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Case report
Unintentional overdose of hyoscine hydrobromide in a young child
  1. Gerd Xuereb1,
  2. Thomas Calleja2,
  3. Janine Borg2 and
  4. David Pace2
  1. 1Foundation Programme Malta, Mater Dei Hospital, Msida, Malta
  2. 2Department of Child & Adolescent Health, Mater Dei Hospital, Msida, Malta
  1. Correspondence to Dr Gerd Xuereb; gerdxuereb{at}gmail.com

Abstract

A 4-year-old girl presented with confusion, ataxia and hallucinations 3 hours after an accidental overdose of 108 μg per kg of hyoscine hydrobromide (Kwells Kids). She was hypotensive and tachycardic at presentation. Investigations revealed QTc prolongation on ECG. The girl was admitted for observation overnight and was noted to have persistent visual and auditory hallucinations, which resolved without treatment. To our knowledge, this is the first reported case of an overdose of hyoscine hydrobromide at such a young age. Clinicians should be aware that unintentional ingestions in this age group may present with psychiatric manifestations. Hyoscine hydrobromide is easily accessible and available over the counter. It has serious consequences in overdose. Its packaging and appearance are attractive to young children making it susceptible to unintentional ingestions. We argue that its container should be altered to be more childproof.

  • paediatrics
  • pharmacology and therapeutics
  • Unwanted effects/adverse reactions
  • Toxicology
  • Safety
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Footnotes

  • Contributors The patient was under the care of DP. GX, TC and JB conducted a review of the current literature and on previously reported cases of hyoscine hydrobromide toxicity. The findings were critically analysed and evaluated by GX, TC and JB. The case report was written by GX, TC and JB. DP critically revised the case report. The study was supervised by DP. All authors read and approved the final version submitted for publication.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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