Some Drugs Manifesting Differing Toxicity in Children
Drug | Clinical Syndrome | Mechanism | Comments |
|---|---|---|---|
Cyanosis | Formation of methemoglobin (ferrous iron oxidized to ferric iron) | Incidence rare | |
Affects only neonates | |||
Respiratory depression Death | Genetic variant | ||
Diphenoxylate | Respiratory depression Death | CNS depression (in immature CNS) | Overdose syndrome, usually in children < 2 years |
Fluoroquinolones | Cartilage toxicity | Unknown | Suspected based on animal studies, but adverse effects in humans unproved—short-term use may be safe |
Seizures CNS toxicity | Probably enhanced absorption in children | Should not be used in children < 50 kg (alternative should be used) | |
Altered CNS function Extrapyramidal effects Opisthotonus Bulging fontanelles | Actions via multiple CNS receptors | Febrile and dehydrated infants especially at risk | |
Selective serotonin reuptake inhibitors | Suicidal ideation | Unknown | Increased incidence of suicidal ideation in children and adolescents |
Discoloration and pitting of tooth enamel | Chelation with calcium in growing teeth | Not given to children < 8 years | |
* See also the American Academy of Pediatrics' clinical report | |||
CNS = central nervous system. | |||