Three-year-old girl attended the emergency department after accidental ingestion three hours earlier of approximately 45 ml of an antitussive syrup made up of a combination of dextromethorphan hydrochloride (2 mg/ml) and pseudoephedrine hydrochloride (6 mg/ml).
On arrival, blood pressure 125/89 mmHg, heart rate 97 bpm, respiratory rate 28 rpm, oxygen saturation 100% and temperature 36.5 °C. Weight: 13 kg. Physical examination was normal.
The estimated ingested dose of dextromethorphan was 90 mg (6.9 mg/kg) and 270 mg (20.7 mg/kg) of pseudoephedrine. The patient was admitted for observation in the Intensive Care Unit because of the risk of possible cardiovascular, anticholinergic and central nervous system side effects.
During the first 12 hours, the patient presented mild sinus tachycardia (maximum 130 bpm), associated with blood pressure > P95, with no other cardiac rhythm abnormalities. She did not show any alteration in the level of consciousness at any time. She was discharged after 24 hours.

