title: Retrospective review of unintentional pediatric ingestions of doxylamine.
abstract: BACKGROUND
  Doxylamine is a first-generation antihistamine similar in structure to diphenhydramine. Unlike diphenhydramine, however, there is a paucity of data regarding the risk of toxicity following unintentional exposures in pediatric patients.
  
  
  METHODS
  We performed an observational case series with data collected retrospectively from a poison system database for all single-substance pediatric (5 years-old and younger) doxylamine ingestions for the period of 1997-2012. Data collected included age, gender, weight, reason for exposure, exact or estimated maximum dose, clinical effects and medical interventions.
  
  
  RESULTS
  A total of 140 cases were identified; 74 (53%) involved males. Ages ranged 6 months to 5 years. In 30 cases (21%), the exact amount ingested was documented and ranged from 6.25-50 mg with a maximum weight-based dose of 6.2 mg/kg. In 76 cases, the estimated maximum dose ranged from 12.5 to 375 mg with a maximum weight-based dose of 37 mg/kg. All symptoms were mild and self-limiting. The only documented intervention was the administration of activated charcoal in 13 cases.
  
  
  CONCLUSIONS
  Unintentional isolated pediatric doxylamine ingestions did not result in significant toxicity in our 140 cases. Reported doses of up to 6.2 mg/kg resulted in only transient drowsiness and tachycardia.
authors: San Diego Division, California Poison Control System , San Diego, CA , USA.
authors: F Lee
authors: FL
authors: Cantrell
authors: Alycia K
authors: AK
authors: Clark
authors: Michael
authors: M
authors: McKinley
authors: Mariam
authors: M
authors: Qozi
mesh_terms: D000059:Accidents; D000367:Age Factors; D000931:Antidotes / Q000627:therapeutic use; D002140:California; D002606:Charcoal / Q000627:therapeutic use; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004319:Doxylamine / Q000506:poisoning*; D005260:Female; D006634:Histamine H1 Antagonists / Q000506:poisoning*; D006801:Humans; D007223:Infant; D008297:Male; D011041:Poisoning / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012894:Sleep Stages / Q000187:drug effects; D013610:Tachycardia / Q000139:chemically induced / Q000175:diagnosis; D016896:Treatment Outcome
chemical_list: D000931:Antidotes; D006634:Histamine H1 Antagonists; D002606:Charcoal; D004319:Doxylamine
keywords: Antihistamine; Doxylamine; Pediatric; Poisoning