Metamizol Sodic - Milliliters or Drops ?

Background: Accidental poisoning with metamizol sodic, by confounding the number of drops with the number of milliliters are going to become an important problem of admission in our emergency department.

Objectives: The aim of this study was to describe signs and symptoms of the intoxication, the evolution, the treatment and to established some measures to avoid these situations.

Material and Methods: A retrospective study was performed. The study group includes 12 children admitted in the emergency room due to January 2017 until December 2018.

Results and Discussions: In the study group, age between 7 months and 8 years, the children received a number of milliliters of metamizol sodic equal with the number of drops necessary. Time between ingestion and the admission in the emergency room varied between a few minutes (when the parents took note the incident), until 72 hours. The maximum dose was 15 grams. The symptomatology was severe (seizures, sleepiness) in 3 cases, moderate (vomiting, nausea, abdominal pain, purpura) in 6 cases, 3 cases were asymptomatics. Laboratory investigations revealed leucopenia in 5 cases, trombocitopenia-1, hepatocytolisis - 3, modifications of renal function tests- 3, and in 3 were cases normal. The treatment consisted in gastric lavage- 4 cases, forced diuresis, hepatoprotectives, corticosteroid therapy - 3 cases. The outcome was favorable in all the cases, 3 children developed cutaneous rash and 2 bronchospasm after few days.

Conclusion: Be careful with metamizol sodic dosage!