Document Detail


Zolpidem (Ambien): a pediatric case series.
MedLine Citation:
PMID:  9279301     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In 1993, the nonbenzodiazepine sedative-hypnotic zolpidem tartrate (Ambien) was approved for use in the US. Zolpidem has an imidazopyridine structure and possesses a rapid onset of action and a short half-life. The toxic threshold and profile have not been well established in the pediatric population. METHODS: All pediatric zolpidem exposures reported to a regional poison information center over 24 months were reviewed retrospectively from the American Association of Poison Control Centers Toxic Exposure Surveillance System data collection forms. RESULTS: Twelve pediatric zolpidem exposures were reported. Seven were unintentional (ages 20 mon-5 y) and five were intentional misuse/suicide (ages 12-16 y). The regional poison information center was contacted within 1 h in ten cases with onset of symptoms within 10 to 60 min (mean 31.6 min). One child had no effect with 2.5 mg. As little as 5 mg caused symptoms with minor outcome in six unintentional ingestions (5-30 mg). Minor to moderate symptoms were reported 1-4 h after intentional ingestions (12.5-150 mg). The duration of symptoms in the unintentional cases ranged from less than 60 min up to 4 h (mean 2.4 h) and 6-10 h (mean 7.5 h) in the intentional exposures. Treatment consisted of observation (4), syrup of ipecac (1), lavage and activated charcoal (1), activated charcoal alone (5), and unknown (1). CONCLUSION: Due to the very rapid onset of central nervous system symptoms in children, emesis is not a treatment option. Supportive care, activated charcoal in large ingestions, and observation until symptoms resolve may be sufficient in most pediatric cases.
Authors:
D L Kurta; L B Myers; E P Krenzelok
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of toxicology. Clinical toxicology     Volume:  35     ISSN:  0731-3810     ISO Abbreviation:  J. Toxicol. Clin. Toxicol.     Publication Date:  1997  
Date Detail:
Created Date:  1997-09-17     Completed Date:  1997-09-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8213460     Medline TA:  J Toxicol Clin Toxicol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  453-7     Citation Subset:  AIM; IM    
Affiliation:
Pittsburgh Poison Center, Children's Hospital of Pittsburgh, Pennsylvania 15213, USA. Kurtad@chplink.chp.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Central Nervous System Diseases / chemically induced,  therapy
Charcoal / therapeutic use
Child
Child, Preschool
Female
Humans
Hypnotics and Sedatives / poisoning*
Infant
Male
Poison Control Centers / statistics & numerical data
Poisoning / etiology,  therapy
Pyridines / poisoning*
Retrospective Studies
Suicide, Attempted / statistics & numerical data
Chemical
Reg. No./Substance:
0/Hypnotics and Sedatives; 0/Pyridines; 16291-96-6/Charcoal; 82626-48-0/zolpidem
Comments/Corrections
Comment In:
J Toxicol Clin Toxicol. 1998;36(1-2):143-4   [PMID:  9541063 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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