Pediatric Fatalities Associated With Over the Counter (Nonprescription) Cough and Cold Medications

Annals of Emergency Medicine

Volumn 53, Issue 4, 2009, Pages 411-417

  Dart, Richard C ^a,b   Paul, Ian M ^c   Bond, G Randall ^d   Winston, David C ^e   Manoguerra, Anthony S ^f   Palmer, Robert B ^a   Kauffman, Ralph E ^g   Banner, William ^h   Green, Jody L ^a   Rumack, Barry H ^a,b  

^a ROCKY MOUNTAIN POISON AND DRUG CENTER   (United States)

^b UNIVERSITY OF COLORADO SCHOOL OF MEDICINE   (United States)

^c PENN STATE COLLEGE OF MEDICINE   (United States)

^d CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER   (United States)

^e Pima County Forensic Science Center   (United States)

^f UNIVERSITY OF CALIFORNIA SAN DIEGO   (United States)

^g UNIVERSITY OF MISSOURI KANSAS CITY SCHOOL OF MEDICINE   (United States)

^h Children's Hospital at Saint Francis   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANTIHISTAMINIC AGENT; ANTITUSSIVE AGENT; BROMPHENIRAMINE; CHLORPHENIRAMINE; DECONGESTIVE AGENT; DEXTROMETHORPHAN; DIPHENHYDRAMINE; DOXYLAMINE; EXPECTORANT AGENT; GUAIFENESIN; NON PRESCRIPTION DRUG; PHENYLEPHRINE; PSEUDOEPHEDRINE;

AGE DISTRIBUTION; ARTICLE; CHILD; CHILD HEALTH CARE; CHILDHOOD MORTALITY; COMMON COLD; CONTROLLED STUDY; COUGHING; DRUG MISUSE; DRUG OVERDOSE; EMERGENCY HEALTH SERVICE; FEMALE; HUMAN; MAJOR CLINICAL STUDY; MALE; MEDICATION ERROR; PRESCHOOL CHILD; PRIORITY JOURNAL; SCHOOL CHILD; SEDATION; SEX DIFFERENCE;

ADVERSE DRUG REACTION REPORTING SYSTEMS; ANTITUSSIVE AGENTS; CHILD; CHILD, PRESCHOOL; COMMON COLD; COUGH; FEMALE; HUMANS; INFANT; INFANT, NEWBORN; MALE; NASAL DECONGESTANTS; NONPRESCRIPTION DRUGS; OVERDOSE; POISONING; RISK FACTORS; UNITED STATES;

EID: 62349102021     PISSN: 01960644     EISSN: 10976760     Source Type: Journal    
DOI: 10.1016/j.annemergmed.2008.09.015     Document Type: Article

References (36)

1. Consumer Healthcare Product Association. OTC Sales by Category-2003-2006 (2007), Consumer Healthcare Products Association, Washington, DC
2. Kaufman D.W., Kelly J.P., Rosenberg L., et al. Recent patterns of medication use in the ambulatory adult population of the United States: the Slone survey. JAMA 287 (2002) 337-344 [methods described in unpublished data analysis provided to McNeil Consumer Healthcare by D. Kaufman]
3. Dart RC. Review of national poison center data and fatality root cause analysis. Testimony before Advisory Committee to the Food and Drug Administration (October 18, 2007). Washington, DC.
4. Srinivasan A., Budnitz D., and Shehab N. Infant deaths associated with cough and cold medications-two states, 2005. MMWR Morb Mortal Wkly Rep 56 (2007) 1-4
5. Aubrey A. Poll: parents still trust cold meds for kids. http://www.npr.org/templates/story/story.php?storyId=17184769 Accessed December 26, 2007.
6. Dockets Management. Joint meeting of the Nonprescription Drugs Advisory Committee and the Pediatric Advisory Committee, October 18-19, 2007. Briefing information. http://www.fda.gov/ohrms/dockets/ac/07/briefing/2007-4323b1-00-index.htm Accessed November 19, 2007
7. Davis J.H., and Hunt H.H. Accidental Benadryl poisoning: report of a fatal case. J Pediatr 34 (1949) 358-361
8. Wyngaarden J.B., and Seevers M.H. The toxic effects of antihistaminic drugs. JAMA 145 (1951) 277-282
9. Aaron F.E. A case of acute diphenhydramine hydrochloride poisoning. Br Med J 2 (1953) 24
10. Timpermann J., and Verbauwhede W. Toxic epidermal necrolysis (Lyell syndrome) and its medico-legal implications. Z Rechtsmed 71 (1972) 139-144
11. Bayley M., Walsh F.M., and Valaske M.J. Fatal overdose from Bendectin. Clin Pediatr (Phila) 14 (1975) 507-509 514
12. Vycudilik W., and Pollak S.T. Determination of diphenhydramine in autolyzed brain tissue in the course of cerebral death syndrome caused by intoxication. Zeitschrift Rechtsmedizin 95 (1985) 129-135
13. Knight K.M., and Doucet H.J. Gastric rupture and death caused by ipecac syrup. South Med J 80 (1987) 786-787
14. Goetz C.M., Lopez G., Dean B.S., et al. Accidental childhood death from diphenhydramine overdosage. Am J Emerg Med 8 (1990) 321-322
15. Maswoswe J.J., Egbunike I., Stewart K.R., et al. Suspected fatal diphenhydramine toxicity by application to the skin of an infant with varicella. Hosp Pharm 29 (1994) 26 28-30
16. Hanzlick R. National Association of Medical Examiners Pediatric Toxicology (PedTox) Registry Report 3. Case submission summary and data for acetaminophen, benzene, carboxyhemoglobin, dextromethorphan, ethanol, phenobarbital, and pseudoephedrine. Am J Forensic Med Pathol 16 (1995) 270-277
17. Lindsay C.A., Williams G.D., and Levin D.L. Fatal adult respiratory distress syndrome after diphenhydramine toxicity in a child: a case report. Crit Care Med 23 (1995) 777-781
18. Hanzlick R. National Association of Medical Examiner's Pediatric Toxicology (PedTox) Registry. Toxicology 107 (1996) 153-158
19. Jumbelic M.I., Hanzlick R., and Cohle S. Alkylamine antihistamine toxicity and review of Pediatric Toxicology Registry of the National Association of Medical Examiners. Report 4: alkylamines. Am J Forensic Med Pathol 18 (1997) 65-69
20. Magnani B., and Evans R. Codeine intoxication in the neonate. Pediatrics 104 (1999) e75
21. Bailey B., Daneman R., Daneman N., et al. Discrepancy between CYP2D6 phenotype and genotype derived from post-mortem dextromethorphan blood level. Forensic Sci Int 110 (2000) 61-70
22. Groudine S.B., Hollinger I., Jones J., et al. New York State guidelines on the topical use of phenylephrine in the operating room. The Phenylephrine Advisory Committee. Anesthesiology 92 (2000) 859-864
23. Gunn V.L., Taha S.H., Liebelt E.L., et al. Toxicity of over the counter cough and cold medications. Pediatrics 108 (2001) E52
24. Baker A.M., Johnson D.G., Levisky J.A., et al. Fatal diphenhydramine intoxication in infants. J Forensic Sci 48 (2003) 425-428
25. Boland D.M., Rein J., Lew E.O., et al. Fatal cold medication intoxication in an infant. J Anal Toxicol 27 (2003) 523-526
26. Marinetti L., Lehman L., Casto B., et al. Over the counter cold medications-postmortem findings in infants and the relationship to cause of death. J Anal Toxicol 29 (2005) 738-743
27. Sharfstein J.M. The Baltimore Statement on the Use of Over the Counter Cough and Cold Medications by Children Five and Under (2006), City of Baltimore Health Department, Baltimore, MD
28. Pragst F., Herre S., and Bakdash A. Poisonings with diphenhydramine-a survey of 68 clinical and 55 death cases. Forensic Sci Int 161 (2006) 189-197
29. Wingert W.E., Mundy L.A., Collins G.L., et al. Possible role of pseudoephedrine and other over the counter cold medications in the deaths of very young children. J Forensic Sci 52 (2007) 487-490
30. Consumer Healthcare Products Association. Makers of OTC cough and cold medicines announce voluntary withdrawal of oral infant medicines. http://www.chpa-info.org/ChpaPortal/PressRoom/NewsReleases/2007/10_11_07_CCMedicines.htm Accessed November 19, 2007.
31. Sorenson S.B., Shen H., and Kraus J.F. Coroner-reviewed infant and toddler deaths. Eval Rev 1997 (1997) 58-76
32. Herman-Giddens M.E., Brown G., Verbiest S., et al. Underascertainment of child abuse mortality in the United States. JAMA 282 (1999) 463-467
33. Webster R.A., Schnitzer P.G., Jenny C., et al. Child death review: the state of the nation. Am J Prev Med 25 (2003) 58-64
34. Rimsza M.E., and Newberry S. Unexpected infant deaths associated with use of cough and cold medications. Pediatrics 122 (2008) e318-e322
35. Schaefer M.K., Shehab N., Cohen A.L., et al. Adverse events from cough and cold medications in children. Pediatrics 121 (2008) 1-5
36. Chang M.Y. Regulatory history of pediatric cough/cold products. Joint meeting of Nonprescription Drug Advisory Committee (NDAC) and the Pediatric Advisory Committee (PAC), Silver Spring, Maryland. http://www.fda.gov/ohrms/dockets/AC/07/slides/2007-4323s1-02-FDA-chang.ppt Accessed August 6, 2008.