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Calcium channel blocker ingestions in children
M G Belson1, S E Gorman, K Sullivan
1Georgia Poison Center, Emory University School of Medicine, Atlanta, USA. Marty_Belson@oz.ped.emory.edu
The American Journal of Emergency Medicine
|September 22, 2000
Summary
Most pediatric calcium channel blocker (CCB) ingestions result in no or minor toxicity. Asymptomatic children ingesting small amounts of CCBs may be monitored at home, with specific observation times for sustained-release formulations.
Area of Science:
- Pediatric Toxicology
- Cardiovascular Pharmacology
- Poison Control Center Data Analysis
Background:
- Limited data exists on calcium channel blocker (CCB) toxicity in children.
- CCB ingestions are a concern for potential cardiovascular and central nervous system effects.
Purpose of the Study:
- Determine the frequency and range of toxicity from CCB ingestions in children.
- Establish appropriate observation times and assess effective interventions for pediatric CCB ingestions.
Main Methods:
- Retrospective review of 283 children younger than 7 years with CCB ingestions reported to a regional poison center over 6 years.
- Exclusion of patients with co-ingestants causing cardiovascular or CNS effects.
- Analysis of ingestion amounts, time to symptom onset, and clinical outcomes.
Main Results:
- Nifedipine, verapamil, and amlodipine were the most common CCBs ingested.
- 6% of patients experienced symptoms, including vomiting and CNS/cardiovascular effects.
- 74% of patients had no clinical effects; no deaths or major effects were reported.
Conclusions:
- Most pediatric CCB ingestions involve small amounts and result in minimal toxicity.
- Home monitoring may be appropriate for asymptomatic children ingesting specific amounts of sustained-release CCBs.
- Recommended observation periods are 3 hours for regular-release and 14 hours for sustained-release CCBs.