title: Toxicity of antihypertensives in unintentional poisoning of young children.
abstract: BACKGROUND
  Knowledge is limited about the toxicity of unintentional exposure to antihypertensives in young children (0-6 years of age).
  
  
  OBJECTIVE
  Our aim was to research symptoms and poisoning severity in unintentional poisonings in this group of age and determine adequate poisoning management.
  
  
  METHODS
  We performed a 10-year retrospective, explorative analysis of the Mainz Poison Center/Germany database with regard to circumstances of poison exposure, dosage, symptoms, and treatment. To be able to relate drug exposure with reported symptoms, analyses were restricted to single drug exposures. Written follow-up information was obtained in about 50% of all cases.
  
  
  RESULTS
  A total of 1489 cases were analyzed, of which 957 were single drug exposures with 421 exposures to beta-blocking agents, 364 to inhibitors of the renin-angiotensin system, 122 to calcium channel blockers, and 50 to antiadrenergic drugs. No severe (Poisoning Severity Score [PSS]=3) or fatal poisonings (PSS=4) were reported and, with the exception of atenolol, propranolol, irbesartan, isradipin, clonidine, and moxonidine, no poisonings with a PSS>1. We did not find a significant relationship between dosage, release formulation and symptoms, or PSS. All patients fully recovered without specific treatment.
  
  
  CONCLUSIONS
  In young children with unintentional, single drug exposure to the most popular antihypertensive medication (i.e., metoprolol, bisoprolol, ramipril, enalapril, lisinopril, captopril, candesartan, valsartan, amlodipine, and verapamil), only mild symptoms occurred, and hospital evaluation is not a must. However, children with recent exposure to clonidine or moxonidine should be evaluated at a hospital due to an increased likelihood of poisonings of at least moderate severity.
authors.affiliation: Mainz Poison Center, Mainz, Germany; 2(nd) Medical Clinic, University Medical Center Mainz, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Hetterich
authors.affiliation: Krankenhaus der Barmherzigen Brüder Trier, Trier, Germany.
authors.forename: Enise
authors.initials: E
authors.lastname: Lauterbach
authors.affiliation: Mainz Poison Center, Mainz, Germany; 2(nd) Medical Clinic, University Medical Center Mainz, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Stürer
authors.affiliation: Mainz Poison Center, Mainz, Germany; 2(nd) Medical Clinic, University Medical Center Mainz, Germany.
authors.forename: Ludwig S
authors.initials: LS
authors.lastname: Weilemann
authors.affiliation: Mainz Poison Center, Mainz, Germany; 2(nd) Medical Clinic, University Medical Center Mainz, Germany; Krankenhaus der Barmherzigen Brüder Trier, Trier, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Lauterbach
mesh_terms: D000322:Adrenergic Agonists / Q000506:poisoning; D000959:Antihypertensive Agents / Q000506:poisoning*; D002121:Calcium Channel Blockers / Q000506:poisoning; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D005858:Germany; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies
chemical_list: D000322:Adrenergic Agonists; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers
keywords: antiadrenergic drugs; beta blocker; calcium channel blocker; renin-angiotensin-aldosterone antagonist