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Enquiries to the UK National Poisons Information Service regarding dextromethorphant toxicity [Abstract]

Waring, W.S., Good, A.M., Thomas, S.H.L., Thompson, John Paul, Vale, J.A. and Bateman, D.N. 2010. Enquiries to the UK National Poisons Information Service regarding dextromethorphant toxicity [Abstract]. Clinical Toxicology 48 (3) , p. 262. 10.3109/15563651003740240

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Abstract

Objective: Dextromethorphan is a readily accessible antitussive agent. Recreational abuse has been associated with dissociative effects, and deaths have been reported after ingestion of very large doses.1,2 This study examined the clinical features associated with dextromethorphan ingestion in the United Kingdom.  Methods:  The National Poisons Information Service is commissioned by the Health Protection Agency to provide clinical advice on the management of poisoned patients in the United Kingdom. Enquiries concerning dextromethorphan were examined retrospectively.  Results: Data were available between 2004 to 2007. There were data concerning 354 patients with median age 7 years (95% CI 4 to 14 years) of whom 194 were female (55.0%). Cases involved accidental ingestion in 261 (73.9%), deliberate overdose in 87 (24.6%), and adverse effects of therapeutic dose in 5 (1.4%). Median dose was 45 mg (range 3 to 2750 mg). Commonest co-ingested agents were paracetamol in 147 (41.6%), promethazine in 132 (37.4%), diphenhydramine in 73 (20.7%), pseudoephedrine in 67 (19.0%), triprolidine in 53 (15.0%), and menthol in 32 (9.1%). There were no symptoms or signs of toxicity in 257 patients (72.8%). The dose was higher in patients with symptoms; 120 mg (IQR 50 to 225 mg) versus 30 mg (IQR 8 to 90 mg), p<0.0001 by Mann Whitney test. Dextromethorphan dose was predictive of toxicity; receiver operating characteristic AUC 72.5% (95% CI 67.1 to 77.4%). Clinical features were drowsiness in 50 (14.2%), minor haemodynamic effects in 14 (4.0%), nausea or vomiting in 13 (3.7%), dizziness and ataxia in 10 (2.8%), agitation in 7 (2.0%), non-specific abdominal pain in 4 (1.1%), mydriasis in 3 (0.8%), dry mouth in 3 (0.8%), blurred vision in 2 (0.6%), headache in 2 (0.6%), and tremor in 1 (0.3%). None had features of severe poisoning. Conclusion: Dextromethorphan enquiries to the National Poisons Information Service often concern accidental exposures in children. The majority of patients had no clinical features or only minor symptoms.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
Additional Information: 2010 International Congress of the European Association of Poisons Centres and Clinical Toxicologists, 11-14 May 2010, Bordeaux, France
Publisher: Informa Healthcare
ISSN: 0731-3810
Last Modified: 04 Apr 2020 01:22
URI: https://orca.cardiff.ac.uk/id/eprint/18492

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