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Pediatric lisinopril ingestions reported to Texas poison control centers

M B Forrester1

  • 1Texas Department of State Health Services, 1100 W 49th Street, Austin, TX 78756, USA. mathias.forrester@dshs.state.tx.us

Human & Experimental Toxicology
|March 21, 2007
PubMed

Insights

Lisinopril ingestion in children under 5 years old can lead to serious outcomes. Higher doses, multiple tablets, and immediate healthcare facility involvement are associated with increased risk.

Area of Science:

  • Pediatric Toxicology
  • Emergency Medicine
  • Pharmacovigilance

Background:

  • Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor typically prescribed for adults.
  • Pediatric use of lisinopril is generally not recommended due to potential risks.
  • Understanding factors contributing to adverse events in pediatric ingestions is crucial for safety.

Purpose of the Study:

  • To identify factors associated with serious medical outcomes in pediatric lisinopril ingestions.
  • To inform the development of triage guidelines for managing young children exposed to lisinopril.

Main Methods:

  • Retrospective analysis of pediatric lisinopril ingestion cases (< or =5 years) reported to Texas poison control centers (1998-2005).
  • Evaluation of serious medical outcomes based on dose, quantity ingested, and healthcare seeking behavior.
  • Statistical analysis using rate ratios (RR) and 95% confidence intervals (CI) to assess significance.

Main Results:

  • Out of 691 cases, 3.8% (26 children) experienced serious outcomes.
  • Factors significantly associated with serious outcomes included higher doses (>80 mg), multiple tablets (≥5), and immediate or poison control center-referred healthcare facility contact.
  • Patients with serious outcomes were more likely to require management in healthcare facilities.

Conclusions:

  • Pediatric lisinopril ingestions, particularly with higher doses or quantities, pose a risk for serious adverse events.
  • The need for immediate healthcare facility intervention is a strong indicator of severity.
  • Findings support the development of specific triage protocols for pediatric lisinopril exposures.

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