Poisonings are a significant public health concern — in 2024 alone, U.S. poison centers received over 2 million reported exposures.
Listen in as our expert panel of toxicologists and poison-center specialists discusses common questions and best practices about poisoning treatment, from when to call the poison center versus head to the emergency department, to which everyday medications belong on the “one pill can kill” list for kids. They’ll also take a close look at acetaminophen poisoning — one of the most common reported and treatable exposures — including how the antidote N-acetylcysteine (NAC) works. Plus, you’ll walk away with practical takeaways on which antidotes to keep in stock and how to counsel patients on safe medication storage and disposal.
This podcast is an excerpt from one of TRC’s monthly live CE webinars, the full webinar originally aired in August 2026.
🏷️ Use code mt1026b at checkout for 10% off a new or upgraded subscription.
Special guests:
- Anita C. Ma, PharmD
- Managing Director – San Francisco Division, California Poison Control System
- Assistant Clinical Professor of Pharmacy, University of California, San Francisco
- Amber Patt, PharmD
- Toxicology & Addiction Medicine Clinical Pharmacy Specialist
- University of Rochester Medical Center, Strong Memorial Hospital, Rochester, NY
You’ll also hear practical advice from panelists on TRC’s Editorial Advisory Board:
- Craig D. Williams, PharmD, FNLA, BCPS
- Clinical Professor of Pharmacy Practice
- Oregon Health and Science University
CE Information:
None of the speakers have anything to disclose.
TRC Healthcare offers CE credit for this podcast. Log in to your Pharmacist’s Letter, Pharmacy Technician’s Letter, or Prescriber Insights account and look for the title of this podcast in the list of available CE courses.
The clinical resources related to this podcast are part of a subscription to Pharmacist’s Letter, Pharmacy Technician’s Letter, and Prescriber Insights:
- Chart: Drugs for Selected Medication Overdoses and Poisonings
- FAQ: Meds for Opioid Overdose
- Quick Start Guide: Opioid Reversal Agents
Email us: [email protected].
The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
Medication Talk is a production of TRC Healthcare.
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Transcript:
This transcript is automatically generated.
00:00:07 Amber Patt
One pill can kill, but how often do we know for sure that kiddo just had one pill or just had like one mouthful of this substance? And that’s what I always keep in the back of my mind. So sure, the kid might come in and the parent says, oh, I think they got into one aspirin. But kids, you turn your back, they get into everything. And how can you really be sure it’s just one? And so that’s kind of where I like to err on the side of caution with these things.
00:00:35 Anita C. Ma
The simple message for families would be to keep it locked, keep it labeled, dispose things properly, and know who to call.
00:00:47 Narrator
Welcome to Medication Talk, an official podcast of TRC Healthcare. Home of pharmacist letter, prescriber insights, and the most trusted clinical resources.
00:00:55 Narrator
On this episode, our expert panel discusses common questions and best practices about poisoning treatment, including when to call the poison center versus head to the emergency department, and which everyday medications land on the one pill can kill list for kids. They’ll also take a close look at acetaminophen poisoning, one of the most common reported and treatable exposures, including how the antidote N-acetylcysteine works.
00:01:21 Narrator
Plus, you’ll get practical takeaways on which antidotes to keep in stock and how to counsel patients on safe medication storage and disposal. Our guests today are two toxicology-focused clinical pharmacists. Dr. Anita Ma, Managing Director of the San Francisco Division of the California Poison Control System, and Dr. Amber Patt, Toxicology and Addiction Medicine Clinical Pharmacy Specialist at the University of Rochester Medical Center’s Strong Memorial Hospital.
00:01:50 Narrator
You’ll also hear practical advice from a panelist on TRC’s editorial advisory board, Dr. Craig Williams from the Oregon Health and Science University. This podcast is an excerpt from one of TRC’s monthly live CE webinars. Each month, experts and frontline providers discuss and debate challenges in practice, evidence-based practice recommendations, and other topics relevant to our subscribers.
00:02:15 CE Narrator
And now, the CE information.
00:02:19 Narrator
This podcast offers continuing education credit for pharmacists, pharmacy technicians, physicians, and nurses. Please log in to your pharmacist letter, pharmacy technician’s letter, or prescriber insights account and look for the title of this podcast in the list of available CE courses. None of the speakers have anything to disclose. Now, let’s join TRC editor and clinical pharmacist, Dr. Steve Small, and start our discussion.
00:02:46 Steve Small
Anita, when should we tell patients to call the poison center versus telling them to go to the emergency department. I’m sure community pharmacists maybe encounter this once in a while. Any advice you can give there?
00:02:58 Anita C. Ma
I think that there is a common misconception that people need to decide on their own whether an exposure is serious enough to go to the emergency department. And I would say call the poison early. That’s what we’re here for. Many exposures can be safely managed at home with just observation and specific instructions. So calling us may help avoid an unnecessary ED visit. Obviously, if someone is unconscious, having a seizure, any like airway, breathing, circulation issues, that’s an emergency and they should call 911 immediately. And I would say one other thing would be don’t wait for symptoms to develop before calling the poison center. Some poisonings are initially may not have any symptoms, you might be asymptomatic, and some treatment and monitoring decisions are time sensitive. So takeaway point for me would be if the patient’s unstable, you would want to call 911. Otherwise, if you’re really unsure about a potential poisoning, I would call the poison center. And we’re available 24-7, and we can help determine whether that person can safely stay at home or needs to be evaluated in the emergency department.
00:04:12 Amber Patt
The other thing that I would add to it too, and this is maybe a little bit off topic in a sense, but if you ever suspect that a patient is struggling with like suicidal ideation or that maybe the overdose or exposure was an attempt to hurt themselves, that patient should definitely go to the emergency room.
00:04:31 Anita C. Ma
That’s a very good addition. Yeah.
00:04:34 Steve Small
Great. And maybe Amber, from your perspective, let’s say we have a patient who’s already admitted to the hospital for a poisoning case.
00:04:42 Steve Small
When should perhaps the medical resident consider calling the poison center versus maybe a different option?
00:04:51 Amber Patt
Ultimately, they should call the poison center whenever they have a question about managing a poisoned patient.
00:04:58 Amber Patt
The emergency medicine residents get some training when it comes to toxicology and managing overdoses. I’ll say here at our institution, because we are on site as toxicologists, we do a lot of that training up front, but most institutions don’t have tox on site. And so a lot of these residents are kind of left with the very basics and training. So like Anita said, the Poison Center is always available 24-7, 365. You can call them and they’ll direct that resident to an on-call medical or clinical toxicologist who will literally walk them through everything step by step, help them with dosing, help them with antidotes and just managing the patient overall. So whenever they’re feeling like they have any questions at all or unsure on how to manage, call the Poison Center.
00:05:47 Steve Small
This is also a good time to share that poisonhelp.org can be an online resource to help answer questions in real time with an expert about poisoning management, including these questions about triage. It’s free, confidential and run by America’s Poison Centers, which partners with CDC, FDA and the Health Resources and Services Administration. Which medications are most dangerous if accidentally ingested by a child, for instance? Are there any substances that heighten your worry when those calls come in?
00:06:23 Anita C. Ma
That’s a really good question. Fortunately, I would say that most accidental pediatric ingestions are low risk and can be managed safely at home after consultation with the poison center. But there are a number of medications and substances where one pill or a very small amount can cause severe toxicity in a smaller child, including clonidine, alpha-adrenergic agonists, beta blockers, calcium channel blockers, opioids, sulfonylureas, and tricyclic antidepressants. We sometimes refer to this as the one pill can kill list, and this is not an all-inclusive list. There are potentially very dangerous exposures, including certain antiarrhythmics, such as flecainide, some antipsychotics, chloroquine, iron, theophylline, diphenoxylate with atropine, even oil of wintergreen. And then included in the list here is button batteries, which is not a prescription medications. We think about camphor, caustics, hydrocarbons, and even some toxic alcohols and certain car products can be very dangerous in young children. So if there is a child who had a potentially serious ingestion, they can look initially well, look well appearing, and I wouldn’t say the absence of symptoms is reassurance, and I wouldn’t necessarily wait for symptoms to develop. So if there is a possible ingestion of one of these substances or the caretaker doesn’t really know how much the child got into or what they got into, I would call the poison center right away and we can help assess for that specific substance, formulation, concentration, a possible dose. We might get a patient’s wait just to help determine what needs to happen next.
00:08:27 Craig D. Williams
Steve, can I ask, I’m just curious, there’s a couple of pretty common medicines on here. I wouldn’t expect to be on a one pill can kill list, so just anticipating listeners listening. I wouldn’t think one pill of aspirin be potentially fatal for a child? Same with like metoprolol, but do Amber, Anita have any insight into how that can be fatal for a kid, a single dose?
00:08:48 Amber Patt
I think, you know, in terms of the one pill of aspirin, we don’t really see it being a fatal dose, but to Anita’s point, the oil of wintergreen, absolutely. Now, aspirin can be incredibly toxic. It’s, you know, one of the overdoses that I enjoy managing from a pharmacology and a toxicology perspective, but it’s awful for the patient and it’s very, very dangerous. And so I think the big point here and the thing that I think of is one pill can kill, but how often do we know for sure that kiddo just had one pill or just had like one mouthful of this substance? And that’s what I always keep in the back of my mind. So sure, the kid might come in and the parent says, oh, I think they got into one aspirin. But kids, you turn your back, they get into everything. And how can you really be sure it’s just one?
00:09:36 Amber Patt
And so that’s kind of where I like to err on the side of caution with these things.
00:09:42 Steve Small
And then now that we have the patient with us, what antidotes should pharmacies, whether it’s the hospital or community, what should they carry in stock? And from your experience, what antidotes are often missing? Amber, do you want to start us off with that one?
00:09:58 Amber Patt
Sure. So from a community perspective, I was thinking long and hard about this question and really what I think the community setting should carry is naloxone, right? Intranasal naloxone, if you have a patient there that, or you see someone in a potential opioid overdose scenario, that is the antidote to use. I don’t necessarily see utility in community pharmacies carrying other antidotes because to be realistic, that would be occurring at the hospital setting. And when it comes to inpatients, I think it really just depends on the facility themselves. If they’re a small institution versus a large institution, the smaller institutions generally will have capabilities to transfer patients, well, in theory, to larger institutions in hopes of getting specific antidotes. But I would, you know, I’m actually going to do a shout out and a plug to my colleague at the Upstate New York Poison Center, Gina Maraffa. She did a paper, I believe it was in 2012 with colleagues that was the antidotes for toxicological emergencies, a practical review. And they highlight what inpatient pharmacies at the very least should carry. And it’s really like, is it emergent or time sensitive, right? So these emergent meds would be naloxone, any kind of prothrombin complexes or anti-coag reversals.
00:11:26 Amber Patt
Cyanokit or hydroxycobalamin. And that’s interesting because it’s really for cyanide toxicity and people saying, oh, cyanide, that’s not very common. But you know what’s common is cyanide exposures and house fires. And that’s really where we see the utility of Cyanokit in the emergency department if criteria are met.
00:11:45 Amber Patt
And then time-sensitive things like N-acetylcysteine for acetaminophen overdose because it’s 100% effective if given within 8 hours. DigiFab for digoxin toxicity and fomepizole for toxic alcohol exposure. Those are the things that come to my mind that are important to carry.
00:12:04 Craig D. Williams
There are a couple nice publications out there for hospital pharmacies thinking about what do we need to have, some of the things you have anyway. So IV calcium can be a partial antidote for calcium channel blocker overdoses. So some of the things are gonna be in any reasonably sized hospital pharmacy anyway, but there are a couple nice publications with lists of things that wouldn’t necessarily come to mind. But yeah, Amber hit on some major ones.
00:12:30 Amber Patt
I think another important thing too is understanding where to get these antidotes. So if you’re like me and you’re a clinical pharmacist in a hospital setting, regardless if you’re the toxicologist or whatever, it’s knowing where to get these antidotes. So I have a whole spreadsheet of, these are the antidotes that we don’t necessarily carry or not on formulary, but in a pinch, where can I get these things? And that’s usually like, and things that are a little bit more unique exposures. But some of these things have to come directly from like the CDC or, from REAC/TS, which is the radiation specialist. And so it can be a little nuanced. And so knowing where to get those is important.
00:13:14 Steve Small
And to help you sort through antidote options, get our Drugs for Selected Medication Overdoses and Poisonings resource. It lists antidotes, what they treat, adult dosing options, and other considerations.
00:13:29 Steve Small
Now that we have a good foundation here on how to initially approach poisonings, let’s dig deeper into treatments. For example, questions about charcoal come up often in practice. So Amber, how does oral charcoal work to treat poisonings when it is used appropriately in the setting of a hospital with poison center consultation?
00:13:52 Amber Patt
So activated charcoal is generally produced in a two-step process where you take carbon material, wood, peat, coconut, et cetera, and you heat it up to like, I don’t know, 600, 800 degrees Celsius, and you use an oxidizing agent, something like carbon dioxide or an acid.
00:14:11 Amber Patt
And what that does is it forms these teeny tiny microscopic pores. And when these pores in the form of activated charcoal come into contact with a specific xenobiotic, as we say, which just means a foreign material or something foreign to the body, so that can be medications or substances, whatever, a foreign xenobiotic, they do something called adsorb to the charcoal. And what that means is that the activated charcoal is relying on, I’m gonna throw us all back to our chemistry days, these van der Waals forces to essentially get the xenobiotic to stick to it and form this activated charcoal xenobiotic complex. And then that can be eliminated. What’s really important is that activated charcoal is not absorbed with a B. It’s not actually going into systemic circulation. It’s adsorbed with a D as in dog. So that’s an important distinction. So the xenobiotic has to be present in the gut to even have an effect.
00:15:13 Steve Small
And it sounds like a fantastic tool, but what is then the best time frame to give charcoal based on that?
00:15:19 Amber Patt
So the board’s answer to this question, if you’re a pharmacist or a medical resident or what have you, is the best time to give charcoal is within an hour from exposure. But from a toxicologist perspective, we can kind of manipulate that a little bit. The data that is really exemplified with that hour is taken from healthy patients that ingested subtherapeutic doses of acetaminophen. And they found kinetically that the absorption occurs within an hour or so. And these are not the patients that we’re seeing on our tox service or at the poison centers or clinically.
00:15:58 Amber Patt
And there’s a big difference between pharmacokinetics and toxicokinetics. So it’s really important as toxicologists and pharmacists to keep that in mind when making a decision on whether or not to administer activated charcoal.
00:16:11 Amber Patt
And since most of our tox data is retrospective in nature, we don’t have the most robust evidence to support its use. And so every practitioner or toxicologist is going to have a differing opinion when it comes to charcoal. But my thought process in general is if there’s no contraindications, which we’ll probably talk about that later. There is a believable gut burden, meaning you think that there’s still some kind of xenobiotic in the gut. It can still be used as long as it’ll stick to charcoal and all of that. It really just depends on the gut motility and the kinetics.
00:16:46 Amber Patt
And so things like extended release or delayed release capsules, things that undergo enterohepatic recirculation, we usually have like a four to six hour time frame for ingestion. And there’s even certain mushrooms like Amanita phalloides that can be used for up to 36 hours with a technique called multi-dose activated charcoal.
00:17:05 Steve Small
And Anita, when should we not use charcoal?
00:17:10 Anita C. Ma
I think that there’s about, I think there’s going to be 3 situations in which I wouldn’t use activated charcoal. The first would be if the drug or the toxin or the xenobiotic are poorly absorbed by charcoal, such as like liquids, alcohols, corrosives, ions, metals, such as like iron, lithium, hydrocarbons.
00:17:38 Anita C. Ma
Second is if there is a risk of choking when the airway isn’t protected. If the patient’s significantly sedated, unable to protect their airway, I wouldn’t give charcoal. And the third one would be GI contraindications such as ileus, intestinal obstruction, maybe risk of GI perforation. Those are my initial thoughts.
00:18:05 Amber Patt
Yeah, I second that, Anita. We actually use a mnemonic, and Anita was kind of describing it. We call it PHAILES, P-H-A-I-L-E-S. And these are the things that do not adsorb to charcoal or we don’t recommend using charcoal. So P for pesticides, H for hydrocarbons, A for alcohols and acids.
00:18:25 Amber Patt
I for iron and other metals, L for lithium, E for electrolytes, and S for solvents. That’s not a comprehensive list, but it’s kind of a fun mnemonic and way to remember things that charcoal just isn’t going to work for. And then there’s things too like caustics, right? So if a little kid gets into a caustic, like something that’s very alkaline or acidic, most of the time, GI is going to have to go in and scope that patient. They need to be able to take a camera to see. And if the patient has charcoal, which is incredibly messy and stains and it’s very, very black, they’re not going to be able to see anything. And so in any situation where we think that GI is going to have to scope the patient, we’re not going to give them charcoal.
00:19:06 Amber Patt
But I think the, like Anita said, the most important thing when you’re thinking about giving charcoal is, that patient’s airway protected? If there’s any risk that their airway is not protected or there could be a risk of aspiration, that’s a problem because oftentimes the aspiration itself might be worse than the poison or the toxin. And so it’s really weighing the risk versus benefit, right? And we also want to make sure that we’re not giving charcoal to something that’s a benign ingestion or something, like they had a couple melatonin, right? We want to make sure that it’s something that is life-threatening or dangerous to the patient. There’s not an antidote for, there’s no contraindications because charcoal itself is not a benign therapy. And patients have died from getting it the wrong way and aspirating.
00:19:58 Steve Small
And now with knowing where charcoal fits, we wanted to get into some common toxidromes that folks may be encountering in practice or they’ve heard about and acetaminophen comes top of mind. What happens during acetaminophen poisoning and how does N-acetylcysteine or NAC work as an antidote here?
00:20:15 Amber Patt
Yeah, I’ll try not to get too nerdy here, Steve, but I feel like everyone on this presentation would appreciate it. So I’ll just go ahead and go for it. So before we talk about acetaminophen or Tylenol poisoning, I think it’s important to discuss the metabolism in terms of therapeutic doses, right? So when you take, for example, a 500 milligram tablet of Tylenol or acetaminophen, there are three pathways that it follows. The first pathway is where about 90% of that acetaminophen gets glucuronated and sulfated into more polar compounds, and it just makes it easier to excrete it or pee it out. 5% is renally eliminated unchanged, and then 5%, another 5% is metabolized by an enzyme called CYP2E1, where it becomes something called NAPQI. NAPQI stands for N-acetyl-p-benzoquinone amine. Say that 10 times fast, right?
00:21:14 Amber Patt
And so a lot of our listeners might be saying, hey, I recognize NAPQI. That’s bad. That’s a toxic metabolite. And you’re right, it is. It’s a free radical. But in those therapeutic doses, that 5% of NAPQI generation, our bodies can essentially detox it with glutathione. Glutathione is an antioxidant. And so that 5% NAPQI isn’t problematic.
00:21:39 Amber Patt
So now let’s look at it from the context of an overdose, right? So let’s say instead of a 500 milligram tablet, somebody takes a handful of 500 milligram tablets. Those pathways are going to change a little bit. So 5% of it is still going to be renally eliminated, unchanged, and you’re just going to pee it out. But here’s the difference. In an overdose setting, you’re going to oversaturate that first pathway. So instead of having 90% of that acetaminophen glucuronated and sulfated, only about 70 to 75% is. So what does that mean? That means now that 25% has been shifted to become NAPQI.
00:22:21 Amber Patt
Our bodies can’t detox 25% of NAPQI and that’s where the problem is. We just don’t have enough glutathione supply. So without getting too in the weeds, what happens is NAPQI is going to bind to those hepatocytes. There’s going to be a cascade of events that occur that alter mitochondrial function and results essentially in hepatocellular death. And that’s where we see the liver toxicity come into play.
00:22:43 Steve Small
And it’s important to note here that acetaminifen overdoses are serious and can be deadly. Symptoms can be vague at first, such as nausea and vomiting or abdominal pain. And the sequence of organ damage with this poisoning can take days.
00:22:58 Amber Patt
To answer the second question about how does NAC work, N-acetyl cysteine, It’s going to do a couple things, but essentially it’s rapidly detoxifying that NAPQI. So you can think of it as NAC itself is a glutathione precursor. So it’s going to help shift that pathway back towards the glucuronidation and sulfation instead of having that acetaminophen being metabolized by CYP2E1. And it also is a free radical scavenger through its antioxidant effects.
00:23:28 Amber Patt
And what’s really cool about this is NAC is 100% effective if you give it within 8 hours of ingestion.
00:23:35 Steve Small
Excellent. Thank you for that review there. And Anita, when do you recommend using oral versus intravenous NAC? Because I know many pharmacies probably carry both in their hospital.
00:23:47 Anita C. Ma
I would say the more so we give IV NAC, but oral NAC I think is reasonable on a patient who is awake, alert, able to protect their airway and able to tolerate oral medications. I’ve tasted it before, I’ve smelled it before, and it just is really hard for people to tolerate it.
00:24:11 Amber Patt
Yeah, I agree. The only time that I’m going to recommend oral NAC is if we can’t get IV access for some reason, or if we want to use oral as an adjunct to IV, because you’re totally right. Oral NAC tastes and smells horrible to the order where if I’m recommending it, I’m making sure that I’m telling the provider to let the nurse know, hey, you need to do a couple things. You need to A, mix this outside of the room, because if your patient smells it, they’re not going to drink it. You want to put it on.
00:24:41 Amber Patt
You want to mix it with some kind of soda or juice and then put a lid on it because this stuff stinks. So yeah, I totally agree with you. I use it as an adjunct or if I can’t get access. IV is always my go-to.
00:24:59 Steve Small
I love those practical tips. And I’m sure some hospital pharmacists may be familiar with different regimens for IV NAC, multiple bags, some being 2 bags versus 3 bags. Amber, can you discuss whether is the two bag NAC system better than the classic 3 bag regimen?
00:25:23 Amber Patt
Yeah, sure, So for a long time, most hospitals did the three bag regimen, but recently the FDA did approve the two bag regimen.
00:25:32 Amber Patt
And I believe it was a 2023 systematic review of Cole and colleagues, they looked at the safety and the efficacy of this two-bag NAC regimen. And what they found was in terms of liver injury, that it had similar outcomes as the three-bag method, but the two-bag method was associated with fewer adverse effects, fewer treatments, and fewer interruptions.
00:25:57 Amber Patt
So my takeaway, admittedly, our service and our hospital uses the three bag regimen. I think it really depends on the facility and what they’re most comfortable with. I think, say a facility wanted to switch over to the two bag regimen, that’s all good and fine, but there’s always a learning curve. You have to change protocols, you have to change the way that the orders are entered, provider education, nursing education, all of that.
00:26:25 Craig D. Williams
It speaks to the point that there shouldn’t be one fixed regimen. So it’s not like everyone has the one. No one’s figured out the one magical antidote. So the medicine works. You have to get quite a bit in pretty quick. And you might not be done with these doses. I mean, you have to see what the patient says.
00:26:41 Steve Small
And then going back, Anita, when should NAC be discontinued? I’m sure not everybody just stops at two or three bags, right?
00:26:49 Anita C. Ma
I don’t think that there is a minimum duration.
00:26:52 Anita C. Ma
The California Poison Control System has cessation parameters, so our parameters are Tylenol level less than 10, and then AST, ALT, normal and not rising. The LFTs are elevated or rising, both the AST and the ALT need to downtrend times 2 consecutive measurements or 25% from that peak. And measurements of synthetic function like INR, T-billy improving, and a Tylenol that’s undetectable less than 10.
00:27:27 Steve Small
And what can pharmacists do to help coordinate that discontinuation? Because I’m sure there can be miscommunication, assumptions at all, we’re going to stop the regimen. Is there anything you’ve seen work well in hospital pharmacies to make sure that NAC is stopped at the right time and there isn’t pause in therapy?
00:27:45 Anita C. Ma
Usually we’ll provide our phone number. So nursing staff or physicians will call about one, two hours prior to completion of that current bag and touch base with us to see if any additional NAC should be given. So I would just have open communication with nursing staff, the physicians, and just have them either follow up with us or we’ll call back at a later time.
00:28:11 Craig D. Williams
It might be easier at a smaller hospital for one clinician to kind of own that and to understand those labs. But I think the huge thing is this is not a, you don’t give NAC and you’re done. So we like the analogy of insulin for diabetic ketoacidosis. We’re never sure when we’re done that. You got to monitor the patient, check labs and everybody’s individual. But yes, someone has to own that follow-up at the right time and make a decision.
00:28:33 Steve Small
Definitely not a set it and forget it approach, and we can definitely emphasize that.
00:28:39 Steve Small
Let’s switch gears here and talk about how to prevent poisonings in the 1st place, since we can all play a role. I want to ask you, Anita, because you brought it up earlier, what are good counseling tips to give patients to prevent these types of poisonings? Are there any best practices for safe storage we should be recommending?
00:28:56 Anita C. Ma
For children, I think the biggest thing is really limiting access. Medications and other potentially poisonous substances should be stored out of reach, ideally in a lock cabinet. I also recommend keeping medications in their original label containers. And I always remind families that child-resistant packaging does not mean that a child can’t get into it.
00:29:23 Anita C. Ma
So we still need to think carefully about where the medications are stored, because a lot of the times, families will call and say, hey, this bottle was supposed to be child-resistant, child-proof. We have to advise them that it is child-resistant, not child-proof. Another important area is proper disposal, especially things like medication patches, syringes.
00:29:47 Anita C. Ma
Some of these patches that may be taken off can still contain some medication, even if they’ve been used. So we don’t want those becoming an accidental exposure. And finally, keeping the poison center number readily available is important. Prevention is obviously the goal, but if an exposure does occur, call early rather than waiting for symptoms to develop is ideal. So the simple message for families would be to keep it locked, keep it labeled, dispose things properly and know who to call.
00:30:22 Amber Patt
I was just going to say another thing that I would just mention, because I see it all the time. This goes out to our community pharmacists, pharmacy techs, you know, providers in the outpatient setting, methotrexate, especially in the elderly population. Please, please counsel those patients that it’s like usually for rheumatoid, is it rheumatoid arthritis or whenever it’s supposed to be taken once a week, not every day. And I feel so badly for the elderly patients who get confused, but it’s so important just to take the time with them to make sure they really understand. And Anita, you’re right there with me. You get it.
00:31:01 Amber Patt
Yeah, I think it’s really just from a pharmacist perspective and techs and just recognizing those patients and the pharmacist taking a little bit of extra time with them and making sure they’re speaking loudly and having the patient repeat back to them and just, it’s one of those medications like Anita said that we see pretty frequently, and it’s always an error in the patient didn’t realize it’s not supposed to be every day. So it’s easily prevented if we can really hone in on these patients and just make sure that they understand to the best of their ability.
00:31:39 Narrator
We hope you enjoyed and gained practical insights from listening to this discussion. Now that you’ve listened, pharmacists, pharmacy technicians, physicians, and nurses can receive CE credit.
00:31:50 Narrator
Just log into your pharmacist letter, pharmacy technician’s letter, or Prescriber Insights account and look for the title of this podcast in the list of available CE courses. On those websites, you’ll also be able to access and print out additional materials on this topic, like charts and other quick reference tools. If you’re not yet a pharmacist letter, pharmacy technician’s letter, or Prescriber Insights subscriber, now’s the time. Sign up today to stay ahead with trusted, unbiased insights and continuing education.
00:32:19 Narrator
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00:32:49 Narrator
Thanks for listening to Medication Talk.
Medication Talk
