{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:19:47Z","timestamp":1791497987491,"version":"4.3.4"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T00:00:00Z","timestamp":1716249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>In forensic toxicology, the pediatric population requires special focus when evaluating positive findings because of the many toxicokinetic and toxicodynamic differences (e.g., metabolic capabilities, body size, etc.) between the pediatric and adult populations. In particular, the administration of over-the-counter (OTC) medications needs careful consideration, as dosages given to the pediatric population (0\u2009days\u201318\u2009years), particularly those given to individuals &amp;lt;5 years of age, tend to be lower than those given to individuals closer to adulthood. Postmortem pediatric data from 11 years (2010\u20132020) was compiled. A total of 1413 positive cases contained one or more of the following common OTC medications: antihistamines (brompheniramine, chlorpheniramine, diphenhydramine, doxylamine and pheniramine), pain relievers (acetaminophen, naproxen, ibuprofen and salicylates), cold\/flu medications (dextro\/levomethorphan, guaifenesin, ephedrine and pseudoephedrine), gastrointestinal aids (dicyclomine and loperamide) and\/or sleep aids (melatonin). Antihistamines, cold\/flu medications and pain relievers are the most common classes of drugs encountered in the postmortem pediatric population. To evaluate trends, three main age groups were created: \u22645\u2009years old (5\u2009U, birth-5\u2009years old), middle childhood (MC, 6\u201311\u2009years old), and early adolescence (EA, 12\u201318\u2009years old). When considering the data, it must be noted that many of these drugs may be co-administered in single and\/or multi-drug formulations. In addition, some drugs may have a variety of uses, e.g. antihistamines may also be used as sleep aids. Of note, the prevalence of cases involving those aged 6\u201311\u2009years old was far less than their younger and older pediatric counterparts. With the widespread availability of OTC medications, unintentional overdoses, recreational misuse and suicidal overdoses can occur in the vulnerable, pediatric population.<\/jats:p>","DOI":"10.1093\/jat\/bkae042","type":"journal-article","created":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T21:21:15Z","timestamp":1716240075000},"page":"473-481","source":"Crossref","is-referenced-by-count":5,"title":["Over-the-counter medications encountered in the postmortem pediatric population from 2010\u20132020"],"prefix":"10.1093","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3047-4990","authenticated-orcid":false,"given":"Jennifer L","family":"Swatek","sequence":"first","affiliation":[{"name":"Toxicological Services, NMS Labs , 200 Welsh Rd, Horsham, PA 19044, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4592-6512","authenticated-orcid":false,"given":"Stephanie M","family":"Marco","sequence":"additional","affiliation":[{"name":"Toxicological Services, NMS Labs , 200 Welsh Rd, Horsham, PA 19044, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5921-0385","authenticated-orcid":false,"given":"Kari M","family":"Midthun","sequence":"additional","affiliation":[{"name":"Toxicological Services, NMS Labs , 200 Welsh Rd, Horsham, PA 19044, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,5,21]]},"reference":[{"key":"2024082121410356200_R1","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1007\/978-1-61779-403-2_18","volume-title":"Forensic Pathology of Infancy and Childhood","author":"Middleberg","year":"2014"},{"key":"2024082121410356200_R2","doi-asserted-by":"crossref","first-page":"e454","DOI":"10.3928\/19382359-20171120-02","article-title":"Pediatric poisonings: the risk of over-the-counter pharmaceuticals","volume":"46","author":"Hines","year":"2017","journal-title":"Pediatric Annals"},{"key":"2024082121410356200_R3","doi-asserted-by":"crossref","first-page":"175","DOI":"10.5863\/1551-6776-25.3.175","article-title":"Key potentially inappropriate drugs in pediatrics: the KIDs list","volume":"25","author":"Meyers","year":"2020","journal-title":"The Journal of Pediatric Pharmacology and Therapeutics"},{"key":"2024082121410356200_R4","article-title":"FDA takes Action Against the use of OTC Benzocaine Teething Products due to Serious Safety Risk, lack of Benefit","author":"U.S. Food & Drug Administration (FDA)","year":"2020"},{"key":"2024082121410356200_R5","article-title":"Should you give kids Medicine for Coughs and Colds?","author":"U.S. Food & Drug Administration (FDA)","year":"2023"},{"key":"2024082121410356200_R6","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2016-3070","article-title":"Safety profile of cough and cold medication use in pediatrics","volume":"139","author":"Green","year":"2017","journal-title":"Pediatrics"},{"key":"2024082121410356200_R7","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2022-059016","article-title":"Characteristics of fatal poisonings among infants and young children in the United States","volume":"151","author":"Gaw","year":"2023","journal-title":"Pediatrics"},{"key":"2024082121410356200_R8","doi-asserted-by":"crossref","first-page":"208","DOI":"10.18773\/austprescr.2016.071","article-title":"Paediatric pharmacokinetics and drug doses","volume":"39","author":"O\u2019Hara","year":"2016","journal-title":"Australian Prescriber"},{"key":"2024082121410356200_R9","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1111\/bcp.12267","article-title":"Paediatric pharmacokinetics: key considerations","volume":"79","author":"Batchelor","year":"2015","journal-title":"British Journal of Clinical Pharmacology"},{"key":"2024082121410356200_R10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.24926\/iip.v9i3.979","article-title":"Adolescents\u2019 misuse of over-the-counter medications: the need for pharmacist-led intervention","volume":"9","author":"Abraham","year":"2018","journal-title":"Innovations in Pharmacy"},{"key":"2024082121410356200_R11","article-title":"FDA Warns about Serious Problems with high Doses of the Allergy Medicine Diphenhydramine (Benadryl)","author":"U.S. Food & Drug Administration (FDA)","year":"2020"},{"key":"2024082121410356200_R12","article-title":"Acetaminophen Toxicity: Practice Essentials, Background, Pathophysiology","author":"Farrell,","year":"2023"},{"key":"2024082121410356200_R13","article-title":"Index of \/ftp1\/Pediatric_Terminologies\/NICHD","author":"National Institute of Child Health & Human Development (NICHD)"},{"key":"2024082121410356200_R14","article-title":"Adverse Drug Events in Children | Medication Safety Program","author":"Centers for Disease Control (CDC)","year":"2023"},{"key":"2024082121410356200_R15","doi-asserted-by":"crossref","first-page":"1464","DOI":"10.1542\/peds.2008-0854","article-title":"Parental misinterpretations of over-the-counter pediatric cough and cold medication labels","volume":"123","author":"Lokker","year":"2009","journal-title":"Pediatrics"},{"key":"2024082121410356200_R16","article-title":"Poison Statistics. National Data","author":"Poison Control. National Capital Poison Center"},{"key":"2024082121410356200_R17","doi-asserted-by":"crossref","first-page":"xiii","DOI":"10.1016\/j.psc.2008.03.001","article-title":"Suicidal behavior: a developmental perspective","volume":"31","author":"Oquendo","year":"2008","journal-title":"The Psychiatric Clinics of North America"},{"key":"2024082121410356200_R18","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1177\/875512251302900204","article-title":"Dextromethorphan abuse: a literature review","volume":"29","author":"Gershman","year":"2013","journal-title":"Journal of Pharmacy Technology"},{"key":"2024082121410356200_R19","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1097\/ADM.0000000000000104","article-title":"Mania after misuse of dextromethorphan: a case report and brief review of \u2018robotripping\u2019","volume":"9","author":"Stanciu","year":"2015","journal-title":"Journal of Addiction Medicine"},{"key":"2024082121410356200_R20","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1097\/01.NME.0000546250.46289.48","article-title":"Teen issues, part two: trends in alcohol and substance use","volume":"16","author":"Espelin","year":"2018","journal-title":"Nursing Made Incredibly Easy"},{"key":"2024082121410356200_R21","article-title":"Dangers of the TikTok Benadryl Challenge","author":"Minhaj","year":"2021"},{"key":"2024082121410356200_R22","article-title":"Dangerous TikTok Trends Inciting Teen Substance Use","author":"Turnbridge","year":"2021"},{"key":"2024082121410356200_R23","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0204443","article-title":"Is there such a thing as a \u2018lope\u2019 dope? analysis of loperamide-related European Medicines Agency (EMA) pharmacovigilance database reports","volume":"13","author":"Schifano","year":"2018","journal-title":"PLOS ONE"}],"container-title":["Journal of Analytical Toxicology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jat\/advance-article-pdf\/doi\/10.1093\/jat\/bkae042\/58341180\/bkae042.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jat\/article-pdf\/48\/7\/473\/58875970\/bkae042.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jat\/article-pdf\/48\/7\/473\/58875970\/bkae042.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T01:58:14Z","timestamp":1724291894000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jat\/article\/48\/7\/473\/7678880"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,21]]},"references-count":23,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,5,21]]},"published-print":{"date-parts":[[2024,8,21]]}},"URL":"https:\/\/doi.org\/10.1093\/jat\/bkae042","relation":{},"ISSN":["0146-4760","1945-2403"],"issn-type":[{"value":"0146-4760","type":"print"},{"value":"1945-2403","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,9]]},"published":{"date-parts":[[2024,5,21]]}}}