Mon 28th June 2010
Two children in the past three months have required liver transplants after being given painkillers, prompting medics to call for a review of over-the-counter medicine.
Both of the children had overdosed on paracetamol. One of them is a two-year-old from Wellington.
Now a group of Capital & Coast District Health Board clinicians is calling for a review of the way drugs – including those on supermarket shelves – are dispensed.
They point to an increase in addiction to codeine-based drugs, which have been used in scores of suicide attempts.
The National Poisons Centre lists paracetamol as the most common substance in the poisoning of children under five, accounting for about 65 per cent of its calls. In the past five years the centre has been alerted to 1814 children under seven accidentally taking paracetamol, 389 of them needing medical help.
There were 617 notifications of children accidentally taking ibuprofen, with 97 requiring medical help, and 731 notifications of children accidentally taking aspirin, of whom 122 needed medical help.
A spokeswoman said it was not clear how many of those products were bought over the counter and how many were prescribed.
Children took accidental overdoses when they were given the wrong dose unintentionally or found drugs and took them.
Starship hospital child health director Richard Aickin said the cases were rare, but would have life-long ramifications for the children, aged between two and three.
He would not reveal details of the two recent transplant cases, other than that they resulted from paracetamol overdoses.
Dosing children too regularly or giving too much in single doses were the usual causes of the problem, he said. “It’s quite difficult for them to take enough by themselves to cause serious problems.”
An overdose of paracetamol could cause irreversible liver damage, vomiting, stomach pain, loss of consciousness and bleeding. Symptoms were the same for adults and children. “It’s just a total shutdown in body chemistry.”
He called for paracetamol to be sold only in small bottles, as opposed to the one-litre bottles available in pharmacies. All medicines should be sold in child-proof packaging unless otherwise requested, he said.
Geoff Robinson, a Capital & Coast chief medical officer and detoxification unit physician, suspected many New Zealanders, young and old, were severely damaging themselves with over-the-counter drugs such as ibuprofen, aspirin and paracetamol.
National Poisons Centre figures showed ibuprofen had been used in many intentional overdoses, he said. It could cause ulcers, while aspirin could cause bleeding in the stomach if used in excessive doses.
Dr Robinson is one of a group of Wellington physicians who last week published a report pointing to a trend of codeine addiction from over-the-counter medicines. These drugs included easily accessible products such as Nurofen Plus and Panadeine Plus.
The report, in the New Zealand Medical Journal, calls for a review of how commonly used over-the-counter drugs are sold.
STEPS TO KEEP YOUR FAMILY SAFE
- Stick to the instructions on packaging, and always check instructions on different products – not all paracetamol is the same strength. Some pharmacies provide a free service of weighing your child to determine the correct dosage.
- Keep medicine in childproof packaging.
- Keep medicine out of sight and reach of children, preferably in a locked cabinet.
- Check ingredients in other medications – other products can contain paracetamol which could lead to an accidental overdose.
- Don’t bulk buy. Choosing smaller containers can minimise the risk of an overdose.Don’t think you’re safe if you don’t have symptoms straight away – people can overdose through a build-up of paracetamol if they continually take a higher dose.
- If in doubt, ask your doctor or pharmacist for advice.
Source: Starship hospital, National Poisons Centre
