By Steven Reinberg
TUESDAY, Nov. 15, 2022 (HealthDay Information) — Growing numbers of younger youngsters are displaying up in emergency rooms after by chance ingesting the cough suppressant benzonatate, U.S. well being officers reported Tuesday.
Benzonatate is a non-narcotic cough suppressant first accredited by the U.S. Meals and Drug Administration in 1958 for kids ages 10 and up. It really works by decreasing the cough reflex within the lungs and airways.
“Benzonatate is an interesting cough and chilly medicine as a result of its non-narcotic properties,” mentioned Dr. Elise Perlman, an emergency division doctor at Cohen Kids’s Medical Middle in Queens, N.Y.
“Because of this, there was a notable improve in benzonatate prescriptions; nonetheless, there has additionally been a concomitant rise in toxicity and antagonistic results reported,” mentioned Perlman, who was not concerned within the examine.
The variety of youngsters underneath 5 and people aged 10 to fifteen seen in emergency rooms between 2010 and 2018 did certainly improve considerably, based on researchers from the U.S. Meals and Drug Administration.
The rise in benzonatate poisoning between 2010 and 2018 may very well be an unintended impact of public efforts to cut back inappropriate narcotic prescribing, mentioned FDA spokeswoman Chanapa Tantibanchachai. Over the identical time, prescriptions for cough medicines that include codeine and hydrocodone dropped.
For the examine, researchers led by Dr. Ivone Kim, of the FDA’s Workplace of Surveillance and Epidemiology, collected information on almost 4,700 instances of benzonatate poisoning reported to U.S. poison management facilities from 2010 to 2018.
Of those reported instances, 77% have been unintentional exposures and most concerned youngsters underneath 5 (83%). Most benzonatate instances that concerned misuse or abuse have been amongst youngsters ages 10 to 16 (61%), the researchers discovered.
The variety of youngsters prescribed benzonatate cough medicines has elevated by 62%, from about 217,000 in 2012 to 351,000 in 2019. Because the variety of prescriptions elevated, so did the variety of those that went to emergency rooms after overdosing on the drug, based on the examine.
Amongst these underneath 17 who by chance overdosed, 79% had no unwanted effects, 2% had average unwanted effects, lower than 1% had vital unwanted effects, and a small fraction of 1% died.
Deaths concerned youngsters aged 9 months to 4 years. Scientific results included cardiac arrest, respiratory arrest, seizure, cough or choking, nonreactive dilated pupils, acidosis, excessive blood sugar, electrolyte abnormalities, extra secretions, gradual heartbeat and no heartbeat, the researchers famous.
Amongst 133 older youngsters who deliberately overdosed on benzonatate, 66% had no unwanted effects and 13% had average unwanted effects. There have been no main unwanted effects or deaths on this age group, the researchers discovered.
Tantibanchachai mentioned the researchers advise protecting cough medicines that include this drug out of the attain of youngsters.
Quite a few research and case reviews have been printed describing severe toxicity from each unintentional and intentional ingestions of benzonatate together with agitation, dangerously irregular coronary heart rhythms, seizures, cardiac arrest and loss of life, she mentioned.
“When somebody is sick with a nagging and unrelenting cough, it’s pure to hunt remedy to hasten restoration utilizing a ‘fast repair.’ Benzonatate is considered one of them,” Perlman mentioned. “That is vital as a result of merely having these and different medicines within the residence runs the inherent danger of each unintentional and intentional ingestions amongst younger youngsters and adolescents resulting in poisonous antagonistic results, a few of which could be deadly even in small portions.”
Younger youngsters usually tend to strive medicines primarily based on accessibility, look, style and scent, whereas teenagers usually tend to misuse or abuse medicines within the residence with “suicidal intent,” Perlman mentioned.
“It’s of utmost significance to stay cognizant that what we carry into our properties poses a menace and might compromise the security of our youngsters,” Perlman suggested. “As dad and mom, this initiative begins by limiting using over-the-counter and prescribed medicines, resembling benzonatate and different cough and chilly cures, and protecting medicines out of attain and safely saved to stop exploration, misuse and abuse.”
In terms of cough and chilly signs, the main target ought to be on supportive care, together with ache management and oral hydration with out the intuition for a “fast repair” utilizing cough and chilly medicines resembling benzonatate, she mentioned.
The report was printed on-line Nov. 15 within the journal Pediatrics.
For extra on benzonatate, see the U.S. Nationwide Library of Medication.
SOURCES: Chanapa Tantibanchachai, MS, spokeswoman, U.S. Meals and Drug Administration; Elise Perlman, MD, emergency division doctor, Cohen Kids’s Medical Middle, Queens, N.Y.; Pediatrics, Nov. 15, 2022, on-line