Bar-Oz Benjamin, Levichek Zina, Koren Gideon
The Motherisk Program, Division of Clinical Pharmacology, The Hospital for Sick Children and The University of Toronto, Toronto, Ontario, Canada.
Paediatr Drugs. 2004;6(2):123-6. doi: 10.2165/00148581-200406020-00005.
To provide an updated list of the highly toxic medications in North America that can kill a 10 kg toddler upon ingestion of 1-2 dose units.
All drugs available in North America were reviewed and their reported lethal doses in children or adults (where no pediatric data existed) were identified. The dose units of drugs available in North America were subsequently identified, followed by those dose units that could kill a toddler upon ingestion of 1-2 dose units or teaspoonfuls.
Tricyclic antidepressants, antipsychotics, quinine derivatives, calcium channel blockers, opioids, and oral hypoglycemics can kill a toddler with 1-2 dose units. This list of drugs was responsible for 40% of toddler fatalities reported to the American Association of Poison Control Center Toxic Exposure Surveillance System between 1990-2000.
Drugs that can kill a toddler with 1-2 dose units should be known to clinicians as such exposures warrant immediate and intensive management. A new system of special labeling of these drugs should be considered.
提供一份北美地区高毒性药物的最新清单，这些药物在1 - 2个剂量单位被10公斤重的幼儿摄入后可致其死亡。
对北美地区所有可用药物进行审查，并确定其在儿童或成人中的报告致死剂量（若无儿科数据，则采用成人数据）。随后确定北美地区可用药物的剂量单位，接着找出那些幼儿摄入1 - 2个剂量单位或一茶匙量后可致死的剂量单位。
三环类抗抑郁药、抗精神病药、奎宁衍生物、钙通道阻滞剂、阿片类药物和口服降糖药在1 - 2个剂量单位时可致幼儿死亡。在1990 - 2000年期间向美国毒物控制中心协会毒物暴露监测系统报告的幼儿死亡案例中, 40%是由这份药物清单中的药物所致。
临床医生应了解那些幼儿摄入1 - 2个剂量单位即可致死的药物，因为此类暴露情况需要立即进行强化处理。应考虑为此类药物设计一种新的特殊标签系统。
