Xuereb Gerd, Calleja Thomas, Borg Janine, Pace David
Foundation Programme Malta, Mater Dei Hospital, Msida, Malta
Department of Child & Adolescent Health, Mater Dei Hospital, Msida, Malta.
BMJ Case Rep. 2020 Feb 11;13(2):e234029. doi: 10.1136/bcr-2019-234029.
A 4-year-old girl presented with confusion, ataxia and hallucinations 3 hours after an accidental overdose of 108 μg per kg of hyoscine hydrobromide (Kwells Kids). She was hypotensive and tachycardic at presentation. Investigations revealed QTc prolongation on ECG. The girl was admitted for observation overnight and was noted to have persistent visual and auditory hallucinations, which resolved without treatment. To our knowledge, this is the first reported case of an overdose of hyoscine hydrobromide at such a young age. Clinicians should be aware that unintentional ingestions in this age group may present with psychiatric manifestations. Hyoscine hydrobromide is easily accessible and available over the counter. It has serious consequences in overdose. Its packaging and appearance are attractive to young children making it susceptible to unintentional ingestions. We argue that its container should be altered to be more childproof.
一名4岁女孩在意外过量服用每公斤108微克氢溴酸东莨菪碱(乘晕宁儿童装)3小时后出现意识模糊、共济失调和幻觉。就诊时她血压低且心动过速。检查发现心电图QTc延长。该女孩入院观察了一夜,被发现有持续的视幻觉和听幻觉,未经治疗自行缓解。据我们所知,这是首次报道如此年幼的儿童过量服用氢溴酸东莨菪碱的病例。临床医生应意识到,这个年龄组的无意摄入可能会出现精神症状。氢溴酸东莨菪碱很容易买到且无需处方。过量服用会产生严重后果。其包装和外观对幼儿有吸引力,容易导致无意摄入。我们认为其容器应改进,使其更具防儿童开启功能。