A high risk for overdose exists among young
children who spend extended periods of time with
older caregivers such as grandparents. Many older
people have difficulty with child-resistant drug
packaging or set out their medications to remem-
ber to take them. Brightly colored tablets and cap-
sules are attractive to young children who think
they are candy. The coatings on many pills contain
sugar to mask unpleasant flavors during the time
the pill is in the person’s mouth and to aid in
making the pill easy to swallow. A child may
experience life-threatening poisoning from taking
only a few pills, far fewer than would cause
adverse effects in an adult. Medications to treat
HEARTconditions and iron supplements are among
the most hazardous drugs for overdose in chil-
dren. Overdose of acetaminophen and aspirin may
cause permanent LIVER FAILURE or RENAL FAILUREoverdose 165COMMON DRUG OVERDOSE SYMPTOMSType of Drug Common Symptoms
acetaminophen initial: NAUSEA, VOMITING, excessive sweating
later: ABDOMINAL PAIN, HEPATOMEGALY, JAUNDICE, LIVER FAILURE, RENAL
FAILURE
ANTIHISTAMINE MEDICATIONS(brompheniramine, cetirizine, initial: extremely dry mucous membranes and SKIN, flushing,
clemastine, diphenhydramine, doxylamine, fexofenadine, difficulty urinating, agitation, confusion
loratadine, meclizine, promethazine, tripelennamine, later: seizures, extremeHYPERTENSION, ARRHYTHMIA, COMA
triprolidine)
aspirin, salicylates, and NONSTEROIDAL ANTI-INFLAMATORY initial: TINNITUS, vomiting, FEVER, rapid HEART RATE, rapidBREATHING,
DRUGS(NSAIDS) confusion, HALLUCINATION
later: kidney failure, HEART FAILURE, coma, gastrointestinal bleeding
BARBITURATE(pentobarbital, phenobarbital, secobarbital) initial: drowsiness, lack of coordination, slurred speech, depressed
breathing, slow heart rate
later: coma, RESPIRATORY FAILURE
BENZODIAZEPINES(alprazolam, chlordiazepoxide, initial: drowsiness, blurred vision, agitation, confusion,
clorazepate, diazepam, flurazepam, lorazepam, hallucinations, depressed breathing, HYPOTENSION
oxazepam, prazepam, temazepam, triazolam) later: loss of CONSCIOUSNESS, coma
digoxin initial: nausea, confusion, blurred vision
later: irregular heart beat, CARDIAC ARREST
iron (ferrous gluconate, ferrous fumarate, ferrous sulfate, initial: nausea, vomiting, metallic taste in MOUTH, chills, HEADACHE,
multiple vitamin and mineral supplement products dizziness, flushing
containing iron) later: rapid heart rate, hypotension, coma
NARCOTICS(codeine, fentanyl, hydrocodone, initial: drowsiness, hypotension, depressed breathing, pinpoint
hydromorphone, meperidine, methadone, morphine, pupils
oxycodone) later: respiratory failure
tricyclic ANTIDEPRESSANT MEDICATIONS(amitriptyline, initial: irregular heart rate, nausea, vomiting, DIARRHEA, hypotension
desipramine, doxepin, imipramine, nortriptyline, later: seizures, psychotic behavior, arrhythmias, extreme
protriptyline, trimipramine) HYPERTENSION, cardiac arrest