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Overdose in infant caused by over-the-counter cough medicine

Sofya Pugach1, Isaac Z Pugach

  • 1Veteran Affair North Texas Health Care System, Dallas, TX 75216, USA. drpugach@yahoo.com

Southern Medical Journal
|March 13, 2009
PubMed

Insights

Over-the-counter cough syrup can cause severe, life-threatening intoxication in infants, even with Food and Drug Administration warnings. Parents should avoid using these medications in children due to potential adverse effects.

Area of Science:

  • Pediatric Emergency Medicine
  • Clinical Toxicology
  • Pharmacovigilance

Background:

  • Millions of over-the-counter (OTC) medications are purchased annually for pediatric use, despite known risks.
  • The Food and Drug Administration (FDA) has issued warnings regarding the unsafe administration of these products to children.
  • Continued use highlights a gap in parental understanding or adherence to safety guidelines.

Observation:

  • A 4-month-old infant presented with acute, life-threatening intoxication.
  • Symptoms included altered mental status and impaired coordination.
  • Laboratory tests revealed phencyclidine (PCP) and elevated ethanol levels.

Findings:

  • The infant's severe clinical presentation and laboratory results were attributed to the administration of OTC cough syrup.
  • The specific ingredients in the cough syrup mimicked the effects of illicit substances and alcohol intoxication.
  • This case underscores the potential for common OTC medications to cause severe adverse events in vulnerable populations.

Implications:

  • Highlights the critical need for enhanced parental education on pediatric OTC medication safety.
  • Suggests a review of OTC cough syrup formulations and labeling for pediatric use.
  • Emphasizes the importance of considering common medications in the differential diagnosis of pediatric intoxication.

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