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Zolpidem (Ambien): a pediatric case series
D L Kurta1, L B Myers, E P Krenzelok
1Pittsburgh Poison Center, Children's Hospital of Pittsburgh, Pennsylvania 15213, USA. Kurtad@chplink.chp.edu
Journal of Toxicology. Clinical Toxicology
|January 1, 1997
Summary
Pediatric zolpidem (Ambien) ingestions can cause rapid central nervous system symptoms. Supportive care and activated charcoal are recommended treatments for children, as emesis is not advised due to rapid symptom onset.
Area of Science:
- Pediatric toxicology
- Pharmacology
- Emergency medicine
Background:
- Zolpidem tartrate (Ambien), a nonbenzodiazepine sedative-hypnotic, was approved in the US in 1993.
- It has a rapid onset and short half-life, but its toxic threshold in children is not well-established.
Observation:
- A retrospective review of pediatric zolpidem exposures over 24 months was conducted.
- Twelve cases were identified, including unintentional ingestions and intentional misuse/suicide attempts.
Findings:
- Symptom onset occurred within 10-60 minutes, with as little as 5 mg causing effects in unintentional cases.
- Intentional ingestions (12.5-150 mg) resulted in minor to moderate symptoms lasting 6-10 hours, while unintentional cases lasted up to 4 hours.
Implications:
- Rapid onset of CNS symptoms in children makes emesis an unsuitable treatment.
- Supportive care, activated charcoal for large ingestions, and observation are recommended for pediatric zolpidem exposures.