As Americans take more and more medications on a regular basis, pharmaceutical poisonings of children are on the rise. A recent study by Bond et al. (2011) looked at Poison Control Center data from 2001-08 and found a 30% increase in children under 5 years of age visiting emergency departments (EDs) for medication poisonings. Bond et al. report a 43% increase in injuries and a 36% increase in hospitalizations. There are now more injuries in small children due to medication exposure than motor vehicle accidents, and the severity is increasing along with the number.

The largest part of the burden on EDs seems to be from children ingesting prescription medication on their own. Three types of medications are associated with the highest number of total ED visits and increased admission and/or injury rate—opioids, cardiovascular agents and sedative-hypnotics. While one or two tablets of beta or calcium channel blockers may have relatively mild effects such as hypoglycemia, clinically important symptoms rise with dose. Of the 66 deaths directly related to pediatric pharmaceutical poisoning from 2001-08, more than half were due to opioid analgesic or cardiovascular drugs.

What can we do to help bring these numbers down? Patient education is an important part of the equation. All medications should be stored in child-resistant containers and more importantly, out of the reach of small children. Another analysis of Poison Control Center data suggested that ease of access to medication was the only statistically significant factor in pediatric poisonings. Medications should not be stored on tables or countertops, on low shelves or in purses. New flow-restriction packaging and single tablet-dispensing containers would also help prevent poisonings. The Advocacy Committee will have downloadable patient handouts on pediatric pharmaceutical poisonings and other topics on the RSA website soon.