OCt 14, 2002: Which OTC products are toxic in low dose?

This is Part II of products in the home that can cause toxicity.  

Oragel Teething Ointment- One of the problems with Oragel is that parents think they can use it more frequently than recommended.  An 11-month old child recently came to the ED looking like a Smurf.  One of the ED pediatricians recognized the cause of the blueness.  The child was teething and oragel had been frequently applied to her gums.  Pulse oximetry was 83%.  Methemoglobin was 35%.  The child was not treated with methylene blue as he was asymptomatic and doing well.  The child was discharged from the ED a few hours later.  Remember high doses of this product can also cause seizures.  Benzocaine is the offending agent.
Campho-Phenique- The camphor in this product can cause seizures in very low dose.  Seizures usually occur within minutes of ingestion.  Treatment is supportive.
Ben-Gay-This product contains methylsalicylate.  Remember to check salicylate concentration.

As always, if there are any questions, call the MTPC.

I am interested in any questions that you would like answered in “Question of the Week.”  Please e-mail me with any suggestions at donna.seger@Vanderbilt.edu

Donna Seger, M.D.
Medical Director, Middle Tennessee Poison Center