESULTS
  Adult medication prescriptions were statistically significantly associated with exposures and poisonings in children of all ages, with the strongest association observed for opioids. Across medications, the greatest risk was among children 0 to 5 years old, followed by 13- to 19-year-olds. Rates of emergency department visits were highest for events related to hypoglycemics (60.1%) and β-blockers (59.7%), whereas serious injuries and hospitalizations occurred most frequently with opioids (26.8% and 35.2%, respectively) and hypoglycemics (19.5% and 49.4%, respectively).
  
  
  CONCLUSIONS
  Increasing adult drug prescriptions are strongly associated with rising pediatric exposures and poisonings, particularly for opioids and among children 0 to 5 years old. These associations have sizable impacts, including high rates of serious injury and health care use.
authors.affiliation: Division of Emergency Medicine, Children's Hospital Boston, Boston, MA 02115, USA. lindsey.burghardt@childrens.harvard.edu
authors.forename: Lindsey C
authors.initials: LC
authors.lastname: Burghardt
authors.forename: John W
authors.initials: JW
authors.lastname: Ayers
authors.forename: John S
authors.initials: JS
authors.lastname: Brownstein
authors.forename: Alvin C
authors.initials: AC
authors.lastname: Bronstein
authors.forename: Michele Burns
authors.initials: MB
authors.lastname: Ewald
authors.forename: Florence T
authors.initials: FT
authors.lastname: Bourgeois
mesh_terms: D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000506:poisoning / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D000701:Analgesics, Opioid / Q000506:poisoning / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000506:poisoning / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000506:poisoning / Q000627:therapeutic use; D007223:Infant; D008297:Male; D011039:Poison Control Centers / Q000706:statistics & numerical data; D055553:Prescription Drugs / Q000506:poisoning* / Q000600:supply & distribution / Q000627:therapeutic use*; D012307:Risk Factors; D014481:United States
chemical_list: D000319:Adrenergic beta-Antagonists; D000701:Analgesics, Opioid; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents; D055553:Prescription Drugs
keywords: drug therapy; epidemiology; poisoning; prescription drugs; prevention and control