We read with interest the recent article regarding amlodipine toxicity in children
(
1
). Although we agree that amlodipine poisoning poses significant risks in children,
we are weary of some of the assumptions made by the authors. The limitations of the
poison center data system have been well recognized for many years and published elsewhere
(
2
). Without reiterating all of its inequities, we must remember that data collected
reflect “exposures,” which are unreliable when no attempt is made to confirm “ingestions” by either qualitative or quantitative testing. This confusion is carried throughout
the article, beginning with the title that should read “Amlodipine Exposure” not “Amlodipine
Toxicity.” Similarly, when the discussion states that the study comprises the largest
cohort of pediatric amlodipine ingestions reported to date, the authors clearly overstep
their bounds because, with the exception of the symptomatic children, it is quite
possible that no other child has even ingested any amlodipine. Exposures do not equal
ingestions.To read this article in full you will need to make a payment
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References
- Amlodipine toxicity in children less than 6 years of age: a dose-response analysis using national poison data system data.J Emerg Med. 2010; 39: 186-193
- Understanding the limitations of retrospective analyses of poison center data.Clin Toxicol (Phila). 2007; 45: 943-945
Article info
Publication history
Published online: June 21, 2010
Identification
Copyright
© 2011 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
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- Amlodipine Toxicity in Children Less Than 6 Years of Age: A Dose-Response Analysis Using National Poison Data System DataJournal of Emergency MedicineVol. 39Issue 2
- PreviewBackground: Amlodipine is a long-acting calcium channel blocker capable of producing hypotension and dysrhythmia in overdose. The toxic doses of amlodipine in children are unclear. Objectives: The purposes of this study were to describe amlodipine poisoning in children and to determine whether a dose-response relationship could be detected in this population using standardized call data from United States (US) poison centers. Patients and Methods: 1251 amlodipine-only ingestions in children < 6 years of age were reviewed.
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