• Am J Emerg Med · Feb 2022

    Case Reports

    Fatal cold medication poisoning in an adolescent.

    • Sam Ontiveros and Lee Cantrell.
    • UC San Diego Medical Center, Dept. of Emergency Medicine, 200 W. Arbor Drive, San Diego, CA 92103-8676, USA. Electronic address: lcantrell@calpoison.org.
    • Am J Emerg Med. 2022 Feb 1; 52: 269.e1-269.e2.

    BackgroundToxicity 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.Copyright © 2021 Elsevier Inc. All rights reserved.

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