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Fatal cold medication poisoning in an adolescent.

Sam Ontiveros, Lee Cantrell

The American journal of emergency medicine February 1, 2022 DOI: 10.1016/j.ajem.2021.08.043 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Case report Peer reviewed
Sample size 1
Population Adolescent decedent
Keywords Chlorpheniramine Dextromethorphan Fatal Poisoning
Key findings Markedly elevated postmortem chlorpheniramine and dextromethorphan blood concentrations were found in an adolescent decedent with no other identifiable cause of death.

Abstract

Toxicity from the intentional misuse of over-the-counter (OTC) combination cold products has been widely recognized. Adolescents are most frequently involved and dextromethorphan containing products are the most popular. Desired symptoms include stimulatory effects, euphoria, hallucinations, and dissociation. Potential adverse effects include tachycardia, agitation, hyperthermia, acidosis, and coma. However, mortality is rare [ 1-3]. Co-formulated ingredients such as acetaminophen, pseudoephedrine, and antihistamines may also be present and potentiate dangerous effects. We report a case of an adolescent decedent with markedly elevated postmortem chlorpheniramine (CPA) and dextromethorphan (DXM) blood concentrations and no other identifiable cause of death.