Jimson weed abuse in an Oklahoma teen.

Jimson weed, a plant often abused by teenagers and young adults, grows wild throughout Oklahoma. It is best known for its hallucinogenic properties; however intoxication can lead to anticholinergic manifestations that are potentially dangerous. Over the past six years, sixty-three individuals in Oklahoma have been hospitalized for jimson weed intoxication, including this Oklahoma teen. Importance lies in proper identification, understanding, and management in persons presenting with jimson weed poisoning.

Salicylate toxicity associated with administration of Percy medicine in an infant.

Percy Medicine is a nonprescription gastrointestinal suspension containing bismuth subsalicylate as the active ingredient (1050 mg/10-ml dose). A 3-month-old infant with colic developed salicylate toxicity requiring hospitalization in the pediatric intensive care unit (PICU) as a result of continued administration of this medicine. Bismuth subsalicylate has an aspirin equivalency conversion factor of 0.479 (approximately half the strength of aspirin). For 3.5 weeks the infant's parents administered the medicine, which provided the equivalent of aspirin 57-84 mg/kg/day with no reported problems. However, on the day of admission the baby presented with central nervous system depression and respiratory distress. Assessment at a local emergency facility revealed metabolic acidosis; his serum salicylate concentration was 747 mg/L. After acute management, the patient was transferred to our hospital, where he was treated with whole bowel irrigation and alkalinization therapy. Subsequently, the baby required 4 days of management in the PICU and 2 additional days of observation in a general nursing unit before he was discharged home without incident. The parents had chosen Percy Medicine based on the picture of a baby on the front of the package and because of its placement on the shelf next to a drug their family physician had recommended previously. Salicylate-containing products are not routinely recommended for children aged 1 year or younger. The general public may assume that over-the-counter products are safe because they do not require a prescription. Health care professionals must be responsible for educating the public regarding risks associated with over-the-counter products and the need to read and follow label directions.

Self-reported therapeutic errors to a poison control center.

BACKGROUND: The techniques for avoiding medication errors in healthcare settings can be extrapolated to improving pharmaceutical care and medication safety in the patient's home. Understanding patient self-dosing errors in self dosing is important in the development of prevention strategies. OBJECTIVE: To examine cases of therapeutic errors in patient self dosing as reported to the Oklahoma Poison Control Center, with the goal of proposing prevention strategies and education. METHODS: A retrospective study of self-dosing errors was performed examining root cause, patient age, and pharmaceutical agent. RESULTS: Patient self-dosing errors accounted for 8.75% of all poison control exposures as compiled by the Oklahoma Poison Control Center in 2001. The most common reasons for therapeutic errors in all age groups involved taking or giving the wrong formulation or concentration, inadvertently taking/giving medication twice and another incorrect dose. CONCLUSION: Patient education is the key to preventing therapeutic errors in the home.

Poisoning trends and the importance of educating patients about poison prevention.

Medical professionals are recognized as a vital link in communities for education and treatment of poisoning exposures. The Oklahoma Poison Control Center (OPCC) is a resource for medical professionals as well as the public. Nationally and in Oklahoma, among all age groups, analgesics are responsible for the most fatalities. Trends in common exposures in the age 5 and younger age group and the 13 through 19 age group, an acetaminophen protocol, information about the poison center and HIPPA privacy regulations, poison prevention tips and where to obtain educational materials are outlined. National Poison Prevention Week, March 21-27, 2004, is an excellent time to educate all age groups about poison prevention techniques and what to do when there is a poisoning emergency. Board certified toxicologists, pharmacists and registered nurses are available 24 hours a day, 7 days a week by calling 1-800-222-1222.