Hyoscine ingestion

I had the best on call last Saturday. There was no admissions after 12 midnight! And I got to sleep the whole night, the longest sleep I've ever had during on call, almost 5 hours! I was all fresh the next day, I didn't have the post-call eye bags.

What's interesting about my call was one case, a little boy ingested his grandmother's anti-psychotic drugs. Poor boy. He was only 3 years old. What happened was that he ate a few pills that was in his grandmother's medicine box, you know the ones where you keep according to the days. So there were about 10 pills in there. After he ate them, he pointed his mouth to his mother and it was then that they realize the medicine box had been opened. That's the thing about children, you have to be extra careful when they are around, you have to think ahead of them because at that age, they are very curious about many things and always wanting to try out new things. So on the way to the ED (emergency department), he was drowsy and fell into a very deep sleep. When we encounter cases like this, as in ingestion of poison/drugs, we need to call the Pusat Racun Negara. So I called them up and asked about the side effects (long-term and short-term) of each drug, so that I know what to look out for during our observation. Sadly, all the pills in the medicine box had no antidote. But stomach wash was done and so far, he was stable, except for the fact that his BP was relatively high for his age. After discussing with the officer in Pusat Racun Negara, I came up with a conclusion that he swallowed hyoscine and the officer at agreed too because the hyoscine pill is small and sweet, as it's sugar-coated, so it made more sense why the boy didn't spit out the pill.

He fell into a very deep sleep, he even peed, which normally, he is dry by day. I felt sorry looking at the parents, they were so anxious. The next day, he woke up and was back to himself! I had to prick him the next day because I needed to measure the drug level in his body and check his liver and renal function.. after the blood taking session, he was well and fully alert... who wouldn't be alert after someone pokes a needle, right?

It was a very interesting case because I got to know about the drugs in detail. Lesson learnt... always be careful and store medications away from children!