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Generic drug for ropinirole in acute gastroenteritis (Taqwa al-Jassim, Saudi Arabia) with a low number of deaths and severe illness in children after the use of low-potency tablet (0.1%–1%). This study describes the case of a child who ingested 0.1% ropinirole tablets and an ophthalmological condition the role of aspirin treatment during acute gastroenteritis after ingestion of pharmaceutical products.
Drug-induced gastroenteritis, particularly in small children, has been a major source of morbidity and mortality in several countries including Saudi Arabia.4,5 The drug-induced gastroenteritis described in this report occurred a child aged 6 months who was administered low-potency tablets of risperidone, a drug used to treat schizophrenia. He experienced vomiting and neurological impairment for 4 days. Six other children, five girls and one boy aged 4–8, have subsequently developed diarrhoea within the previous 6 months with severe illness vomiting, abdominal pain, diarrhoea, and hypotension. A case series by the Public Health Agency of Canada reported a total 7 cases with gastrointestinal symptoms and one death.6 In a study conducted Saudi Arabia, the incidence of acute gastroenteritis varied from 0.21% to 1.5% during 2002–2004, and the average number of deaths was 1.8 per 100 000 population.4
Risperidone is recommended for its safety in children older than 12 years of age because its known pharmacodynamic and toxicological properties.3,7 The drug should not be administered to children younger than 24 months,8 a general guideline established from international guidelines as part of the Food Drug and Cosmetic Act. The risks for severe hepatotoxicity are reported to be negligible.9 Although ophthalmological symptoms have been seen in one patient,10 an ophthalmological cause for the patient's symptoms cannot be excluded. The clinical features of reported cases suggest that in patients younger than 3 years of age, low-potency tablets have the potential of exposing stomach to the drug or ocular drug. risk for severe and gastrointestinal toxicity may therefore be increased if the ophthalmological symptoms are present. However, to protect the skin, drug should be stopped immediately in patients with ocular signs. The risk of and gastrointestinal toxicity Drugstore cream highlighter and contour
may be decreased if the medication is used only with food or at bedtime.
Most cases of ropinirole poisoning caused by acute ingestion have been in children; of the 1 case in whom patient's blood drug levels were determined and the drug showed evidence of enzymatic metabolism at the lower limits of detection for that drug, the oral route of administration was ruled out because of possible drug absorption through the oral mucosa.4 A case series by the Public Health Agency of Canada reported a total 9 cases.6 These patients were treated with aspirin and the patients generally recovered successfully. A case report describes patients who had severe vomiting and diarrhoea, which persisted for 12 days after the use of aspirin and/or ropinirole. The patient had experienced an allergic reaction to ropinirole and received multiple doses of it without a well-timed change in therapy. Patients who ingest medication in an anaerobic system may therefore be at increased risk.
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