PMID- 34454805
OWN - NLM
STAT- MEDLINE
DCOM- 20220127
LR  - 20220127
IS  - 1532-8171 (Electronic)
IS  - 0735-6757 (Linking)
VI  - 52
DP  - 2022 Feb
TI  - Fatal cold medication poisoning in an adolescent.
PG  - 269.e1-269.e2
LID - S0735-6757(21)00683-5 [pii]
LID - 10.1016/j.ajem.2021.08.043 [doi]
AB  - Toxicity from the intentional misuse of over-the-counter (OTC) combination cold 
      products has been widely recognized. Adolescents are most frequently involved and 
      dextromethorphan containing products are the most popular. Desired symptoms 
      include stimulatory effects, euphoria, hallucinations, and dissociation. 
      Potential adverse effects include tachycardia, agitation, hyperthermia, acidosis, 
      and coma. However, mortality is rare [ 1-3]. Co-formulated ingredients such as 
      acetaminophen, pseudoephedrine, and antihistamines may also be present and 
      potentiate dangerous effects. We report a case of an adolescent decedent with 
      markedly elevated postmortem chlorpheniramine (CPA) and dextromethorphan (DXM) 
      blood concentrations and no other identifiable cause of death.
CI  - Copyright (c) 2021 Elsevier Inc. All rights reserved.
FAU - Ontiveros, Sam
AU  - Ontiveros S
AD  - UC San Diego Medical Center, Dept. of Emergency Medicine, 200 W. Arbor Drive, San 
      Diego, CA 92103-8676, USA. Electronic address: lcantrell@calpoison.org.
FAU - Cantrell, Lee
AU  - Cantrell L
AD  - California Poison Control System, San Diego Division, 200 W. Arbor Dr., San 
      Diego, CA, 92103-8925, USA.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20210821
PL  - United States
TA  - Am J Emerg Med
JT  - The American journal of emergency medicine
JID - 8309942
RN  - 0 (Nonprescription Drugs)
RN  - 3U6IO1965U (Chlorpheniramine)
RN  - 7355X3ROTS (Dextromethorphan)
SB  - IM
MH  - Adolescent
MH  - Chlorpheniramine/*poisoning
MH  - Dextromethorphan/*poisoning
MH  - Fatal Outcome
MH  - Humans
MH  - Male
MH  - Nonprescription Drugs/poisoning
MH  - Suicide
OTO - NOTNLM
OT  - Chlorpheniramine
OT  - Dextromethorphan
OT  - Fatal
OT  - Poisoning
COIS- Declaration of Competing Interest None.
EDAT- 2021/08/30 06:00
MHDA- 2022/01/28 06:00
CRDT- 2021/08/29 20:38
PHST- 2021/07/01 00:00 [received]
PHST- 2021/07/29 00:00 [revised]
PHST- 2021/08/17 00:00 [accepted]
PHST- 2021/08/30 06:00 [pubmed]
PHST- 2022/01/28 06:00 [medline]
PHST- 2021/08/29 20:38 [entrez]
AID - S0735-6757(21)00683-5 [pii]
AID - 10.1016/j.ajem.2021.08.043 [doi]
PST - ppublish
SO  - Am J Emerg Med. 2022 Feb;52:269.e1-269.e2. doi: 10.1016/j.ajem.2021.08.043. Epub 
      2021 Aug 21.