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Accidental astemizole overdose in young children
K Hoppu1, T Tikanoja, P Tapanainen
1Children's Hospital, 2nd Department of Paediatrics, Helsinki, Finland.
Lancet (London, England)
|August 31, 1991
Summary
Accidental astemizole poisoning in young children can cause dangerous heart rhythm problems. Careful hospital monitoring is crucial for pediatric patients with astemizole overdose, especially those taking other H1-antihistamines.
Area of Science:
- Pediatric Toxicology
- Cardiology
- Pharmacology
Background:
- Astemizole is a selective H1-histamine receptor antagonist.
- Accidental overdose in young children can lead to significant toxicity.
- Cardiac adverse events are a concern with antihistamine overdose.
Purpose of the Study:
- To report on cases of accidental astemizole poisoning in young children.
- To describe the clinical presentation and cardiac effects of astemizole overdose.
- To recommend appropriate management for pediatric astemizole poisoning.
Main Methods:
- Retrospective case series reporting from a national poison control center.
- Analysis of patient demographics, ingested doses, and clinical outcomes.
- Electrocardiographic (ECG) monitoring for cardiac toxicity, including QTc interval.
- Drug concentration measurements in select cases.
Main Results:
- Six cases of accidental astemizole overdose in children aged 1 year 7 months to 3 years 4 months.
- Ingested doses ranged from 2.5 to 16.7 mg/kg, significantly exceeding recommended levels.
- Prolonged QTc-interval (cardiac toxicity sign) observed in all 5 children with available ECGs.
- Severe ventricular arrhythmias developed in 1 child.
Conclusions:
- Young children with accidental astemizole overdose require careful hospital monitoring.
- Cardiac toxicity, including QTc prolongation and arrhythmias, is a significant risk.
- Similar monitoring may be warranted for overdoses of other selective H1-histamine receptor antagonists.
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