Over-the-counter analgesic-related exposure and toxicity in pediatrics

Abstract

Background: Analgesics are one of the most commonly purchased and used over-the-counter (OTC) medication classes from pharmacies in the United States. Drug toxicity is a leading cause of injury death in the United States. Limited studies, if any, have examined the impact of specific OTC medication toxicities in the pediatric population.

Objective: To examine the toxicity arising from the use of OTC analgesic medications in pediatric patients in Ohio.

Methods: Data from National Poison Data System for Ohio were obtained for the past 5 years. This data were processed to focus on target populations; pediatrics defined as ages 0-17 years experiencing toxicities related to OTC analgesic medications. The data were categorized into 3 groups: 0-6 year old, 7-12 year old, and 13-17 year old, and reported toxicity was studied based on medications used/given, reasoning for toxicity, and medical outcomes.

Results: Patients aged 0-6 years mainly experienced toxicities from acetaminophen (35%) and ibuprofen (52.7%), due to unintentional exposure (general misuse and therapeutic error; 74.2% and 25.4%, respectively), causing primarily minimal clinical effect (48.4%). Ages 7-12 experienced toxicities from acetaminophen (38.5%) and ibuprofen (44.9%) due to unintentional exposure therapeutic error (44.8%) and intentional suspected suicides (30.1%), causing mainly minimal clinical effects (35.5%) and no effect (23.4%). Pediatric ages 13-17 experienced toxicities due to ibuprofen (36.3%) and acetaminophen (38.9%), with primary reasoning of intentional suspected suicide (81.3%), causing medical outcomes of minor effect and no effect (38.2% and 31.2%, respectively). A chi-square test was performed to analyze correlation between case intention (unintentional or intentional) and age group. Proportion of intentional exposures differed by age [X² (2, N = 18,766) = 14,672, P < 0.0001].

Conclusion: Observations from this study underscore the importance of raising awareness about OTC analgesic toxicities which remain prominent in Ohio.