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The effect of the introduction of safety packaging for carbamazepine on toxicity in overdose in adults
Author(s) -
Buckley N. A.,
Newby D. A.,
Dawson A. H.,
Whyte I. M.
Publication year - 1995
Publication title -
pharmacoepidemiology and drug safety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.023
H-Index - 96
eISSN - 1099-1557
pISSN - 1053-8569
DOI - 10.1002/pds.2630040606
Subject(s) - carbamazepine , medicine , drug overdose , sedation , emergency medicine , anesthesia , poison control , epilepsy , psychiatry
Background — Safety packaging has been shown to be effective in preventing childhood poisoning; however similar data for adults is lacking. In February 1993 the Australian packaging for carbamazepine was changed from bottles of tablets to blister packs. Objective — To assess whether there has been a change in the amount of carbamazepine taken per overdose or the severity of poisoning coinciding with this change. Design — Comparison of cohorts of patients presenting before and after repackaging. Setting — Newcastle, Australia. Subjects — Sixty‐seven patients who ingested carbamazepine and presented to a general hospital which serves a well‐defined geographic area. Main outcome measures — Number of tablets and total dose ingested, peak carbamazepine level, degree of sedation, need for intubation and the time in hospital and ventilated. Results — Significantly fewer tablets and a lesser amount was ingested by patients presenting after the repackaging. Though clinical measures were improved slightly after repackaging the differences did not reach statistical significance. Conclusions — Repackaging resulted in less carbamazepine reported to have been ingested in overdose. Clinical measures did not reflect the extent of this change. This may be due to effects of treatment or coingested drugs obscuring any difference or the reported differences may be due to a reporting bias associated with packaging. Repackaging is a promising means of reducing the severity of deliberate self poisoning but further study, including out of hospital mortality data, is required.