Salicylate toxicity associated with administration of Percy Medicine in an infant

Teresa V. Lewis, Randal Badillo, Scott Schaeffer, Tracy Hagemann, Lee McGoodwin

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Percy Medicine is a nonprescription gastrointestinal suspension containing bismuth subsalicylate as the active ingredient (1050 mg/10-ml dose). A 3-month-old infant with colic developed salicylate toxicity requiring hospitalization in the pediatric intensive care unit (PICU) as a result of continued administration of this medicine. Bismuth subsalicylate has an aspirin equivalency conversion factor of 0.479 (approximately half the strength of aspirin). For 3.5 weeks the infant's parents administered the medicine, which provided the equivalent of aspirin 57-84 mg/kg/day with no reported problems. However, on the day of admission the baby presented with central nervous system depression and respiratory distress. Assessment at a local emergency facility revealed metabolic acidosis; his serum salicylate concentration was 747 mg/L. After acute management, the patient was transferred to our hospital, where he was treated with whole bowel irrigation and alkalinization therapy. Subsequently, the baby required 4 days of management in the PICU and 2 additional days of observation in a general nursing unit before he was discharged home without incident. The parents had chosen Percy Medicine based on the picture of a baby on the front of the package and because of its placement on the shelf next to a drug their family physician had recommended previously. Salicylate-containing products are not routinely recommended for children aged 1 year or younger. The general public may assume that over-the-counter products are safe because they do not require a prescription. Health care professionals must be responsible for educating the public regarding risks associated with over-the-counter products and the need to read and follow label directions.

Original languageEnglish (US)
Pages (from-to)403-409
Number of pages7
JournalPharmacotherapy
Volume26
Issue number3
DOIs
StatePublished - Mar 2006
Externally publishedYes

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Salicylates
Medicine
Aspirin
Pediatric Intensive Care Units
Parents
Colic
Family Physicians
Acidosis
Respiratory Insufficiency
Prescriptions
Suspensions
Hospitalization
Nursing
Emergencies
Central Nervous System
Observation
Delivery of Health Care
Serum
Pharmaceutical Preparations
bismuth subsalicylate

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Salicylate toxicity associated with administration of Percy Medicine in an infant. / Lewis, Teresa V.; Badillo, Randal; Schaeffer, Scott; Hagemann, Tracy; McGoodwin, Lee.

In: Pharmacotherapy, Vol. 26, No. 3, 03.2006, p. 403-409.

Research output: Contribution to journalArticle

Lewis, Teresa V. ; Badillo, Randal ; Schaeffer, Scott ; Hagemann, Tracy ; McGoodwin, Lee. / Salicylate toxicity associated with administration of Percy Medicine in an infant. In: Pharmacotherapy. 2006 ; Vol. 26, No. 3. pp. 403-409.
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