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Pediatric atomoxetine ingestions reported to Texas poison control centers, 2003-2005
1Texas Department of State Health Services, Austin, Texas, USA.
Insights
Pediatric atomoxetine ingestions can lead to serious outcomes, particularly with higher doses or intentional self-harm. These findings aid in developing triage guidelines for managing such poison control center cases.
Area of Science:
- Pediatric Toxicology
- Pharmacovigilance
- Clinical Triage
Background:
- Limited data exists on adverse events from pediatric atomoxetine ingestions.
- Poison control centers receive reports of such ingestions, necessitating outcome analysis.
Purpose of the Study:
- To determine the proportion of serious outcomes in pediatric atomoxetine ingestions.
- To identify variables associated with serious outcomes in these cases.
- To inform triage guidelines for managing pediatric atomoxetine exposures.
Main Methods:
- Retrospective analysis of pediatric atomoxetine ingestions reported to Texas poison control centers (2003-2005).
- Evaluation of serious outcomes (moderate/major effects, death, potentially toxic exposures).
- Statistical analysis using rate ratios (RR) and 95% confidence intervals (CI).
Main Results:
- Of 501 cases, 31 (6%) involved serious outcomes.
- Higher rates of serious outcomes were associated with doses >2.8 mg/kg, >200 mg, or >4 tablets.
- Intentional self-harm and pre-existing healthcare facility involvement correlated with increased serious outcomes.
Conclusions:
- The severity of pediatric atomoxetine ingestions depends on dose and ingestion circumstances (e.g., intentional self-harm).
- Management of serious outcomes often involves healthcare facilities.
- Findings support the development of improved triage protocols for pediatric atomoxetine ingestions.
Abstract:
Limited information exists on potentially adverse consequences following pediatric atomoxetine ingestions reported to poison control centers. Using pediatric atomoxetine ingestions reported to Texas poison control centers during 2003-2005, the proportion of cases involving serious outcomes (medical outcomes classified as moderate effects, major effects, death, or judged as potentially toxic exposures) was determined for selected variables and evaluated for statistical significance by calculating the rate ratio (RR) and 95% confidence interval (CI). Of 501 cases identified, 31 (6%) involved serious outcomes. Higher serious outcome rates were found with a maximum dose of >2.8 mg/kg or >200 mg or >4 tablets. Serious outcome rates were also higher if the exposure involved intentional self-harm or the patient was already at or en route to a health care facility when the poison control center was contacted or referred to a health care facility by the poison control center. The severity of the outcome associated with pediatric atomoxetine ingestions was dependent upon the dose and the circumstances of the ingestion (whether intentional self-harm was involved). The management of patients with serious outcomes was more likely to involve health care facilities. This information is useful for creating triage guidelines for the management of pediatric atomoxetine ingestions.
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