Neonatal Care and Clinical Pediatrics

Pediatrics Drug Toxicity

Toxic exposures occur frequently in children throughout the world. Common patterns of poisoning consist of exploratory ingestions in children younger than six years of age and intentional ingestions and recreational drug use in older children and adolescents. Drug treatment in children differs from that in adults, most obviously because it is usually based on weight or surface area. Doses (and dosing intervals) differ because of age-related variations in drug absorption; distribution, metabolism, and elimination (see Pharmacokinetics in Children). A child cannot safely receive an adult drug dose, nor can it be assumed that a child’s dose is proportional to an adult’s dose (i.e, that a 7-kg child requires 1/10 the dose of a 70-kg adult).  Considering the relatively high percentage of toxic exposures that involve drugs, it is fortunate that only a few medications are truly life-threatening to a young child who ingests only one or two pills or one to two teaspoon-sized swallows. None of the medications listed in Table 2 will injure every exposed child.