Martínez-Sánchez Lidia, Aguilar-Salmerón Raquel, Pi-Sala Núria, Gispert-Ametller Maria Àngels, García-Peláez Milagros, Broto-Sumalla Antoni, Fernández de Gamarra-Martínez Edurne, Nogué-Xarau Santiago
Servicio de Urgencias, Hospital Sant Joan de Déu, Barcelona, España; Grupo de Trabajo Red de Antídotos, Sociedad Española de Farmacia Hospitalaria-Societat Catalana de Farmàcia Clínica, España.
Grupo de Trabajo Red de Antídotos, Sociedad Española de Farmacia Hospitalaria-Societat Catalana de Farmàcia Clínica, España; Servicio de Farmacia, Hospital Universitari de Girona Doctor Josep Trueta, Girona, España.
An Pediatr (Engl Ed). 2020 Dec;93(6):380-395. doi: 10.1016/j.anpedi.2020.02.012. Epub 2020 Apr 10.
To prepare a list of highly toxic drugs in infants (HTDs) marketed in Spain, comparing those that reach the lethal dose in a child of 10kg with the ingestion of 1 to 3 units.
HTDs are defined as those capable of causing severe or lethal poisoning in children less than 8-year-old. Severe poisoning is considered as that corresponding to Grade 3 in the Poisoning Severity Score classification and to the "major effects" category in publications in the American Association of Poison Control Centers. A literature review was carried out on the annual reports of the American Association of Poison Control Centers, as well as in PubMed, between January 2000 and February 2019 (Keywords "severe", "fatal", "life-threatening", "poisoning", "child", "paediatric", "toxicological emergency"). An observational, retrospective study was also conducted on infants less than 8-year-old that were seen in a Paediatric Emergency Department due to suspected drug poisoning between July 2012 and June 2018. The active ingredients responsible marketed in Spain were selected, and the lethal or highly toxic doses were determined. The number of units (pills) necessary to reach this dose in children of 10kg was calculated.
A total of 7 HTD groups were identified: analgesics; psychotropics and other medication used in neurological disorders; catarrh decongestants - cough -antihistamine - asthma drugs; cardiovascular drugs; antibiotics, topical preparations, and other drugs. In 29 active ingredients, the ingestion of a single pill could cause death in 10kg infant, in another 13, the ingestion of 2 pills could cause death, as well as the ingestion of 3 pills in 10 cases.
There are numerous HTDs marketed in Spain, some of which are available in potentially fatal presentations with few pills.
列出在西班牙市场上销售的婴幼儿剧毒药物（HTDs）清单，比较那些10公斤儿童摄入1至3单位就能达到致死剂量的药物。
HTDs定义为那些能够对8岁以下儿童造成严重或致命中毒的药物。严重中毒被视为符合中毒严重程度评分分类中的3级以及美国中毒控制中心协会出版物中“主要影响”类别。对美国中毒控制中心协会的年度报告以及2000年1月至2019年2月期间的PubMed进行了文献综述（关键词：“严重”、“致命”、“危及生命”、“中毒”、“儿童”、“儿科”、“毒理学急诊”）。还对2012年7月至2018年6月期间因疑似药物中毒在儿科急诊科就诊的8岁以下婴儿进行了观察性回顾性研究。选择了在西班牙市场上销售的活性成分，并确定了致死或剧毒剂量。计算了10公斤儿童达到该剂量所需的单位（药丸）数量。
共确定了7个HTD组：镇痛药；用于神经系统疾病的精神药物和其他药物；减充血剂 - 止咳 - 抗组胺 - 哮喘药物；心血管药物；抗生素、外用制剂和其他药物。在29种活性成分中，10公斤婴儿摄入1粒药丸可能导致死亡，在另外13种中，摄入2粒药丸可能导致死亡，在10种情况下摄入3粒药丸也可能导致死亡。
西班牙市场上有许多HTDs，其中一些以极少药丸数量的潜在致命剂型出售。
