Medications which can Kill a toddler with one tablet or teaspoonful

To identify medicinal preparations which can be fatal to a toddler upon ingestion of one standard dose unit, four major texts in medical toxicology were reviewed for reported cases of fatal poisoning in small children as well as for fatal doses in adults when no fatalities were reported in children. Using the Physicians Desk Reference, the largest dose unit commercially available for various drugs was identified. Subsequently, the number of dose units that have to be ingested by a toddler to cause fatality was calculated. To compare these data to the clinical reality, the annual reports by the American Association of Poison Control Centers National Collection System were reviewed between 1983-1989. Very few drugs are fatal for a 10 kg toddler upon ingestion of one commercially available dose unit. These include camphor, chloroquine, tricyclics, phenothiazines, quinine, methyl salicylate and theophylline. This short list of drugs was responsible for almost half (42% of fatal cases following acute ingestion in young children (≤ 2 yrs) in the US between 1983-1989. Labelling of these drugs in a unique way may help decrease the number of serious and potentially fatal toxicities in small children.