Adolescent Ingestions: Various Reasons and Medications.

1. David C. Sheridan, MD, MCR* 2. Adrienne Hughes, MD*,† 3. B. Zane Horowitz, MD*,† 1. *Department of Emergency Medicine, Oregon Health & Science University, Portland, OR 2. †Oregon Poison Center, Portland, OR 1. There have been increases in both suicidal and recreational adolescent ingestions over time. 2. Knowledge of these common ingestions is important to properly diagnose, treat, and refer to emergent care as needed. 3. Pediatricians and emergency physicians should be familiar with these ingestions to develop preventive efforts. After completing this article, readers should be able to: 1. Explain the national trends for adolescent suicidal ingestions and recreational abuse. 2. Become familiar with ingestions of prescription drugs, over-the-counter medications, and recreational drugs of abuse. 3. Describe the potential serious clinical complications and treatment options for these ingestions. Adolescents generally do not unintentionally ingest pharmaceutical agents, as seen in the younger pediatric population. The main reasons for adolescent ingestions generally fall into 2 categories: suicidal/self-harm and recreational abuse. These 2 categories are very important and carry different levels of morbidity and mortality. The agents ingested may be unique and require different clinical management and preventive strategies. Suicidal ingestions alone now account for more than 1 million annual emergency department visits, making this a very timely and important review article. (1) Adolescent suicidality and suicide attempts are growing in number, now accounting for more than 1.12 million emergency department visits per year. (1) The reasons for this are multifactorial, with ingestions a common part of a suicide plan or attempt. One recent study evaluated national trends in suicidal ingestions over the most recent decade using the National Poison Center System, a database that consists of all calls to poison centers in the United States. (2) This study found that there were approximately 400,000 calls for “intentional-suspected suicide.” More importantly, calls about adolescent ingestions accounted for more than 80% of all intentional ingestion calls during the study period. The top 5 agents ingested included over-the-counter (OTC) medications of acetaminophen, ibuprofen, and antihistamines, as well as the prescription psychiatric …