Characterization of acetaminophen overdose‐related emergency department visits and hospitalizations in the United States

Manthripragada, Angelika D.; Zhou, Esther H.; Budnitz, Daniel S.; Lovegrove, Maribeth C.; Willy, Mary E.

doi:10.1002/pds.2090

Cited by 73 publications

(60 citation statements)

References 17 publications

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“…The inappropriate use of pain killers, such as paracetamol, might be associated with serious toxicity particularly in children for whom the risk of accidental ingestion is high [33]. Therefore, it is important to give special attention to this issue and to implement special strategies to minimize this risk.…”

Section: Discussionmentioning

confidence: 98%

Do parents in Saudi Arabia store medications safely?

Ruwaili

Balushi

Alharf

et al. 2014

International Journal of Pediatrics and Adolescent Medicine

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Background and objectives: Safe storage of medications can prevent the accidental poisoning of children. How medications are stored in homes in the Saudi community is not known. The objective of this study was to assess the safety measures for drug storage that are employed by parents to avoid unintentional drug poisoning of children below the age of 6 years. Materials and methods: This was a cross-sectional survey study based on a validated questionnaire created using the Survey Monkey online tool. Results: Ninety-three percent of the respondents did not store medications in secure and safe places such as locked boxes or locked drawers; however, more than half of the respondents (54.3%) stored medications at a level that was above the eye level of an adult. The majority of drugs (60.2%) were kept in the fridge; 45.9% were kept in kitchens, 45.1% in bedrooms, 8% in living rooms and 2% in bathrooms. Thirty percent of the respondents stored medications in two places, and 10% stored medication in three or more places. Eighty-nine percent disposed of unwanted medicines by throwing them in the trash, only 11% returned them to the pharmacy, and 11% flush them down the toilet. Conclusions: These results raise concerns about how drugs are stored and disposed of in the community. Additional community education and awareness programs regarding the safe storage of drugs in the home and the identification of useful and accessible methods of drug disposal are needed.

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Section: Discussionmentioning

confidence: 98%

Do parents in Saudi Arabia store medications safely?

Ruwaili

Balushi

Alharf

et al. 2014

International Journal of Pediatrics and Adolescent Medicine

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“…[3][4][5][6] Recent attention has been focused on the unintentional misuse of OTC pain medication, and acetaminophen specifically, which is the most commonly-used OTC product in the U.S. with 19 % of adults reporting taking the drug in a given week. [7][8][9][10] Acetaminophen overdose is the leading cause of acute liver failure. [11][12][13] In 2009, the FDA convened a panel to review the existing evidence and characterize the problem of acetaminophen overdose.…”

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confidence: 99%

Risk of Unintentional Overdose with Non-Prescription Acetaminophen Products

et al. 2012

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BACKGROUND: There is increasing concern over the risk of consumer unintentional misuse of non-prescription (a.k.a. 'over-the-counter') medications containing acetaminophen, which could lead to acute liver failure. OBJECTIVE: To determine the prevalence of potential misuse and overdose of over-the-counter medications containing acetaminophen, either alone or in combination. DESIGN: Cross-sectional, structured interviews with literacy assessment. SETTING: One academic and one community-based general internal medicine practice in Chicago, IL, and one academic general internal medicine practice and a public hospital clinic in Atlanta, GA. PATIENTS: Five hundred adults seeking primary care, ages 18-80. MEASUREMENT: Demonstration of how and when patients would take over-the-counter medications containing acetaminophen, alone or in combination with one another, over a 24-hour period. RESULTS: Overall, 23.8 % of participants demonstrated they would overdose on a single over-the-counter acetaminophen product by exceeding a dose of four grams in a 24-hour period; 5.2 % made serious errors by dosing out more than six grams. In addition, 45.6 % of adults demonstrated they would overdose by 'double-dipping' with two acetaminophen-containing products. In multivariable analyses, limited literacy (Relative Risk Ratio (RR) 1.65, 95 % Confidence Interval (CI) 1.03-2.66) and heavy acetaminophen use in the past six months (RR 1.70, 95 % CI 1.10-2.64) were independently associated with overdosing over-the-counter products. CONCLUSION: Misunderstanding of the active ingredient and proper instructions for over-the-counter medications containing acetaminophen is common. The potential for errors and adverse events associated with unintentional misuse of these products is substantial, particularly among heavy users of acetaminophen and those with limited literacy.

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“…7 Approximately 25% of the patients taking NSAIDs face several adverse events, even in case of prescribed drug; and several cases of deaths are reported in relation with acetaminophen overdoses. 8,9 On the other hand, OCT analgesics are generally perceived as non-harmful by the population; and consequently, many users end up with misuse. In the developed countries, sale, purchase and consumption of OTC analgesics are strictly regulated since 1998.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Determinants of Over-the-Counter Analgesics Usage among Patients attending Primary Health Care Centers in Jeddah, Saudi Arabia

Babakor¹,

Ghamdi²

2018

JYP

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Objective: To estimate the prevalence and describe the pattern of OTC use among patients attending primary healthcare (PHC) centers, and to assess their knowledge and attitude regarding the related side effects. Method: A cross-sectional study was carried out among 400 adult patients attending the General Medicine clinic in 10 selected PHC centers in Jeddah, Saudi Arabia. The data collected included socioeconomic parameters, practice and pattern of OTC analgesics use in past 6 months, knowledge and attitude about OTC analgesics, and safety assessment. Results: Results showed that 84.4% of the participants were using OTC analgesics, at least twice per week in 59.3% of the cases, and for <1 week duration in 65.8%. The prevalence of use was highest among illiterate and highly educated participants (p=0.000), and those with moderate income (p=0.011). Acetaminophen (paracetamol) was the most frequently used drug (86.1%), followed by ibuprofen (25.1%) and diclofenac (14.7%); and headache (71.1%), arthralgia (17.7%) and toothache (17.4%) were the most common conditions leading to usage. A simple health problem (64.0%), previous experience with the drug (35.1%) and lack of time (12.1%) were the most common reasons for OTC analgesics use. Among all, 58.1% admitted having no knowledge about OTC analgesic side effects; while 7.1% reported having experienced side effects. Conclusion: There is an alarming prevalence of OTC analgesics use among patients, with inadequate levels of awareness about the associated risks. Awareness and knowledge of users should be further investigated to determine the need for information for this specific or a larger population.Key words: Analgesics, Auto medication, Non-steroid anti-inflammatory, Over-the-counter, Painkiller, Paracetamol. Key MessageThere is high prevalence of OTC analgesics usage combined with low levels of awareness and knowledge about the related hazards; which exposes to misusage that may carry accidents and severe side effects especially among the high-risk populations. The lack of awareness and knowledge highlights the need for targeted information.

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Characterization of acetaminophen overdose‐related emergency department visits and hospitalizations in the United States

Cited by 73 publications

References 17 publications

Do parents in Saudi Arabia store medications safely?

Do parents in Saudi Arabia store medications safely?

Risk of Unintentional Overdose with Non-Prescription Acetaminophen Products

Prevalence and Determinants of Over-the-Counter Analgesics Usage among Patients attending Primary Health Care Centers in Jeddah, Saudi Arabia

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