Healthy Skepticism Library item: 6395
Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.
Publication type: Journal Article
Balit CR, Lynch AM, Gilmore SP, Murray L, Isbister GK.
Lignocaine and chlorhexidine toxicity in children resulting from mouth paint ingestion: a bottling problem.
J Paediatr Child Health 2006 Jun 01; 42:(6):350-3
http://www.blackwell-synergy.com/doi/abs/10.1111/j.1440-1754.2006.00871.x
Abstract:
BACKGROUND: A pharmaceutical product was marketed in Australia for ‘teething’ in an almost identical container to a popular paediatric paracetamol preparation. The product contained lignocaine and chlorhexidine. The similarity of the packaging resulted in large number of therapeutic errors in which the ‘teething’ preparation was given in error for paracetamol. As the exact dose of the erroneously administered mouth paint was known this provided an opportunity for outcome assessment of lignocaine ingestion. METHODS: Calls to two state poison information centres regarding this product were prospectively followed up. Information collected included: demographics, type of exposure, details of the exposure and adverse effects. A systematic review of the literature was used to identify all previous reported cases of lignocaine and chlorhexidine ingestion. RESULTS: There were 28 cases with complete follow up where the product was given in therapeutic errors (10 girls and 18 boys; median age 11 months; range 2 months-4 years). The mean ingested dose of lignocaine was 2.7 mg/kg (standard deviation 1.3 mg) and chlorhexidine was 0.06 mg/kg (standard deviation 0.03 mg). The largest ingested lignocaine dose was 5.9 mg/kg. Two children developed minor symptoms: one vomited twice and the other was reported to have increased salivation and difficulty with solid food for 20 min. No other adverse effects were reported. The literature review suggested that severe effects occurred with doses more than 15 mg/kg. CONCLUSION: No major adverse effects occurred with lignocaine ingestions of less than 6 mg/kg and it would be appropriate to observe these patients at home. Chlorhexidine did not appear to cause clinical effects in this low concentration.
Keywords:
Administration, Oral
Anesthetics, Local/administration & dosage
Anesthetics, Local/poisoning*
Child, Preschool
Chlorhexidine/administration & dosage
Chlorhexidine/poisoning*
Drug Labeling
Drug Packaging*
Female
Humans
Infant
Lidocaine/administration & dosage
Lidocaine/poisoning*
Male
Medication Errors/statistics & numerical data*
Mouthwashes/administration & dosage
Mouthwashes/poisoning*
Poison Control Centers/statistics & numerical data
South Australia
