Posters IV - The American Academy of Clinical Toxicology

291
Poisonings Associated with Medication Organizers
Rita Mrvos 1 , Edward P Krenzelok 1
1 University of Pittsburgh Medical Center, Pittsburgh PA USA
Background: Pill organizer container usage is becoming more prevalent in homes. The majority of these
organizers are not child resistant and targeted for use in the elderly population to encourage compliance
with medication regimes. To determine the prevalence of exposures involving these types of containers all
exposure calls over a 4 month period involving pill organizers reported to a RPIC were reviewed.
Methods: All poisoning exposure calls received at a RPIC were documented in the usual manner. If
during the interview the caller mentioned that the medication was in a pill organizer when the exposure
occurred, the information was documented on the chart. No further questioning about the container was
done. The case was then tagged for review. Using Crystal Reports the medical record database was
queried for these tagged cases and data collection included age, gender, exposure site, patient flow,
hospital flow, outcome and substance(s). The data was analyzed using descriptive statistics. Results: 75
exposures involving pill organizers were identified during the 4 month study period. 24 (32%) were adults
and 51 (68%) were children less 6 years of age. Multiple medications were involved in 47 (62.6%) of the
exposures including 1 case with 10 substances, 12 patients were exposed to 3 different medications and 19
to 2 different meds. 28 of the adults (33%) were treated in a health care facility. 2 were admitted to a
critical care unit, 2 were admitted to a non critical care unit, 3 were treated and released and 1 case was
lost to f/u. Of the 51 pediatric exposures, 19(37%) required evaluation in a health care facility. Of these,
13 (68%) were treated and released from the emergency department, 1 (5%) was admitted to critical care,
3 (16%) were admitted to a non critical care unit and 2 (11%) cases were lost to follow-up. Conclusion:
Although improved medication compliance in an aging population is highly desirable, many factors play a
role in medication safety including pill organizers. Education as to the proper way to take, administer and
store medications remains a vital part of ongoing education.
292
Inconsistencies in non-pharmaceutical commercial product labels
Lee Cantrell 1 , Sean Nordt 2 , Jamey Krauss 3
1 California Poison Control System- San Diego Division, CA USC Keck School of Medicine, CA
3 Univ. of Calif. San Francisco School of Pharmacy, CA
Background: Human exposures to non-pharmaceutical commercial products occur frequently. Many
product labels contain instructions for managing unintentional exposures, however the information
provided varies considerably. US government regulatory agencies do not specifically mandate the type or
location of information that must be contained in case of accidental exposure. The AAPCC has published
guidelines for industries to use the national toll-free poison center (PC) telephone number, however there
is no published data to determine if companies are adhering to these guidelines. While other authors have
described the inadequate quality of product first aid instructions, the purpose of this study was to
characterize the type and physical location of first aid instructions and consumer referral information.
Methods:A random, convenience sample of commercial product label information was obtained from a
variety of local retail stores over a 6 month period. Twelve common non-pharmaceutical product
categories with large numbers of annual human exposures were identified from NPDS data. A minimum
of 10 unique products for each category were required. The following information was collected on a
standardized Excel spreadsheet: product name and manufacturer, location on container, presence and type