The US Food and Drug Administration (FDA) is responsible for making sure every food and beverage consumed and every drug used in the United States is safe for the general population. To ensure safety, clinical trials are conducted on humans before a drug can gain approval for marketing in this country. It’s an exhaustive but flawed system. Clinical trials are almost never conducted on women of childbearing years and, even more rarely, on infants and children. As a result, we don’t know how many of the most commonly used prescription and over-the-counter (OTC) drugs in use today are safe during pregnancy, nursing, and childhood but we do know many are lethal to small children.

When clinical trials first began, the general understanding was that it was safest to conduct medical experiments on men and, if the men showed the desired effect, the drug must be safe for women, too, and, in smaller doses, for children. This is not the case. Gender differences, often those associated with reproductive hormones, produce different effects of a drug on men and women. Downsizing the adult male dosage to kid-size proportions is often done but isn’t always safe.

Dr. Cathleen Clancy says, “There are lots of pills that kill.” Clancy is an associate medical director for the National Capital Poison Center in Washington, DC. Pain relievers, often labeled as analgesics, top the list of drugs that kill kids. Those that are derived from opium, such as Percocet, Vicodin, and anything that contains codeine, methadone, or morphine, are the most lethal to children. They’re also associated with an alarming number of adult overdose deaths.

Clancy says more people call the poison center about acetaminophen than anything else. Sold OTC under brand names that include Tylenol, Clancy says people don’t often respect it enough because it’s so “overwhelmingly available.” It can cause fatal liver failure and, with kids, one dose can be enough to damage the liver.

Many parents give children smaller doses of medicines but this isn’t a safe practice. Children should only be given medications, including OTC medications, as prescribed by their pediatricians.

It’s not just the parent-administered drugs that are a concern, either. Clancy cites one case where a 12-month-old baby fished a blood-pressure pill out of his dad’s wallet. After time in the emergency room and pediatric intensive care unit, the child survived but others aren’t as lucky.

Medicines in patch form are just as dangerous to children as pills are. Clancy warns that children may use or suck on discarded patches not disposed of effectively. Most used patches contain enough residual medication to cause an overdose in infants and small children. When a child accidentally swallows a patch, s/he is at risk of suffocation as well as poisoning.

Clancy warns that parents need to be diligent about proper storage and disposal of all medicines in the home. So often, it’s what the curious child finds and puts into his or her own mouth that can lead to tragedy.

Source: Suchard, Jeffrey R., MD, FACEP, FACMT. “One Pill Can Kill Pediatric Poisoning (presentation pdf).” Scientific Assembly / American College of Emergency Physicians, October 15 - 18, 2011, San Francisco, California. Irving, Texas: American College of Emergency Physicians, n.d. Web. Mar 7, 2014.

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