Non-health Care Facility Medication Errors Associated with Hormones and Hormone Antagonists in the United States.
80 and over; Adolescent; Adult; Age Distribution; Aged; Child; Databases; Drug-Related Side Effects and Adverse Reactions/diagnosis/*epidemiology/mortality/therapy; Factual; Female; Hormone antagonists; Hormone Antagonists/*adverse effects; Hormones; Hormones/*adverse effects; Humans; Infant; Male; Medication Errors/*statistics & numerical data; Middle Aged; Newborn; Oral hypoglycemic medications; Poison control center; Poison Control Centers; Preschool; Retrospective Studies; Risk Factors; Sex Distribution; Time Factors; Unintentional therapeutic error; United States/epidemiology; Young Adult
INTRODUCTION: Hormones and hormone antagonists are frequently associated with medication errors and may result in important adverse outcomes. The purpose of this study is to investigate non-health care facility (non-HCF) medication errors associated with hormones and hormone antagonists in the United States (US). METHODS: A retrospective analysis of National Poison Data System data was conducted to identify characteristics and trends of unintentional non-HCF therapeutic errors involving hormones and hormone antagonists among individuals of all ages from 2000 to 2012. RESULTS: From 2000 to 2012, US poison control centers received 169,695 calls regarding unintentional non-HCF therapeutic errors associated with hormone therapies, averaging 13,053 medication error calls annually. The rate of reported errors increased significantly by 162.6% (p \textless 0.001), from 2.24 per 100,000 US residents in 2000 to 5.89 per 100,000 in 2012. Two thirds of the errors (65.2%) occurred among females. The medications most commonly associated with errors were thyroid preparations (23.2%), corticosteroids (21.9%), and insulin (20.0%). All nine deaths and 93.2% of major effects were attributed to hypoglycemic agents. Sulfonylureas alone accounted 43.9% of major effects. The number and rate of therapeutic errors increased significantly for all medication categories except estrogen and thiazolidinediones. Most errors were managed at the site of exposure (82.9%) and did not result in serious medical outcomes (95.6%). CONCLUSIONS: This study provides an overview of non-HCF medication errors associated with hormones and hormone antagonists in the US. While most errors did not result in adverse outcomes, their increasing frequency places a greater burden on the health care system.
Magal Pranav; Spiller Henry A; Casavant Marcel J; Chounthirath Thitphalak; Hodges Nichole L; Smith Gary A
Journal of medical toxicology : official journal of the American College of Medical Toxicology
2017
2017-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1007/s13181-017-0630-8" target="_blank" rel="noreferrer noopener">10.1007/s13181-017-0630-8</a>
Kratom exposures reported to United States poison control centers: 2011-2017.
dietary supplement; Kratom; National Poison Data System; poison control center; poisoning
CONTEXT: Kratom, or Mitragyna speciosa, is a plant indigenous to Southeast Asia that has gained national attention in the United States for its increased use in the self-management of opioid withdrawal and pain, as well as for concerns about its safety. METHODS: This study analyzes exposures to kratom reported to poison control centers (PCCs) in the United States during 2011-2017 from the National Poison Data System (NPDS). DISCUSSION: From 2011 through 2017, 1807 kratom exposures were reported to United States PCCs. Almost two-thirds (65.0%) of these exposures occurred during 2016-2017. Most exposures occurred among adults \textgreater/=20 years (88.9%), males (70.8%), at a residence (86.1%), and were intentional (74.3%). Among first-ranked kratom exposures, 31.8% resulted in admission to a health care facility (HCF) and 51.9% in a serious medical outcome. Multiple-substance exposures were associated with greater odds of admission to a HCF (OR: 2.80; 95% CI: 2.21-3.55) and a serious medical outcome (OR: 2.25; 95% CI: 1.77-2.85) compared with single-substance exposures. There were 11 deaths associated with kratom exposure, including two that occurred after exposure to kratom only. Among kratom-only exposures, 86.1% resulted in one or more clinical effects. The most common clinical effects were agitation/irritability (22.9%) and tachycardia (21.4%). There were seven neonatal exposures, including five experiencing withdrawal. CONCLUSIONS: Kratom is associated with a variety of serious medical outcomes, especially when used with other substances. More research is needed to define the human response to kratom. Increased regulation of kratom products would help guarantee product quality and safety. Individuals who choose to use kratom should be educated about its potential risks, including the dangers of using it in combination with other substances.
Post Sara; Spiller Henry A; Chounthirath Thitphalak; Smith Gary A
Clinical toxicology (Philadelphia, Pa.)
2019
2019-02
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1080/15563650.2019.1569236" target="_blank" rel="noreferrer noopener">10.1080/15563650.2019.1569236</a>
Buprenorphine Exposures Among Children and Adolescents Reported to US Poison Control Centers.
Young Adult; Child; Infant; United States; Odds Ratio; Patient Admission; Human; Adolescence; Preschool; BUPRENORPHINE; HOSPITAL admission & discharge; ODDS ratio; PATIENTS; POISON control centers; SUBSTANCE abuse; UNITED States; Buprenorphine – Poisoning – United States; Buprenorphine – Therapeutic Use; BUPRENORPHINE – Therapeutic use; Poison Control Centers – United States; Substance Use Disorders – Drug Therapy
OBJECTIVE: To investigate buprenorphine exposures among children and adolescents
Post Sara; Spiller Henry A; Casavant Marcel J; Chounthirath Thitphalak; Smith Gary A
Pediatrics
2018
2018-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1542/peds.2017-3652" target="_blank" rel="noreferrer noopener">10.1542/peds.2017-3652</a>
Kratom exposures reported to United States poison control centers: 2011-2017.
dietary supplement; Kratom; National Poison Data System; poison control center; poisoning
CONTEXT: Kratom, or Mitragyna speciosa, is a plant indigenous to Southeast Asia that has gained national attention in the United States for its increased use in the self-management of opioid withdrawal and pain, as well as for concerns about its safety. METHODS: This study analyzes exposures to kratom reported to poison control centers (PCCs) in the United States during 2011-2017 from the National Poison Data System (NPDS). DISCUSSION: From 2011 through 2017, 1807 kratom exposures were reported to United States PCCs. Almost two-thirds (65.0%) of these exposures occurred during 2016-2017. Most exposures occurred among adults >/=20 years (88.9%), males (70.8%), at a residence (86.1%), and were intentional (74.3%). Among first-ranked kratom exposures, 31.8% resulted in admission to a health care facility (HCF) and 51.9% in a serious medical outcome. Multiple-substance exposures were associated with greater odds of admission to a HCF (OR: 2.80; 95% CI: 2.21-3.55) and a serious medical outcome (OR: 2.25; 95% CI: 1.77-2.85) compared with single-substance exposures. There were 11 deaths associated with kratom exposure, including two that occurred after exposure to kratom only. Among kratom-only exposures, 86.1% resulted in one or more clinical effects. The most common clinical effects were agitation/irritability (22.9%) and tachycardia (21.4%). There were seven neonatal exposures, including five experiencing withdrawal. CONCLUSIONS: Kratom is associated with a variety of serious medical outcomes, especially when used with other substances. More research is needed to define the human response to kratom. Increased regulation of kratom products would help guarantee product quality and safety. Individuals who choose to use kratom should be educated about its potential risks, including the dangers of using it in combination with other substances.
Post Sara; Spiller Henry A; Chounthirath Thitphalak; Smith Gary A
Clinical toxicology (Philadelphia, Pa.)
2019
2019-02
<a href="http://doi.org/10.1080/15563650.2019.1569236" target="_blank" rel="noreferrer noopener">10.1080/15563650.2019.1569236</a>
Kratom exposures reported to United States poison control centers: 2011–2017.
dietary supplement; Kratom; National Poison Data System; poison control center; poisoning; poison control center; UNITED States; HEALTH facilities; SOUTHEAST Asia; ENDEMIC plants; Kratom; SAFETY regulations
Context: Kratom, or Mitragyna speciosa, is a plant indigenous to Southeast Asia that has gained national attention in the United States for its increased use in the self-management of opioid withdrawal and pain, as well as for concerns about its safety. Methods: This study analyzes exposures to kratom reported to poison control centers (PCCs) in the United States during 2011–2017 from the National Poison Data System (NPDS). Discussion: From 2011 through 2017, 1807 kratom exposures were reported to United States PCCs. Almost two-thirds (65.0%) of these exposures occurred during 2016–2017. Most exposures occurred among adults ≥20 years (88.9%), males (70.8%), at a residence (86.1%), and were intentional (74.3%). Among first-ranked kratom exposures, 31.8% resulted in admission to a health care facility (HCF) and 51.9% in a serious medical outcome. Multiple-substance exposures were associated with greater odds of admission to a HCF (OR: 2.80; 95% CI: 2.21–3.55) and a serious medical outcome (OR: 2.25; 95% CI: 1.77–2.85) compared with single-substance exposures. There were 11 deaths associated with kratom exposure, including two that occurred after exposure to kratom only. Among kratom-only exposures, 86.1% resulted in one or more clinical effects. The most common clinical effects were agitation/irritability (22.9%) and tachycardia (21.4%). There were seven neonatal exposures, including five experiencing withdrawal. Conclusions: Kratom is associated with a variety of serious medical outcomes, especially when used with other substances. More research is needed to define the human response to kratom. Increased regulation of kratom products would help guarantee product quality and safety. Individuals who choose to use kratom should be educated about its potential risks, including the dangers of using it in combination with other substances. [ABSTRACT FROM AUTHOR]
Post Sara; Spiller Henry A; Chounthirath Thitphalak; Smith Gary A
Clinical Toxicology (15563650)
2019
2019-10
Journal Article
<a href="http://doi.org/10.1080/15563650.2019.1569236" target="_blank" rel="noreferrer noopener">10.1080/15563650.2019.1569236</a>