Abstract
According to the Japan Poison Information Center (JPIC), topical skin medications represent the most common accidentally ingested over-the-counter (OTC) drugs among those aged ≥65 years. Specifically, the unintentional consumption of readily available multi-ingredient antipruritic topical agents is reportedly associated with severe reactions.
Based on a dataset from JPIC, which spans 34 years and comprises inquiries from medical establishments with verifiable outcomes, we investigated patients aged ≥60 years with a history of multi-ingredient antipruritic medication ingestion and need for subsequent hospital care. Of 18 verified cases in which patients consumed OTC topical agents containing at least two of the following products : camphor, local anesthetics, and antihistamines, 14 patients required inpatient treatment. All incidents were attributable to cognitive decline, and most such accidents occurred within residential settings or elderly care facilities. Impaired consciousness was observed in ＞90％ of these patients ; the Glasgow Coma Scale score was ≤8 in eight patients. Notably, one patient experienced pre-hospital cardiopulmonary arrest, one patient developed respiratory arrest, and two had convulsions ; overall, nine patients required respiratory support. Compared with single-agent products, combination drugs demonstrated a higher potential for severe outcomes, even when ingested in small quantities. Our findings underscore the urgent need for preventive strategies against the accidental consumption of OTC antipruritic topical agents among elderly patients, to avoid the potentially life-threatening risks associated with such unintentional ingestion.
