See also
Poisoning - Acute guidelines for initial management
Recreational Drug Overdose
Acute behavioural disturbance: Acute management
Poisons Information contact number (13 11 26)
Background
Most accidental paediatric drug ingestions involve doses that fall well below what would be considered a toxic ingestion. There are a handful of drugs and chemicals that are dangerous after relatively small paediatric ingestions involving 1 or 2 dose units of an available preparation or a mouthful. These agents demand a cautious approach to risk assessment.
Drugs or chemicals with potential paediatric toxicity after accidental small dose ingestions
| Prescription Drug |
Features of toxicity |
|
Amphetamines |
Agitation
Hypertension
Hyperthermia
Seizures |
|
Calcium channel blockers |
Bradycardia
Hypotension
Refractory shock
** Delayed toxicity (beyond 12 hours) may occur after sustained release preparation. |
|
Chloroquine and hydroxychloroquine |
Rapid onset coma
Seizures
Cardiovascular collapse |
|
Opioids (methadone most toxic) |
Coma
Respiratory depression |
|
Propranolol and sotolol (other beta blockers are better tolerated) |
Coma
Seizures
Ventricular dysrhythmias
Hypoglycaemia |
|
Sulfonylureas |
Hypoglycaemia (may be delayed 8 hours) |
|
Theophylline |
Seizures
SVT |
|
TCA |
Coma
Seizures
Hypotension
Ventricular tachycardia |
|
Illicit Drug |
Features of toxicity |
|
Amphetamines (including ice, speed, ecstasy) |
As above for prescription amphetamines
Hyponatraemia with ecstasy |
|
Gamma-hydroxybutyrate (GHB) |
Rapid onset respiratory depression and coma with recovery in a few hours |
|
Chemical |
Features of toxicity |
|
Camphor |
Coma
Seizures
Hypotension (rapid onset) |
|
Hydrocarbons, solvents, eucalyptus oil |
Coma
Seizures
Aspiration (rapid onset) |
|
Lead foreign body (eg fishing sinker) |
Abdominal pain
Nausea
Delayed encephalopathy
Seizures. |
|
Naphthalene moth ball
(Most moth balls now contain less toxic paradichlorbenzene) |
Methaemoglobinaemia,
Haemolysis |
|
Organophosphate and carbamate insecticides |
Cholinergic syndrome
Seizures
Coma |
|
Paraquat herbicide |
Oro-pharyngeal burns
Multi organ failure
Pulmonary fibrosis. |
Admission for observation is mandated if there is any concern that a small child may have ingested one of these drugs or chemicals.
All cases should be discussed with a senior clinician / Poisons Information / clinical toxicologist.
For emergency advice and paediatric or neonatal ICU transfers, call the Paediatric Infant Perinatal Emergency Retrieval (PIPER) Service: 1300 137 650.