School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
BMJ Paediatr Open. 2022 Mar;6(1). doi: 10.1136/bmjpo-2021-001325.
To describe the temporal relationships in attention-deficit hyperactivity disorder (ADHD) medication poisoning exposures in children; describe patient demographics, medications involved, poisoning exposure reasons and disposition.
A population-based, retrospective cohort study of calls to Australia's largest Poisons Information Centre. Poisoning exposure counts and dispensing-adjusted rates were modelled with Poisson, quasi-Poisson and negative binomial regression where appropriate.
Calls to the New South Wales Poisons Information Centre and dispensings on the Pharmaceutical Benefits Scheme.
Children under the age of 5 years.
There were 1175 poisoning exposures to ADHD psychostimulants, 2004-2019; averaging 73 per year. Accidental poisonings accounted for 94% of cases. Methylphenidate was most frequently implicated (63%). Thirty-four per cent of cases were referred to hospital and a further 21% of calls were made by hospital staff. Poisoning exposure counts for all ADHD psychostimulants increased by 2.7% (95% CI=0.42% to 4.9%) per year; however, this differed by agent. Methylphenidate poisoning exposures increased by 5.2% per year (95% CI=4.3% to 6.1%), lisdexamfetamine increased by 62% per year (95% CI=48% to 76%), while dexamphetamine poisoning exposures decreased by 5.5% per year (95% CI=-9.5% to -1.4%). These trends are reflected in the number of dispensings; however, dispensings increased at a faster rate than exposures. When poisoning exposures were expressed as dispensing-adjusted rates, there was a 16% decrease (95% CI=-20% to -13%) per year.
ADHD medication use has increased, associated with an increased number of paediatric poisoning exposures. However, poisoning exposures per dispensed prescription has decreased. The majority of cases required hospitalisation, indicating the need for further poisoning prevention strategies.
描述儿童注意缺陷多动障碍（ADHD）药物中毒暴露的时间关系；描述患者人口统计学特征、涉及药物、中毒暴露原因和处置情况。
对澳大利亚最大的毒物信息中心的来电进行基于人群的回顾性队列研究。适当情况下，使用泊松、拟泊松和负二项回归对中毒暴露计数和配药调整率进行建模。
新南威尔士毒物信息中心的来电和药品福利计划的配药。
5 岁以下儿童。
2004 年至 2019 年，共有 1175 例 ADHD 兴奋剂中毒暴露，平均每年 73 例。意外中毒占 94%。哌醋甲酯最常涉及（63%）。34%的病例被转至医院，另有 21%的电话由医院工作人员打来。所有 ADHD 兴奋剂中毒暴露计数每年增加 2.7%（95%CI=0.42%至 4.9%）；然而，这因药物而异。哌醋甲酯中毒暴露每年增加 5.2%（95%CI=4.3%至 6.1%），左乙拉西坦每年增加 62%（95%CI=48%至 76%），而右旋苯丙胺中毒暴露每年减少 5.5%（95%CI=-9.5%至-1.4%）。这些趋势反映在配药数量上；然而，配药增加的速度快于暴露。当以配药调整后的比率表示中毒暴露时，每年下降 16%（95%CI=-20%至-13%）。
ADHD 药物的使用增加了，与儿童中毒暴露的数量增加有关。然而，每处方配药的中毒暴露量有所下降。大多数病例需要住院治疗，表明需要进一步的中毒预防策略。
