Over-the-counter medications encountered in the postmortem pediatric population from 2010-2020

Area of Science:

• Forensic Toxicology
• Pediatric Pharmacology

Background:

• Pediatric populations exhibit unique toxicokinetic and toxicodynamic profiles compared to adults.
• Dosage considerations for over-the-counter (OTC) medications in children, especially those under five, differ significantly from adult dosages.
• The administration of OTC medications requires careful evaluation in pediatric forensic toxicology due to developmental differences.

Purpose of the Study:

• To analyze trends in postmortem pediatric cases involving common OTC medications.
• To identify the most prevalent classes of OTC drugs found in pediatric postmortem toxicology.
• To examine age-related patterns in OTC medication exposures within the pediatric population.

Main Methods:

• Compiled and analyzed postmortem pediatric data from 2010-2020.
• Identified cases positive for common OTC medications including antihistamines, pain relievers, cold/flu drugs, gastrointestinal aids, and sleep aids.
• Categorized pediatric cases into three age groups: birth-5 years, 6-11 years, and 12-18 years.

Main Results:

• A total of 1413 positive cases involving common OTC medications were identified.
• Antihistamines, cold/flu medications, and pain relievers were the most frequently encountered drug classes.
• The 6-11 years age group showed a lower prevalence of cases compared to younger (birth-5 years) and older (12-18 years) pediatric groups.

Conclusions:

• Common OTC medications are frequently implicated in postmortem pediatric forensic toxicology cases.
• Age-specific toxicokinetic and toxicodynamic differences necessitate tailored approaches to pediatric toxicology.
• The findings highlight the potential for unintentional overdoses, misuse, and suicidal overdoses involving OTC medications in the pediatric population.