Republished: Unintentional overdose of hyoscine hydrobromide in a young child.

In conjunction with BMJ Case Reports , DTB will feature occasional drug-related cases that are likely to be of interest to readers. These will include cases that involve recently marketed drugs for which there is limited knowledge of adverse effects and cases that highlight unusual reactions to drugs that have been marketed for several years. A 4-year-old girl presented with confusion, ataxia and hallucinations 3 hours after an accidental overdose of 108 μg per kg of hyoscine hydrobromide (Kwells Kids). She was hypotensive and tachycardic at presentation. Investigations revealed QTc prolongation on ECG. The girl was admitted for observation overnight and was noted to have persistent visual and auditory hallucinations, which resolved without treatment. To our knowledge, this is the first reported case of an overdose of hyoscine hydrobromide at such a young age. Clinicians should be aware that unintentional ingestions in this age group may present with psychiatric manifestations. Hyoscine hydrobromide is easily accessible and available over the counter. It has serious consequences in overdose. Its packaging and appearance are attractive to young children making it susceptible to unintentional ingestions. We argue that its container should be altered to be more childproof. Early diagnosis and management of medication overdose is crucial to provide high-quality care to our patients. Hyoscine hydrobromide poisoning is a rare but important clinical problem involving accidental or intentional overdose in the paediatric population. Hyoscine hydrobromide is readily available in the community as an over-the-counter medication for nausea and vomiting. Overdose of this anticholinergic medication can lead to toxicity including disorientation, agitation, visual and auditory hallucinations, tachycardia, arrhythmias including QTc prolongation, visual disturbances and urinary retention.1 It is critical that clinicians are familiar with this toxidrome. We present a case of a 4-year-old girl who presented to the paediatric accident & emergency department (A&E) with hyperactivity …