Nonprescription Medication Overdose In Children

What is nonprescription medication overdose in children?

Nonprescription medication is also called over-the-counter (OTC) medicine. A prescription is not needed to buy OTC medicine. A medicine overdose occurs when more medicine is taken than is safe to take. A medicine overdose may be mild, or it may be a life-threatening emergency. OTC medicine is generally safe for your child when it is taken correctly.

What nonprescription medications can cause an overdose?

OTC medicines that may cause an overdose in children include:

• Acetaminophen: This medicine is also called APAP, Tylenol, or paracetamol. Acetaminophen is used to decrease fever (high body temperature) or pain. Acetaminophen can be bought by itself, or can be found along with other medicines in OTC products that are used to treat a cough and other symptoms of a cold.
  
  
• Cough and cold medicine: Cough and cold medicine may include one or more of the following types of medicine:
  
  
  • Analgesics and antipyretics: This medicine is used to decrease pain, and antipyretics are used to decrease a fever. Common names for these medicines include acetaminophen, aspirin, and ibuprofen.
    
    
  • Antihistamines: This medicine is used to decrease mucous (thick fluid) that may be produced with an illness. This medicine is used to decrease a runny nose, symptoms of allergies, and to help a person sleep. Diphenhydramine is the name of a common antihistamine. Antihistamines can also be found along with other medicines in OTC products that are used to treat a cough and other symptoms of a cold.
    
    
  • Antitussives: This medicine is also called cough suppressants. Antitussive medicine is used to decrease a strong cough that does not seem to get better.
    
    
  • Decongestants: This medicine is used to clear (open) the nose and sinuses, and can make it easier to breathe. Sinuses are hollow spaces inside the skull that are located behind the bones of the forehead, cheeks, and eyes. Pseudoephedrine is the name of a common decongestant.
    
    
  • Expectorants: This medicine loosens mucous to allow coughing, which can clear mucus from the lungs and make breathing easier. Guaifenesin is the name of a common expectorant.
  
  
• Nonsteroidal anti-inflammatory drugs: This medicine is also called NSAIDs. NSAIDs are used to decrease pain, swelling, headaches, and fever. Ibuprofen and aspirin are names of common NSAIDs.

What causes a nonprescription medication overdose?

An OTC medicine overdose may be unintentional (happen by mistake) or intentional (done on purpose). The following may lead to an OTC medicine overdose in children:

• Not knowing your child's weight: If you do not know how much your child weighs, you may give him too much medicine and cause an overdose.
  
  
• Giving your child the wrong dose or too much medicine: This can occur if you do not carefully read medicine labels and directions before giving your child medicine.
  
  
• Giving your child more than one medicine at a time: Children's medicine often has the same ingredients, such as acetaminophen. An overdose may happen if you are giving more than one medicine to your child at a time.
  
  
• Giving your child medicine with a kitchen spoon: Children's medicine normally comes with a cup, syringe, spoon, or dropper. An overdose can happen if you use a kitchen spoon to give your child his medicine because the dose may be too high.
  
  
• Sharing medicine: Medicine comes in different forms and doses for adults and children. Sharing medicine with other children or adults may cause an overdose.
  
  
• Giving extended-release medicine to your child too often: Extended-release medicine lasts longer than regular medicine. Giving your child extended-release medicine as often as regular medicine may cause an overdose.
  
  
• Taking too much medicine: A child may try to harm himself by taking too much medicine on purpose. Another person may try to harm a child by giving him too much medicine or giving it too often.

What are the signs and symptoms of a mild nonprescription medication overdose?

Your child may have one or more of the following:

• Flushed (red) skin or dry mouth.
  
  
• Stomach pain, nausea (feeling sick), and vomiting (throwing up).
  
  
• Ringing in the ears and trouble hearing.

What are the signs and symptoms of a severe or life-threatening nonprescription medication overdose?

Your child may have one or more of the following:

• A fast heartbeat.
  
  
• Vomiting (throwing up) that may have blood in it.
  
  
• Trouble having a bowel movement (BM) or being unable to urinate.
  
  
• Hallucinating (seeing or hearing things that are not there) or having trouble talking clearly.
  
  
• Dilated (large) pupils, hyperactivity (unable to stand or sit still), or seizures (convulsions).
  
  
• Dizziness or feeling sleepy, trouble breathing, being confused, or unconscious. Unconscious means your child looks like he is sleeping but he cannot be woken up.

How is a nonprescription medication overdose diagnosed?

Caregivers may not be sure what medicine is causing your child's overdose. Your child's caregiver will ask if he is taking any OTC medicines. Be sure to list every cold or pain medicine your child is taking. Your child's caregiver may ask you when your child took these medicines and how much he took of each. He may also ask how long your child has been taking each medicine. Your child's caregiver may ask if your child has any other medical conditions, such as liver problems or diabetes. He may ask you how you gave your child his medicine and to describe his symptoms. Your child may need tests to learn if his condition is serious or life-threatening. Ask your caregiver for more information about these or other tests your child may need:

• Blood tests: Your child may need blood taken for tests. Blood tests can give caregivers more information about your child's condition. Your child may need to have blood drawn more than once. If you do not know what medicine your child took, blood tests may be able to tell what medicine is in his body. For example, blood tests may be done to check for acetaminophen in your child's body. Your child's caregiver may also do blood tests to check his liver.
  
  
• Urine tests: Your child's caregiver may take a sample of your child's urine. Testing a urine sample may show what medicine is in your child's body.

How is a mild nonprescription medication overdose treated?

Caregivers will give your child oxygen and put in an IV. An IV is a tiny tube placed in your child's vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid. Caregivers will measure how much your child eats and drinks, and if he urinates or has a BM. Ask your caregiver for more information on treating your child's medicine overdose. Your child may need one or more of the following treatments for a mild overdose:

• Activated charcoal: Activated charcoal is a medicine that may be in the form of a powder or liquid. Caregivers may give activated charcoal to your child if he has swallowed too much medicine. Activated charcoal helps soak up the medicine that is still in your child's stomach. Your child may vomit when given activated charcoal.
  
  
• Emetics: Emetics are medicines that cause your child to throw up. Throwing up may help remove the medicine from your child's stomach, so less is taken in by his body.
  
  
• Gastric lavage: Gastric lavage is sometimes called having your stomach pumped. Caregivers clean out your child's stomach to get rid of as much medicine as they can.
  
  
• 12 Lead EKG: An EKG helps caregivers see your child's heart activity. This is important because a medicine overdose may affect your child's heart. It helps caregivers look for changes or problems in different areas of the heart. Sticky pads are placed on your child's chest, arms, and legs. Each pad has a wire that is hooked to a machine or TV-like screen. This machine shows a tracing of your child's heartbeat. This test takes about five to ten minutes. Your child must lie very still during the test.
  
  
• Nasogastric tube: A nasogastric tube is also known as an NG tube. It is a tube that runs from your child's nose to his stomach. The tube may be attached to suction (vacuum) to remove the medicine from your child's stomach. Your child may also be given medicine through this tube, such as activated charcoal.
  
  
• N-acetylcysteine: N-acetylcysteine (NAC) is an antidote. It stops the effect of some types of medicine in your child's body. NAC may prevent some of the problems caused by your child's overdose. It can be given as medicine that your child swallows or through an IV.

How is a severe or life-threatening nonprescription medication overdose treated?

Your child may need one or more of the following treatments for a severe or life-threatening overdose:

• Anticonvulsants: This medicine is given to stop seizures that may be caused by a medicine overdose.
  
  
• Sedatives: If your child is upset or agitated (easily angered), sedatives are medicines that may help keep him calm and relaxed.
  
  
• Vasopressors: A medicine overdose may cause your child's blood pressure to go lower than it should. Vasopressors are medicines that help constrict (make smaller) the blood vessels and increase your child's blood pressure.
  
  
• Ventilator: A ventilator is a machine that helps your child breathe if he cannot breathe well on his own. He may have an endotracheal (ET) tube in his mouth or nose. A tube called a trach may go into an incision (cut) in the front of his neck. The ET tube or trach is attached to the ventilator. Ask your child's caregiver for more information on ventilators.
  
  
• Liver transplant: If your child's liver is badly damaged by a medicine overdose, he may need a liver transplant. This is surgery to replace your child's damaged liver with a healthy donor liver. Ask your child's caregiver for more information on liver transplants.

What are the risks of a nonprescription medication overdose?

High doses of OTC medicine may be very harmful to your child. Large amounts of acetaminophen may cause liver damage and liver failure. An overdose of cough and cold medicine may cause seizures and other life-threatening side effects. An overdose of NSAIDs may cause bleeding in the stomach. Alcohol is used in many OTC medicines. If your child has an overdose of OTC medicine, he may also have an alcohol overdose. Alcohol overdose may increase the chance of stomach bleeding and liver damage. Ask your child's caregiver for more information on the risks of an OTC medicine overdose.

Where can I find more information?

Contact the following:

• 24-Hour Nationwide Poison Control Hotline
  National Capital Poison Center
  3201 New Mexico Avenue, Suite 310
  Washington , DC 20016
  Phone: 1- 800 - 222-1222
  Web Address: http://www.poison.org
  

• Centers for Disease Control and Prevention
  1600 Clifton Road
  Atlanta , GA 30333
  Phone: 1- 800 - 232-4636
  Web Address: http://www.cdc.gov
  

When should I call my caregiver?

Call your caregiver if:

• Your child has a fever (increased body temperature) after he has taken or been given medicine.
  
  
• Your child is flushed (red) and is more tired than usual after he has taken or been given medicine.
  
  
• Your child is sick to his stomach and throwing up after he has taken or been given medicine.
  
  
• Your child misses a dose of his usual medicine, or a dose is not given on time.
  
  
• Your child has swallowed medicine that may be harmful, but he does not have any signs or symptoms.
  
  
• You have questions or concerns about your child's medicine or how to give it.

When should I seek immediate help?

Seek care immediately or call 911 if:

• Your child has taken too much medicine, even if you do not know how much he took.
  
  
• Your child was given too much medicine.
  
  
• After your child has taken or been given medicine, he has pain in his belly.
  
  
• After your child has taken or been given medicine, he has little or no urine, or a hard time having a BM.
  
  
• Your child is confused or sees or hears things that are not there after he has taken or been given medicine.
  
  
• Your child is unconscious, not breathing, or having seizures after he has taken or been given medicine.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

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