Potential harms of pharmacological management for acute behavioural disturbance in children

Note: If pharmacological management is used for children, always monitor the child closely for adverse drug effects.

Pharmacological management for children with acute behavioural disturbance can be associated with potential harms. If pharmacological management for children is used, always seek expert advice and monitor the child closely for adverse drug effects; see Principles of monitoring a patient with acute behavioural disturbance for more information.

Potential harms that are associated with sedative drugs include:

  • oversedation
  • airway obstruction
    • loss of airway tone and protective reflexes
    • laryngospasm
  • respiratory depression
  • aspiration
  • hypotension
  • QT-interval prolongation and arrhythmias
  • complications of immobility (eg pressure injury)
  • paradoxical agitation
  • extrapyramidal adverse effects of antipsychotic drugs 
  • anticholinergic adverse effects of antipsychotic drugs.

Oversedation, causing unconsciousness and loss of protective airway reflexes, is an emergency—if this occurs, seek expert assistance to manage the airway and breathing urgently according to advanced life support protocols1. This is rare after oral sedative drug administration—complications are more likely after parenteral administration of sedative drugs.

1 The Australian Resuscitation Council has advanced airway support protocols [URL] for adults and children; for adults, see ANZCOR Guideline 11.6 Equipment and techniques in adult advanced life support and, for children, see ANZCOR Guideline 12.1 Introduction to paediatric advanced life support and ANZCOR Guideline 12.6 Techniques in paediatric advanced life support.Return