UI research presents proof of accidental overdose by infants on household prescriptions

A recent UI case study showed that infants as young as 10-months-old are liable to accidental ingestion of amphetamine-based ADHD stimulants in their household.

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UI research presents proof of accidental overdose by infants on household prescriptions

The Old Capitol is seen on Sunday, Nov. 25, 2018.

The Old Capitol is seen on Sunday, Nov. 25, 2018.

Lily Smith

The Old Capitol is seen on Sunday, Nov. 25, 2018.

Lily Smith

Lily Smith

The Old Capitol is seen on Sunday, Nov. 25, 2018.

Katie Ann McCarver, News Reporter

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As medicine advances and treatments for chronic illness are consolidated into small tablets or pills, swallowing the latter is routine for most people. However, some may not be aware of the danger that misplacing their prescription bottles could pose for children in the household.

Such is the case for several subjects of a recent study by University of Iowa Clinical Associate Professor Kelly Wood and Clinical Professor Matthew Krasowski, which appeared to reveal that young children could ingest amphetamine-based medicine belonging to people with Attention Deficit Hyperactivity Disorder in their households.

“These were patients being admitted for systematic overdose, and people weren’t quite sure what was going on until results of a urine drug test came back,” Wood said. “They were infants, who you don’t typically think of as the age group that might have an accidental ingestion.”

We wanted to publish this for education, because often you don’t get drug screens on infants, and the amount of amphetamine in their urine was very impressive.”

— University of Iowa Clinical Associate Professor Kelly Wood

Wood said that after amphetamine-based stimulants were revealed as the culprit, many parents or guardians remembered there had been a spill of their own or a child’s prescription, and perhaps not all pills had been picked up before the baby roamed around.

“They were never observed ingestions,” Wood said. “We wanted to publish this for education, because often you don’t get drug screens on infants, and the amount of amphetamine in their urine was very impressive.”

She said the kids who were brought in with symptoms of overdose were irritable, their heart rates were abnormally fast, and their movements dystonic.

“Most every child was acting differently or had altered mental status,” Wood said. “One was biting himself, another had repeated, twisted movements.”

The primary point to remember in her and Krasowski’s studies was that the infants were toxic from ingesting too much of a dose intended for an older sibling or parent or other family member, she said.

The researchers said their patients varied from anywhere between 10 to 18 months old, and for children of that size, the side effects of the pills could theoretically last up to 24 hours.

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“There’s a published study of adults taking ADHD medicine, and the levels of amphetamine in these kids were higher than that,” Krasowski said. “They all ultimately did well, but one or two of these pills is probably enough to admit them to the ER.”

As a result of their published studies, he said, he would like to see doctors take into account the possibility of accidental ADHD amphetamine-based medicine ingestion and go further than a simple drug screening when patients with the aforementioned symptoms come in.

“These kids are young, and they would never normally get these meds, so nobody’s studied it,” Krasowski said. “I think it’s good that people think to ask if anyone in the home has medication.”

Although ADHD has previously been thought of as a childhood disease, Wood said, it is becoming a more common diagnosis among adults, and thus ADHD medications might be more accessible to crawling babies and toddlers.

UI Student Health psychiatrist Paul Natvig said medication is recommended primarily as the therapy for adults.

“Side effects can occur with medications used for ADHD, especially if not dosed correctly,” he said. “Including restlessness, loss of appetite, sweating, stomach upset, and insomnia.”

Although Wood and Krasowski noticed similar symptoms in children who reportedly ingested amphetamines, Natvig said the proper use of these types of ADHD medication should have minimal effect on blood pressure and pulse.

“There can be more side effects, though these are rare,” he said.

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