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Products in Ingestion Accidents*
n 1963, the National Clearinghouse for Poison Control Centers of the U.S. Public Health Service, reviewed poisoning report forms submitted in a 30-month period, July 1959-December 1961. At the time, some confusion resulted because the data involved all The 'c urrent review, age groups. theref'Ore, cQntains only data on children under fivle years of age. The categories of products were selected because these were the products most frequently ingested by children under five. The clearinghouse employs 80 categories in which all medicines and household products ingested are entered. The ten most frequently named substances involved in each of the ten most frequently involvedcategories are-
I
categories of substances Aspirin Soaps, detergents, cleaners Bleach Vitamins and minerals Insecticides (excluding mothballs) Plants Polishes and waxes Hormones Tranquilizers Other analgesics and antipyretics
o R.eprinted with permission of the division of ~ccident prevention, U.S. Public Health Serv~ce. Adapted from the article of the same name
rom the July-August 1966, Bulletin of the National Clearinghouse for Poison Control Centers.
total ingestions (percent) 25.8% 4.2%
3.6% 3.5% 3.2% 2.4% 2.2% 2.1% 2.0% 1.9%
Since the 1959-61 survey, kerosene has dropped from 6th plaoe to 22nd place (from 2.2 percent to 1.2 percent of the total ingestions), disinfectants have dropped from 8th to 12th (from 2.1 percent to 1.8 percent), lye and corrosives from 9th to 15th (2.1 percent to 1.5 percent) and laxatives from 10th place to 14th (from 1.9 percent to 1.5 percent). Plants were formerly in 16th place and rose to 6th, hormones from 24th to 8th, tranquilizers from 12th to 9th la nd other analgesics from lIth to 10th. Each year the National Clearinghouse receives an increasing number of ingestion reports. The increase probably is attributable to increased reporting rather than an actual greater number 'Of accident.al ingestions. The number of reports in the 1965 review roughly was equal to the number of reports in the 30-month survey, July 1959-December 1961. The tables in which hospitalization percentages are given are based on those reports on which these data were specifically mentioned. It will beoome apparent that there were many reports which did not indicate this information. However, since this type of information would undoubtedly not be included in telephone inquiries to the
products in top ten categories reported 100 or more times (1965) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27.
product St. Joseph Aspirin Bayer Aspirin Clorox Thyroid tablets Old English Chocks Bufferin Ajax Top Job Enovid Ammonia Comet Ortho Novum Librium Pride Liquiprin Purex Raid Poly-Vi-Sol Valium Anacin Soaky Pokeweed Vi-Penta Zestabs Roman Excedrin Rexall Aspirin
Total of 27 products Total Cases with Brand Name Specified
cases 3,261 2,402 1,247 368 325 322 309 269 203 188 179 173 172 164 164 161 143 143 141 137 128 114 113
108 106 104 101 11,245 20,256
poison control center, it is possible that the percentage of hospitalized cases is ,a ctually lower than indicated. Also, the criteria for hospitalization and ingestion cases vary with each hospital. Cases may have been admitted either because of a hospital policy Dr for a 24-hour observation. The hospitalization rate for the 100 products reviewed was 12.5 peroent. In the top ten categories for children under five years of age, there were 20,256 products identified by trade name. Mentioned more than 100 times in this survey were 27 products accounting for 11,245 case reports or 55.5 percent of all the identified products. The other 44.5 percent covered 1,418. aspirin
Aspirin accounted for 25.8 percent of the 1965 accidental ingestion reports to the National Clearinghouse in children under five . Although there were 64 brand names identified in 6,470 reports, three brands, St. Joseph (50.4 percent), Bayer (37.1 percent) and Bufferin (4.8 percent), accounted for 92.3 percent of all identified aspirin ingestions. The brand name was not specified in 9,858 aspirin ingestions. Vol. NS7, No.1, January 1967
31
soaps, detergents and cleaners
This variegated class of products, second only to aspirin in its involvement with poisoning accidents among children under five, was named in 4.2 percent of the cases reported to the National Clearinghouse in 1965. It was listed on the reports ,as the agent involved in 2,506 ingestions among which 361 trade names were identified. The ten most frequently ingested in this group contributed 1,227 cases or 46.1 percent of the total cases, including those which had no trade name identification. Ammonia, which led the list in 1959~61, is now in third place; probably because of the difference in the age groups involved in the two studies. Ajax, representing five different products, topped the list with a total of 269 cases reported. In those cases in which hospitalization was known, 11.8 percent of the first ten products were admitted. If ammonia were not considered, the hospitalization for the group would be 5.3 percent. Analysis of the reports of one product in this group indicated that hospitalization was the result of fear from caustic burns based on the advertising of the presence of ammonia. However, many recently advertised products "with ammonia" have a low concentration so that this type of injury is unlikely.
Presently chief of the Public H ealth Service poison control branch, division of accident prevention, Henry L. Verhulst is a pharmacist with an MS in pharmaceutical chemistry. A member of APhA and ASHP, he spent many of his 18 years in PHS working as a pharmacist in various clinics before joining the poison control branch.
The associate director of the National Clearinghouse for Poison Control Centers, John J. Crotty, MD, has been a member of that staff for the past six years. He is a graduate of Holy Cross College and received his MD from Georgetown Medical School. Prior to entering the Public Health Service, Crotty did renal research at a Washington, D.C. hospital.
aspirin most frequently ingested by trade name and type type of aspirin trade name
bleaches
The ingestion of bleaches among children under five years of age accounted for 3.6 percent of the total ingestions reported (in 1962 it was 5.3 percent). In 1,898 cases in which the trade names were identified, there were 105 products and the ten most frequently mentioned accounted for 1,683 of these reports. Clorox was involved in 66 percent of the cases in which the trade names were identified but there is some evidence that Clorox may be used as a generic name for bleaches when the exact brand name is not known. Following this was Purex (7.5 percent), Roman (5.6 percent), Action (4.8 peroent). The remaining 101 trade names identified constituted only 16.3 percent of the identified bleaches ingested. In those cases where hospitalization was reported among the first ten bleaches ingested, only 8.8 percent of the children were admitted. This indicates a reduction in hospitalization from the 1959-61 data in which the comparable figure was 14.1 percent. vitamins and minerals
In the 1,746 vitamin and mineral ingestions with known trade names among children under five years of (continued on page 35) 32
1.
2. 3. 4. 5. 6. 7. 8. 9. 10. 11.
St. Joseph Bayer Bufferin Rexall Johnson Aspergum Abbott McKesson Norwich Squibb Others
Total Unspecified Grand Total
total
baby
adult
3,261 2,402 309 101 61 51 52 24 15
2,321 1,709 118 79 61
21 187 176 8
13
181 6,470 9,858 16,328
unknown
919 506 15 14
51 35 16 2 9 109 4,459 6,395 10,854
3 6 1 34 487 761 1,248
17 5 7 3 38 1,524 2,702 4,226
vitamins and minerals most frequently ingested by trade name and hospitalization
trade name
1. Chocks
2. 3. 4. 5. 6. 7. 8. 9. 10.
Poly-Vi-Sol (Vi Penta) Zestabs Ferrous Sulfate One-A-Day Poly-Vi-Flor Adeflor Unicap Tri-Vi-Sol Deca-Vi-Sol Total
Journal of the AMERICAN PHARMACEUTICAL ASSOCIATION
total cases
322 141 108 78 75 61 60 60 53 52 1010
total with known hospitalization data
72
27 24 56 23 27 13
15 14 10 295
percent hospitalized
1.4 3.7 4.2 41.1 4.3 3.7 7.7 0.0 0.0 0.0 9.5
insecticides most frequently ingested by trade name and hospitalization
trade name
total cases
total with known hospitalization data
percent hospitalized
143 90
61 71
18.0 5.6
80 80 76 74 74 52 53 52
43 62 51 44 31 25 23 37
27.9 67.7 13 .7 15.9 22 .6 20.0 8.7 40.5
779
448
25.0
l. 2.
Raid Harris Famous Roach Tablets 3. Black Flag 4. Gator Roach Hives 5. Terro Ant Killer 6. Ant Buttons 7. Antrol Ant Killer 8. Chlordane 9. 6·12 Insect Repellent 10. Arsenic Total
plants most frequently ingested by trade name and hospitalization total cases
total with known hospitalization data
percent hospitalized
Pokeweed Yew Philodendron Bittersweet Nightshade Holly Honeysuckle Pyracantha Castor beans Jerusalem Cherry
113 76 60 58 57 45 43 38 35 34
53 31 3 17 27 18 10 31 20 8
18.7 0. 0 0.0 0.0 3.7 0.0 0. 0 0.0 25.0 12.5
Total
559
197
8.6
trade name
l. 2. 3. 4. 5. 6. 7. 8. 9. 10.
hormones most frequently ingested by trade name and hospitalization
trade name
l. Thyroid Tablets 2. Enovid 3. Ortho Novum 4. Oracon 5. Norlestrin 6. Cytomel 7. Proloid 8. Synthyroid 9. Premarin 10. Prednisone Total
total with known hospitalization data
percent hospitalized
46 44 38 35 27 20 17
192 80 110 20 22 18 27 19 16 3
7.3 1.3 0.9 0. 0 0. 0 5.6 0. 0 10.5 0.0 0.0
955
507
4.9
total cases 368 188
172
age, 1,010 reports were identified with the first ten preparations listed. These ten products accounted for 57.8 percent of the total identified although there were 210 different tr,a de names The hospitalization rate reported. associated with these products appears to be high (9.5 percent); however, when iron preparations are removed, the percent of hospitalization becomes 1.7 percent. The percentage hospitalization associated with ferrous sulphate (41.1) approaches that of lye and corrosives (43.3 percent) and kerosene (49.0 percent). insecticides
In 1965, insecticides (excluding mothballs which are tabulated separately) were involved in 3.2 percent of all the products ingested by children. In 1959-61 tabulations, the percentage was five percent and has shown a steady decline until this new low. Trade names involved in the 1,785 ingestions in which the product was identified numbered 266. There was a relatively large number of oases (271) in which no specific trade name was mentioned. Because some items such as Raid, Black Flag, Ant Button and Chlordane represent several differen t insecticides, their place on this list is meaningless. plants
One hundred and ninety-six plants were involved in 1,299 ingestions in which the plant was identified. The first ten plants on the list accounted for 42.9 percent of the total. polishes and waxes
The polish and wax category contained 134 trade names among 1,231 identified products. The ten most frequently ingested by children under five contributed 785 cases, 63.8 percent of the total; the other 124 trade named products were distributed among 446 cases. Two products, Old English polish (323 cases) and Pride (164 oases) were the most frequently ingested. This group of substances was associated with a high percentage (33,5) of hospitalization (when such information was given) because the main ingredient in many of the polishes is a petroleum distillate. It should be noted, however, that some polishes have a water base. hormones
One of the new categories in the most frequently ingested list is hormones. The first ten products accounted for 936 reports and 71.7 percent of the entire category and 83.3 percent of the identified hormones. Four of the ten most common items ( continued on next page) Vol. NS7, No.1, January 1967
3S
tranquilizers most frequently ingested by trade name and hospitalization
Trade name
1.
2. 3. 4. 5. 6. 7. 8. 9. 10.
Librium Valium Thorazine Stelazine Mellaril Compazine Tofranil Elavil Equanil Miltown Total
total cases
total with known hospitalization data
percent hospitalized
164 137 99 93 61 51 49 39 37 34 764
107 96 60 58 44 34 30 28 22 20 499
16.8 28.1 43.3 15.5 15.9 23.5 42.9 46.4 13.6 20.0 24.8
other analgesics and antipyretics most frequently ingested by trade name and hospitalization
trade name 1.
when donna daydreams
2. 3. 4. 5. 6. 7. 8. 9. 10.
Total
III
... do her horizons stretch as far as other children's? Or are they limited by the defect with which sh e was born? Today, more and more children like Donna can dream freelycan look forward to freedom from nature's mistakes - thanks to the March of Dimes. Almost 80 per cent of all birth defects can be treated - and often completely corrected - if early diagnosis and proper treat. ment is obtained. Your contribution to the March of Dimes finances more than 75 Birth Defects Centers across the nation to bring the best of care to those who need it most.
fight birth defects JOIN 36
Liquiprin Anacin Excedrin Darvon Congesprin Empirin Pyridium Midol Darvon compound Tempra
MARCH OF DIMES
total cases
total with known hospitalization data
percent hospitalized
161 128 104 82 61 51 42 41 34 33 737
110 87 67 46 39 32 31 19 29 11 471
9.1 10.3 4.3 17.4 7.7 15.6 3.2 5.3 6.9 9.1 9.1
in ingestion accidents
tranquilizers
(continued from page 35)
In 1965, reports received by the clearinghouse identified 1,032 tran· quilizers by brand name and 45 prod· ucts ingested by childr,e n under five, The first four names on the list ac· counted for 47.7 percent and the first ten products accounted for 74.0 percent of the tranquilizer ingestion accidents reported to the clearinghouse. Although 90 percent of reports of ingestion accidents in this category involve children under five, two-thirds are in the older age groups and :are predominently adult suicide attempts.
were thyroid preparations and four were oral contraceptives accounting for 49.0 percent and 47.1 percent, respectively, of all hormone ingestions reported among children under five years of age. It is because of the oral contraceptives that the hormone category has entered the top ten. In 1962, hormones accounted for 1.5 percent of the total ingestion reports received by the clearinghouse and in 1965, 2.1 percent. Only 0.9 percent of the oral contraceptive ingestion cases were hospitalized. A recent analysis of oral contraceptive reports showed that where the symptoms were indicated on the forms, 99 percent of the ingestions had checked "signs and symptomsnone." Another analysis of the thyroid ingestions showed that there were very few serious symptoms indicated even when large amounts were reportedly ingested.
Journal of the AMERICAN PHARMACEUTICAL ASSOCIATION
other analgesics and antipyretics
This category of products is new to the list of the top ten since 1959-61. It is somewhat surprising that with the great number of potential candidates, there were only 80 items identified which accounted for 1,165 ingestions in children under five. The ten most frequently mentioned products in this category accounted for 63.3 percent of all the identified ingestions. •
I
categories of substances Aspirin Soaps, detergents, cleaners Bleach Vitamins and minerals Insecticides (excluding mothballs) Plants Polishes and waxes Hormones Tranquilizers Other analgesics and antipyretics
o R.eprinted with permission of the division of ~ccident prevention, U.S. Public Health Serv~ce. Adapted from the article of the same name
rom the July-August 1966, Bulletin of the National Clearinghouse for Poison Control Centers.
total ingestions (percent) 25.8% 4.2%
3.6% 3.5% 3.2% 2.4% 2.2% 2.1% 2.0% 1.9%
Since the 1959-61 survey, kerosene has dropped from 6th plaoe to 22nd place (from 2.2 percent to 1.2 percent of the total ingestions), disinfectants have dropped from 8th to 12th (from 2.1 percent to 1.8 percent), lye and corrosives from 9th to 15th (2.1 percent to 1.5 percent) and laxatives from 10th place to 14th (from 1.9 percent to 1.5 percent). Plants were formerly in 16th place and rose to 6th, hormones from 24th to 8th, tranquilizers from 12th to 9th la nd other analgesics from lIth to 10th. Each year the National Clearinghouse receives an increasing number of ingestion reports. The increase probably is attributable to increased reporting rather than an actual greater number 'Of accident.al ingestions. The number of reports in the 1965 review roughly was equal to the number of reports in the 30-month survey, July 1959-December 1961. The tables in which hospitalization percentages are given are based on those reports on which these data were specifically mentioned. It will beoome apparent that there were many reports which did not indicate this information. However, since this type of information would undoubtedly not be included in telephone inquiries to the
products in top ten categories reported 100 or more times (1965) 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27.
product St. Joseph Aspirin Bayer Aspirin Clorox Thyroid tablets Old English Chocks Bufferin Ajax Top Job Enovid Ammonia Comet Ortho Novum Librium Pride Liquiprin Purex Raid Poly-Vi-Sol Valium Anacin Soaky Pokeweed Vi-Penta Zestabs Roman Excedrin Rexall Aspirin
Total of 27 products Total Cases with Brand Name Specified
cases 3,261 2,402 1,247 368 325 322 309 269 203 188 179 173 172 164 164 161 143 143 141 137 128 114 113
108 106 104 101 11,245 20,256
poison control center, it is possible that the percentage of hospitalized cases is ,a ctually lower than indicated. Also, the criteria for hospitalization and ingestion cases vary with each hospital. Cases may have been admitted either because of a hospital policy Dr for a 24-hour observation. The hospitalization rate for the 100 products reviewed was 12.5 peroent. In the top ten categories for children under five years of age, there were 20,256 products identified by trade name. Mentioned more than 100 times in this survey were 27 products accounting for 11,245 case reports or 55.5 percent of all the identified products. The other 44.5 percent covered 1,418. aspirin
Aspirin accounted for 25.8 percent of the 1965 accidental ingestion reports to the National Clearinghouse in children under five . Although there were 64 brand names identified in 6,470 reports, three brands, St. Joseph (50.4 percent), Bayer (37.1 percent) and Bufferin (4.8 percent), accounted for 92.3 percent of all identified aspirin ingestions. The brand name was not specified in 9,858 aspirin ingestions. Vol. NS7, No.1, January 1967
31
soaps, detergents and cleaners
This variegated class of products, second only to aspirin in its involvement with poisoning accidents among children under five, was named in 4.2 percent of the cases reported to the National Clearinghouse in 1965. It was listed on the reports ,as the agent involved in 2,506 ingestions among which 361 trade names were identified. The ten most frequently ingested in this group contributed 1,227 cases or 46.1 percent of the total cases, including those which had no trade name identification. Ammonia, which led the list in 1959~61, is now in third place; probably because of the difference in the age groups involved in the two studies. Ajax, representing five different products, topped the list with a total of 269 cases reported. In those cases in which hospitalization was known, 11.8 percent of the first ten products were admitted. If ammonia were not considered, the hospitalization for the group would be 5.3 percent. Analysis of the reports of one product in this group indicated that hospitalization was the result of fear from caustic burns based on the advertising of the presence of ammonia. However, many recently advertised products "with ammonia" have a low concentration so that this type of injury is unlikely.
Presently chief of the Public H ealth Service poison control branch, division of accident prevention, Henry L. Verhulst is a pharmacist with an MS in pharmaceutical chemistry. A member of APhA and ASHP, he spent many of his 18 years in PHS working as a pharmacist in various clinics before joining the poison control branch.
The associate director of the National Clearinghouse for Poison Control Centers, John J. Crotty, MD, has been a member of that staff for the past six years. He is a graduate of Holy Cross College and received his MD from Georgetown Medical School. Prior to entering the Public Health Service, Crotty did renal research at a Washington, D.C. hospital.
aspirin most frequently ingested by trade name and type type of aspirin trade name
bleaches
The ingestion of bleaches among children under five years of age accounted for 3.6 percent of the total ingestions reported (in 1962 it was 5.3 percent). In 1,898 cases in which the trade names were identified, there were 105 products and the ten most frequently mentioned accounted for 1,683 of these reports. Clorox was involved in 66 percent of the cases in which the trade names were identified but there is some evidence that Clorox may be used as a generic name for bleaches when the exact brand name is not known. Following this was Purex (7.5 percent), Roman (5.6 percent), Action (4.8 peroent). The remaining 101 trade names identified constituted only 16.3 percent of the identified bleaches ingested. In those cases where hospitalization was reported among the first ten bleaches ingested, only 8.8 percent of the children were admitted. This indicates a reduction in hospitalization from the 1959-61 data in which the comparable figure was 14.1 percent. vitamins and minerals
In the 1,746 vitamin and mineral ingestions with known trade names among children under five years of (continued on page 35) 32
1.
2. 3. 4. 5. 6. 7. 8. 9. 10. 11.
St. Joseph Bayer Bufferin Rexall Johnson Aspergum Abbott McKesson Norwich Squibb Others
Total Unspecified Grand Total
total
baby
adult
3,261 2,402 309 101 61 51 52 24 15
2,321 1,709 118 79 61
21 187 176 8
13
181 6,470 9,858 16,328
unknown
919 506 15 14
51 35 16 2 9 109 4,459 6,395 10,854
3 6 1 34 487 761 1,248
17 5 7 3 38 1,524 2,702 4,226
vitamins and minerals most frequently ingested by trade name and hospitalization
trade name
1. Chocks
2. 3. 4. 5. 6. 7. 8. 9. 10.
Poly-Vi-Sol (Vi Penta) Zestabs Ferrous Sulfate One-A-Day Poly-Vi-Flor Adeflor Unicap Tri-Vi-Sol Deca-Vi-Sol Total
Journal of the AMERICAN PHARMACEUTICAL ASSOCIATION
total cases
322 141 108 78 75 61 60 60 53 52 1010
total with known hospitalization data
72
27 24 56 23 27 13
15 14 10 295
percent hospitalized
1.4 3.7 4.2 41.1 4.3 3.7 7.7 0.0 0.0 0.0 9.5
insecticides most frequently ingested by trade name and hospitalization
trade name
total cases
total with known hospitalization data
percent hospitalized
143 90
61 71
18.0 5.6
80 80 76 74 74 52 53 52
43 62 51 44 31 25 23 37
27.9 67.7 13 .7 15.9 22 .6 20.0 8.7 40.5
779
448
25.0
l. 2.
Raid Harris Famous Roach Tablets 3. Black Flag 4. Gator Roach Hives 5. Terro Ant Killer 6. Ant Buttons 7. Antrol Ant Killer 8. Chlordane 9. 6·12 Insect Repellent 10. Arsenic Total
plants most frequently ingested by trade name and hospitalization total cases
total with known hospitalization data
percent hospitalized
Pokeweed Yew Philodendron Bittersweet Nightshade Holly Honeysuckle Pyracantha Castor beans Jerusalem Cherry
113 76 60 58 57 45 43 38 35 34
53 31 3 17 27 18 10 31 20 8
18.7 0. 0 0.0 0.0 3.7 0.0 0. 0 0.0 25.0 12.5
Total
559
197
8.6
trade name
l. 2. 3. 4. 5. 6. 7. 8. 9. 10.
hormones most frequently ingested by trade name and hospitalization
trade name
l. Thyroid Tablets 2. Enovid 3. Ortho Novum 4. Oracon 5. Norlestrin 6. Cytomel 7. Proloid 8. Synthyroid 9. Premarin 10. Prednisone Total
total with known hospitalization data
percent hospitalized
46 44 38 35 27 20 17
192 80 110 20 22 18 27 19 16 3
7.3 1.3 0.9 0. 0 0. 0 5.6 0. 0 10.5 0.0 0.0
955
507
4.9
total cases 368 188
172
age, 1,010 reports were identified with the first ten preparations listed. These ten products accounted for 57.8 percent of the total identified although there were 210 different tr,a de names The hospitalization rate reported. associated with these products appears to be high (9.5 percent); however, when iron preparations are removed, the percent of hospitalization becomes 1.7 percent. The percentage hospitalization associated with ferrous sulphate (41.1) approaches that of lye and corrosives (43.3 percent) and kerosene (49.0 percent). insecticides
In 1965, insecticides (excluding mothballs which are tabulated separately) were involved in 3.2 percent of all the products ingested by children. In 1959-61 tabulations, the percentage was five percent and has shown a steady decline until this new low. Trade names involved in the 1,785 ingestions in which the product was identified numbered 266. There was a relatively large number of oases (271) in which no specific trade name was mentioned. Because some items such as Raid, Black Flag, Ant Button and Chlordane represent several differen t insecticides, their place on this list is meaningless. plants
One hundred and ninety-six plants were involved in 1,299 ingestions in which the plant was identified. The first ten plants on the list accounted for 42.9 percent of the total. polishes and waxes
The polish and wax category contained 134 trade names among 1,231 identified products. The ten most frequently ingested by children under five contributed 785 cases, 63.8 percent of the total; the other 124 trade named products were distributed among 446 cases. Two products, Old English polish (323 cases) and Pride (164 oases) were the most frequently ingested. This group of substances was associated with a high percentage (33,5) of hospitalization (when such information was given) because the main ingredient in many of the polishes is a petroleum distillate. It should be noted, however, that some polishes have a water base. hormones
One of the new categories in the most frequently ingested list is hormones. The first ten products accounted for 936 reports and 71.7 percent of the entire category and 83.3 percent of the identified hormones. Four of the ten most common items ( continued on next page) Vol. NS7, No.1, January 1967
3S
tranquilizers most frequently ingested by trade name and hospitalization
Trade name
1.
2. 3. 4. 5. 6. 7. 8. 9. 10.
Librium Valium Thorazine Stelazine Mellaril Compazine Tofranil Elavil Equanil Miltown Total
total cases
total with known hospitalization data
percent hospitalized
164 137 99 93 61 51 49 39 37 34 764
107 96 60 58 44 34 30 28 22 20 499
16.8 28.1 43.3 15.5 15.9 23.5 42.9 46.4 13.6 20.0 24.8
other analgesics and antipyretics most frequently ingested by trade name and hospitalization
trade name 1.
when donna daydreams
2. 3. 4. 5. 6. 7. 8. 9. 10.
Total
III
... do her horizons stretch as far as other children's? Or are they limited by the defect with which sh e was born? Today, more and more children like Donna can dream freelycan look forward to freedom from nature's mistakes - thanks to the March of Dimes. Almost 80 per cent of all birth defects can be treated - and often completely corrected - if early diagnosis and proper treat. ment is obtained. Your contribution to the March of Dimes finances more than 75 Birth Defects Centers across the nation to bring the best of care to those who need it most.
fight birth defects JOIN 36
Liquiprin Anacin Excedrin Darvon Congesprin Empirin Pyridium Midol Darvon compound Tempra
MARCH OF DIMES
total cases
total with known hospitalization data
percent hospitalized
161 128 104 82 61 51 42 41 34 33 737
110 87 67 46 39 32 31 19 29 11 471
9.1 10.3 4.3 17.4 7.7 15.6 3.2 5.3 6.9 9.1 9.1
in ingestion accidents
tranquilizers
(continued from page 35)
In 1965, reports received by the clearinghouse identified 1,032 tran· quilizers by brand name and 45 prod· ucts ingested by childr,e n under five, The first four names on the list ac· counted for 47.7 percent and the first ten products accounted for 74.0 percent of the tranquilizer ingestion accidents reported to the clearinghouse. Although 90 percent of reports of ingestion accidents in this category involve children under five, two-thirds are in the older age groups and :are predominently adult suicide attempts.
were thyroid preparations and four were oral contraceptives accounting for 49.0 percent and 47.1 percent, respectively, of all hormone ingestions reported among children under five years of age. It is because of the oral contraceptives that the hormone category has entered the top ten. In 1962, hormones accounted for 1.5 percent of the total ingestion reports received by the clearinghouse and in 1965, 2.1 percent. Only 0.9 percent of the oral contraceptive ingestion cases were hospitalized. A recent analysis of oral contraceptive reports showed that where the symptoms were indicated on the forms, 99 percent of the ingestions had checked "signs and symptomsnone." Another analysis of the thyroid ingestions showed that there were very few serious symptoms indicated even when large amounts were reportedly ingested.
Journal of the AMERICAN PHARMACEUTICAL ASSOCIATION
other analgesics and antipyretics
This category of products is new to the list of the top ten since 1959-61. It is somewhat surprising that with the great number of potential candidates, there were only 80 items identified which accounted for 1,165 ingestions in children under five. The ten most frequently mentioned products in this category accounted for 63.3 percent of all the identified ingestions. •