Schwartz Lauren, Mercurio-Zappala Maria, Howland Mary Ann, Hoffman Robert S, Su Mark K
J Am Pharm Assoc (2003). 2017 Mar-Apr;57(2S):S83-S86. doi: 10.1016/j.japh.2017.01.015.
To develop key messages for methadone and buprenorphine safety education material based on an analysis of calls to the NYC Poison Control Center (NYC PCC) and designed for distribution to caregivers of young children.
Retrospective review of all calls for children 5 years of age and younger involving methadone or buprenorphine from January 1, 2000, to June 15, 2014. A data abstraction form was completed for each case to capture patient demographics, exposure and caller sites, caller relation to patient, qualitative information regarding the exposure scenario, the product information, if naloxone was given, and the medical outcome of the case.
A total of 123 cases were identified. The ages of the children ranged from 4 days to 5 years; 55% were boys. All exposures occurred in a home environment. The majority of the calls were made to the NYC PCC by the doctor (74%) or nurse (2%) at a health care facility. Approximately one-fourth of the calls came from the home and were made by the parent (22%) or grandparent (2%). More than one-half of the exposures involved methadone (64%). Naloxone was administered in 28% of cases. Approximately one-fourth of the children did not experience any effect after the reported exposure, one-half (51%) experienced some effect (minor, moderate, or major), and there was 1 death (1%). More than one-half of the children were admitted to the hospital, with 40% admitted to critical care and 13% to noncritical care. Approximately 23% were treated and released from the hospital, and 20% were lost to follow-up or never arrived to the hospital. The remaining 4% were managed on site without a visit to the hospital.
Exposures to methadone and buprenorphine are dangerous with some leading to serious health effects. Safe storage and disposal instructions are needed for homes where children may be present.
基于对纽约市中毒控制中心（NYC PCC）来电的分析，制定美沙酮和丁丙诺啡安全教育材料的关键信息，并设计分发给幼儿的照料者。
回顾性分析2000年1月1日至2014年6月15日期间所有涉及5岁及以下儿童的美沙酮或丁丙诺啡来电。为每个病例填写一份数据摘要表，以获取患者人口统计学信息、暴露和来电地点、来电者与患者的关系、关于暴露情况的定性信息、产品信息、是否给予纳洛酮以及病例的医疗结果。
共识别出123例病例。儿童年龄从4天至5岁不等；55%为男孩。所有暴露均发生在家庭环境中。大多数来电是由医疗机构的医生（74%）或护士（2%）拨打给NYC PCC的。约四分之一的来电来自家庭，由父母（22%）或祖父母（2%）拨打。超过一半的暴露涉及美沙酮（64%）。28%的病例给予了纳洛酮。约四分之一的儿童在报告的暴露后未出现任何影响，一半（51%）出现了某种影响（轻微、中度或重度），有1例死亡（1%）。超过一半的儿童被送往医院，40%被送入重症监护病房，13%被送入非重症监护病房。约23%在医院接受治疗后出院，20%失访或未到医院。其余4%在现场得到处理，未前往医院。
美沙酮和丁丙诺啡暴露很危险，有些会导致严重的健康影响。对于可能有儿童的家庭，需要安全储存和处置说明。
