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Small doses, big problems: a selected review of highly toxic common medications.

Abstract
Many commonly used medications have serious toxicity in children when ingested in small doses. The toxicologic characteristics of methyl salicylate, camphor, topical imidazolines, benzocaine, and diphenoxylate-atropine are striking examples. All of these medications except Lomotil are over-the-counter and therefore, are often perceived as minimally harmful when ingested. For all of these substances, however, doses as little as 1/4 teaspoon or 1/2 tablet can have serious or fatal consequences. Thus, referral to an emergency department is prudent for ingestions involving these products. Options for initial gastrointestinal (GI) decontamination are variable, depending on the estimated amount and time of the ingestion. Induction of emesis is contraindicated for significant camphor, topical imidazoline, and Lomotil ingestions. Activated charcoal should be administered in all cases. Finally, the emergency physician must recognize the potential seriousness of these ingestions, as well as their clinical presentations to provide expeditious evaluation and treatment.
AuthorsE L Liebelt, M W Shannon
JournalPediatric emergency care (Pediatr Emerg Care) Vol. 9 Issue 5 Pg. 292-7 (Oct 1993) ISSN: 0749-5161 [Print] United States
PMID8247936 (Publication Type: Journal Article, Review)
Chemical References
  • Drug Combinations
  • Gastrointestinal Agents
  • Imidazoles
  • Nonprescription Drugs
  • Salicylates
  • atropine sulfate-diphenoxylate hydrochloride drug combination
  • Diphenoxylate
  • Camphor
  • Atropine
  • methyl salicylate
  • Benzocaine
Topics
  • Atropine (poisoning)
  • Benzocaine (poisoning)
  • Camphor (poisoning)
  • Child
  • Diphenoxylate (poisoning)
  • Drug Combinations
  • Gastrointestinal Agents (poisoning)
  • Humans
  • Imidazoles (poisoning)
  • Nonprescription Drugs (poisoning)
  • Salicylates (poisoning)

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