Poisoning with nasal drops (naphthyzine poisoning). What to do? Overdose of Nazivin in children - symptoms of poisoning and side effects of the drug Overdose of vasoconstrictor drops in a child symptoms

Is it possible to do harm with such a simple over-the-counter drug?

Canadian pediatricians presented an analysis of a case involving an overdose of vasoconstrictor drops: a 4-month-old baby was admitted to the intensive care unit after using vasoconstrictor drops in the nose due to congestion for 2 days. The baby received 8 drops of xylometazoline in the nose (0.1% concentration) 12 hours before the child was admitted to the intensive care unit.
This dosage is for adults; in children it is used only from 6 to 12 years. This child was admitted to the intensive care unit in a coma. The situation ended well.
The Medline library contains an analysis of 13 cases of xylometazoline overdose in children under 5 years of age, 11 of which occurred in children under 2 years of age.
Doesn't seem like much, does it? What if it was YOUR child?
In addition, these phenomena may have varying degrees of severity, go unnoticed or simply not be documented.
Unfortunately, the minimum nontoxic dose of xylometazoline for such young children has not been established. When instilling xylometazoline, pharmacological reference books recommend maintaining an 8-10 hour interval between doses and in children under 6 years of age using strictly 1 drop of the drug in a pediatric dosage in each nasal passage. And such a dosage does not pose a danger to children's health.
This is just an example of the incorrect use of one substance, but this is possible with any vasoconstrictor nasal drops. And, unfortunately, even full compliance with the instructions does not guarantee the absence of an overdose. Since there are data on cases of overdose of oxymetazoline/xylometazoline in premature babies or babies in the first months of life when taking the drug according to the instructions in children with symptoms of nasal congestion due to ARVI.

Overdose symptoms:
difficulty breathing or stopping breathing;

lethargy, even to coma;

blurred vision;
blue lips and nails;
change in pupil size;
violation of blood pressure - first an increase, then a decrease;
tachycardia;
headache;
irritability;
decrease in body temperature;
convulsions;
nausea and vomiting;
trembling of limbs.

If you suspect poisoning of a child with a vasoconstrictor drug, you should immediately seek help.
Tell your doctor:
patient's condition;
height;
weight;
name of the drug;
timing of use and dosage.

How to avoid such reactions to the drug:
keep medications out of the reach of children;
do not use vasoconstrictor drops as self-medication for more than 3 days;
Vasoconstrictors do not have a regular dosage regimen - this is a means of symptomatic relief, if we are talking about a common runny nose - there is congestion - we drip. The nose is breathing - let us pass.
For otitis media, the doctor may prescribe a different regimen.
The time interval between doses is of great importance, for example, for Xylometazoline it is 8-10 hours; Oxymetazoline -12 hours; Phenylephrine -4-6 hours.
Such drugs cannot be used in newborns without a doctor’s prescription!
It is strictly forbidden to use nasal drops, e.g. naphthyzine, into a nebulizer or other devices and do inhalations!
The form of release of vasoconstrictors for children - drops - is much preferable, so you can see exactly what got into the nose. ️Vasoconstrictor drops in the treatment of a runny nose are not the most important medicine! Even swelling can be quite safely removed with hypertonic saline solution.
Be careful and stay healthy!

Any home medicine cabinet will probably contain vasoconstrictor nasal drops. It would seem that these are harmless remedies that quickly relieve nasal congestion during a runny nose. But in Australia they are prohibited for use by children under 2 years old, in the UK - up to 6 years old, and in some places in Italy - even up to 12 years old. They are also recommended to be used with caution during pregnancy. Reason – they are dangerous for small patients!

What threat do vasoconstrictor nasal drops pose to children?

Nasal drops that quickly relieve swelling and restore nasal breathing contain a drug from the group of so-called alpha-2 adrenergic agonists. They constrict the blood vessels of the mucous membrane of the nasal passages and reduce the production of inflammatory serous or mucous secretions. But these substances are easily absorbed into the blood. And then, along with the desired local effect, their pronounced side effect on the entire cardiovascular system appears. The worst thing is that they affect the brain in such a way that they reduce blood pressure until the development of hypotonic shock. Think about it: simply putting drops into your nose can cause severe poisoning!

For whom are vasoconstrictor nasal drops most dangerous?

The younger the child, the smaller the dose of adrenergic agonist required for the baby to require emergency assistance. That's why The most vulnerable age is children from one to two years old(about half of all cases). The second place in the frequency of serious complications is occupied by infants under one year old and children from 2 to 3 years old.

How does hypotonic shock manifest in children?

A stuffy nose causes a lot of trouble for a child. He cannot breathe normally, and therefore is capricious during meals and games, during daytime sleep, and often wakes up crying at night. It would seem that there is nothing unusual in the fact that after an adrenergic agonist is instilled into the nose, the baby stops snoring and quickly falls asleep. Because the first signs of low blood pressure are drowsiness and lethargy- in case of poisoning, as a rule, parents skip it. According to statistics, the most common complaint when seeking help is “the child does not wake up” or “it was difficult to wake up, but falls asleep again.”

The greater the number of vasoconstrictor drops in the nose that are absorbed into the systemic bloodstream, the more pronounced will be the general pallor of the skin, blueness around the mouth, sweating, and coldness of the extremities. In children, breathing becomes rare and barely noticeable to the eye, as if they are not breathing at all. The body is relaxed, any movement is difficult for them. In severe cases, an epileptic seizure or cerebral coma may develop.

What are the dangers of nasal drops during pregnancy?

A nasal spray with an adrenergic agonist narrows not only the superficial vessels of the nasal mucosa. To a lesser extent, but certainly, the lumen of the vessels feeding the placenta is spasmed. As a result, it becomes easier for the mother to breathe briefly, while the baby experiences a lack of oxygen at this time.

Which vasoconstrictor drops are most dangerous?

1. It is part of drugs called Naphazolin ferein, Naphthyzin, Opkon-A, Sanorin, Sanorin with eucalyptus oil.
2. These are Brizolin, Galazolin, Grippostad Rino, Dlynos, Doctor Theiss Nazolin and Rinotais, Influrin, Xilen, Xylobene, Ximelin, Nosolin, Olint, Rizaksil, Rinomaris, Rinostop, Suprima-NOZ, Tizin xylo.
3. These are 4-Wey, Afrin, Nazivin, Nazol and Nazol Advance, Nazosprey, Nesopin, Noxprey, Fazin, Fervex spray for the common cold.

When nasal drops cause poisoning in a child

The main reason is an overdose of the drug. When this happens:

• a solution containing a higher concentration of adrenergic agonists is used than is allowed at a certain age. ;
• . For example, after instilling drops from the nose, mucus is removed and the medicinal spray is immediately reused;

Accidental poisonings also occur in children when a spray bottle is left within reach, and child drinks medicine. Even one sip of an adrenergic agonist, especially on an empty stomach, is enough to cause severe poisoning to develop.

How to protect your baby from dangerous nasal drops

The basic rule is to comply with the requirements for age, quantity and frequency of use of the drug specified in the annotation for the drug. Try not to buy sprays containing naphazoline, xylometazoline and oxymetazoline at the pharmacy. Remember that vasoconstrictor drops do not treat a runny nose, but only facilitate nasal breathing when the mucous membrane is swollen. This is usually observed in the first 1-3 days of a viral infection. Before instilling an adrenergic agonist, you need to clear the nasal passages of mucus using a saline solution or sea water and a suction bulb. Perhaps this procedure will be enough to make the child’s nose “breathe.”

Naphthyzin is a very effective drug that constricts blood vessels in a short period of time. If the drug is used incorrectly, an overdose of naphthyzine may occur.

Naphthyzin is an effective vasoconstrictor drug

Young parents often wonder: can the drug be used by children? The use of naphthyzin is permitted by pediatricians, but only if the concentration of drops and dosage are correctly selected. Naphthyzin is available in the form of 0.05% drops. A solution of 0.1% is an adult dosage, which is strictly prohibited for children to take, as it can cause severe poisoning.

Danger of the drug

Can a child be poisoned by this drug? Of course. Nasal drops seem harmless, but they are quite capable of harming your baby. Poisoning with naphthyzine drops in children is not uncommon. Naphthyzine poisoning occurs when inexperienced parents independently, without a pediatrician’s prescription, treat their child’s runny nose with vasoconstrictor medications. Young mothers very often turn to medical institutions for help with naphthyzine poisoning.

Reasons why poisoning may occur

Naphthyzin, like any other drug, can cause harm to the body. Symptoms can appear not only with long-term use, but also with one-time use of drops. So, let's figure out why seemingly ordinary drops can cause serious poisoning.

• Vasoconstrictor drops called Naphthyzin are available in plastic bottles. It is not always possible to give the child the required number of drops by pressing on the bottle; in this case, the dose may increase several times.
• Parents very often confuse the adult dosage of 0.1% with the children's dosage of 0.05%.
• Very often there is non-compliance with the rules for using a medicinal product. The instructions indicate that the drops should not be used by children under one year of age, and young mothers use the drug on their own, which risks causing serious harm to the health of the baby.
• Naphthyzin is an effective, inexpensive drug that is extremely popular. For children, its use can have dire consequences.

Poisoning with naphthyzine drops in children is not uncommon

First symptoms

Naphthyzine poisoning in children is quite common. In order to determine whether the child has actually been poisoned, it is necessary to monitor his condition. The first symptoms that you might be concerned about are:

• pronounced weakness and lethargy in the baby;
• mood swings, tearfulness;
• cramping pain in the head and slight dizziness;
• nausea turning into vomiting;
• decrease in temperature;
• bradycardia;
• hypotension (low blood pressure);
• complete refusal of food;
• drowsiness;
• pale skin (skin becomes damp and cold);
• slight constriction of the pupils.

When the first such symptoms are detected, it is necessary to urgently call a qualified medical specialist who will provide the necessary assistance and eliminate the symptoms of overdose. It is strictly forbidden to carry out treatment at home!

First aid

While you are waiting for the doctor, do not panic so that it is not transmitted to the child. It is necessary to monitor the baby’s condition, calm him down and ensure a comfortable position.

• Monitor the general condition of the child.
• Drink plenty of fluids. This can be ordinary boiled water.
• Monitor the baby's pulse and breathing.
• Wrap him in a blanket so the child can stay warm.

The medicine must be prescribed by a pediatrician in accordance with the dosage

Treatment for poisoning

First of all, treatment should be aimed at eliminating the symptoms of naphthysine poisoning. Upon arrival of the emergency doctor, it is necessary to tell how the drug was taken and in what dosage. If a mild form of poisoning occurs, the baby will be given first aid on the spot and given further recommendations for treatment. In severe cases, they are transported to the hospital and treated in a hospital setting.

It often happens that children independently use medications for medical purposes. To prevent this from happening, parents should be careful about the storage of all medications, that is, keep them out of the reach of children.

Note for young parents

• The drug should not be used by infants.
• Drops should be prescribed by a pediatrician in accordance with the dosage according to the child’s age.
• Increasing the dose does not increase the effect of the drug, but increases the risk of severe poisoning.
• The recommended dose for a child should not exceed 1-2 drops of a 0.05% Naphthyzin solution.
• Correct use of the drug will clear the child's airways and make nasal breathing easier.
• Due to the fact that the drug is addictive, drops can be used no more than once with an interval of 6-7 hours.
• It is effective to use a pipette to accurately measure a drop. This way you can see the amount of the drug collected.
• In order not to cause addiction in the child, it is necessary to alternate naphthyzin with other drops intended for the treatment of colds in children.

Can a child be poisoned by Naphthyzin? Yes maybe. Even the simplest and safest-looking nasal drops can lead to serious consequences and harm the child’s health. Drug poisoning in children is not uncommon. Poisoning with vasoconstrictor drugs occurs especially often, due to the selection and use of medications by parents independently without a doctor’s prescription, also due to an incorrectly calculated dose of the drug and its incorrect storage.

During colds, runny nose, allergies, teething, there is a need to give drops to children. Parents use Naphthyzin because the drug has a quick effect, removes swelling of the nasal mucosa, and clears the respiratory passages.

In recent years, the number of Naphthyzin poisonings has increased. Mothers are increasingly going to the hospital with similar poisonings in their children.

Naphthyzin, like other drugs, has side effects not only with long-term use, but also with short-term use. Sometimes symptoms of poisoning occur even with a single use.

The main reasons why there is an increase in drug poisoning:

• Naphthyzin is produced in plastic bottles up to 20 ml. Due to such packaging, it is possible to make a mistake and take the wrong dosage, because during one press on the bottle the dose can increase up to ten times;
• Parents often make a mistake and buy a 0.1% solution of the drug, but they should use a 0.05% solution;
• Failure to follow the instructions for using the medicine. Let’s say the instructions indicate that naphthyzine can be used for children older than one year, but in practice it turns out that parents have been using it since the baby’s birth.
• Price for the drug. The cost of the drug is very insignificant, compared to other drops, the price is very meager, about 10 rubles, which is why the medicine is popular, but the price may increase in the future, then you will have to fight for the health and life of the child.

Symptoms

Poisoning with drugs for the common cold is quite common in children. However, in order to accurately determine whether it is poisoning or not, you should monitor the baby’s well-being. Main symptoms of poisoning:

• General weakness of the body;
• Bad mood;
• Dizziness and headache;
• Painful sensations in the abdomen;
• Nausea, possibly vomiting;
• Reduced body temperature;
• Slow heart rate;
• Decreased pressure;
• Lack of appetite;
• Drowsiness;
• Slight constriction of the pupils;
• Pallor of the skin;
• The skin is damp and cold.

If you notice symptoms of poisoning in a child, you should urgently call an ambulance., which will provide professional assistance and eliminate the symptoms of overdose. Carrying out treatment at home is unsafe for the child’s health.

Treatment

Treatment of poisoning consists of eliminating symptoms. If symptoms of naphthyzine poisoning are detected in children, the first thing to do is stop taking the medicine and call a doctor. The doctor should tell how the drug was taken and in what dosage.

It happens that the baby took the medicine himself; such cases occur if the medicines are in full view of the children's eyes. Therefore, it is advisable to place all medications out of the reach of children.

First aid

While you are waiting for an ambulance, the main thing is not to panic and not to pass on your panic state to your child. First of all, you should monitor the child’s condition, provide him with a comfortable position, move him to the bed and calm him down.

Actions:

• Ensure that the child remains conscious;
• Provide your child with plenty of fluids. Cooled boiled water with a volume of up to a liter or more is suitable for this;
• In case of poisoning, it is forbidden to give milk to children, as this promotes rapid absorption of the medicine into the blood;
• Check your breathing and monitor your heart rate;
• Wrap the baby in a blanket or blanket to keep him warm;
• Monitor your pulse.

Naphthyzine poisoning is increasingly occurring, the main reasons being incorrect administration or use of medications that have expired. It is necessary to monitor the expiration date and throw away all drugs that are already spoiled and buy new ones. Otherwise, much larger sums will be required for treatment than for new drops.

Degrees of overdose

The presence of various symptoms depends on the dosage in which the drug was taken. Naphthyzine overdose has three degrees of severity.

1. In the first degree of overdose, there is no need to hospitalize the patient and call an ambulance. Symptoms disappear after stopping the medication. This degree is called mild.
2. With moderate severity, there is no need to hospitalize the child either. Parents can independently help the baby, stop taking the medication and monitor the patient’s condition. If the symptoms go away, then there is no need to call a doctor.
3. The most dangerous degree is severe. In this case, you need to immediately call an ambulance and put the child in the hands of specialists. In this case, hospitalization is mandatory.

Treatment of poisoning should first begin with eliminating the symptoms and stopping the drug.

Can Naphthyzin be used for children?

Naphthyzin is an effective drug that constricts blood vessels in a short time, belongs to the group of selective adrenergic agonists.

Parents often ask whether children are allowed to use the drug? It is allowed, provided that the correct concentration of the solution is selected and the dosage is observed. The drug for children is produced in the form of a 0.05% solution, a 0.1% solution is contraindicated for children; this dose causes poisoning in children.

Instructions

The drug should not be used by children under one year of age. After a year, naphthyzine is prescribed by a doctor, subject to strict adherence to the dosage. The dose of the drug for children is 1-2 drops of 0.05 naphthyzine solution in each nasal passage, this dosage helps clear the airways and makes breathing easier.

Naphthyzin causes the body to become addicted to the drug and the medicine stops working. Increasing the dose does not increase the effect of the drug, but, on the contrary, increases the risk of naphthyzine poisoning (in children this process occurs much faster than in adults, since the body is still quite weak and cannot fight poisoning).

Due to rapid addiction, children can use the medicine no more than once every 7 hours. The effect of the drug begins within thirty minutes.

Since a plastic bottle causes errors in the dosage of the drug and leads to an overdose and subsequently to poisoning, the use of a pipette to maintain the exact dose is considered effective. This way you can see how much of the drug you have taken.

In order not to cause addiction in the child, you should alternate the use of naphthyzine with other similar medications, for example.

Nazivin is a liquid solution belonging to the clinical and pharmacological group of decongestant, vasoconstrictor drugs for local (nasal) use.

The active substance (oxymetazoline) helps relieve nasal congestion, making breathing easier. The advantage of the product is the lack of absorption into the bloodstream and systemic exposure.

Oxymetazoline, the main active ingredient, is an imidazoline derivative and belongs to the alpha-adrenergic receptor stimulants located in the vascular layer of the nasal mucosa and paranasal sinuses.

Local use of the drug helps to narrow blood vessels, thereby eliminating swelling of the mucous membrane. As a result, breathing becomes easier for rhinitis, sinusitis and other diseases due to the opening and expansion of the excretory canals of the paranasal sinuses, nasal cavities, and Eustachian tubes. This mechanism stimulates the drainage function, which significantly reduces the likelihood of developing bacterial complications.

Oxymetazoline has an antiviral effect. The active substance suppresses the activity of pathogenic viruses that cause colds and runny nose.

Release forms and chemical composition

The drug is presented in the form of nasal drops or spray of various dosages - for adults and children. The transparent solution either has no color at all or has a faint yellowish tint.

The following are used as auxiliary components:

• citric acid monohydrate;
• sodium citrate dihydrate;
• benzalkonium chloride;
• glycerol;
• purified water.

Drops are supplied in a glass or plastic bottle with a molded or separate pipette. Spray - in a plastic container with a mechanical sprayer.

The drug is available without a prescription in the form of nasal drops of 5, 10 ml, as well as in the form of a spray in a 10 ml bottle.

Indications for use

The use of Nazivin is advisable for the following pathologies:

• acute respiratory infections, acute respiratory viral infections, accompanied by a runny nose;
• allergic rhinitis;
• vasomotor rhinitis;
• sinusitis.

The drug is also prescribed to prepare the nasal mucosa (eliminate swelling) before diagnostic studies.

Restrictions and contraindications for use

The main contraindications include:

• individual intolerance to the components of the drug;
• children under 1 year of age (for Nazivin at a dosage of 0.025%);
• up to 6 years (for a dose of 0.05%);
• angle-closure glaucoma;
• atrophic rhinitis.

Admission restrictions apply to patients with the following diseases:

• hypertension;
• atherosclerosis;
• tachycardia;
• diabetes mellitus;
• glaucoma;
• coronary arteries;
• hyperthyroidism;
• pheochromocytoma.

Nazivin should be prescribed with caution to pregnant and lactating women. When using the product, the attending physician must evaluate and compare the benefits for the mother's body with the potential risks for the child.

Common Adverse Reactions

Nazivin is well tolerated, with the exception of rare cases when patients noted a burning sensation and drying of the nasal mucosa, which was mainly associated with an overdose.

Side effects include:

• reactive hyperemia;
• itching in the nasal cavity;
• frequent sneezing;
• feeling of tightness in the bridge of the nose.

Rarely observed:

• frontal headache;
• increased heart rate;
• increased blood pressure;
• prostration;
• sleep disturbance.

If such symptoms appear, use of the drug should be suspended until the true causes of deterioration in well-being are determined.

Interaction with other medications

• monoamine oxidase inhibitors (MAOIs);
• tricyclic antidepressants.

A vasoconstrictor pharmaceutical reduces the rate of absorption of local anesthetics (Lidocaine).

Combination with drugs that have similar pharmacological properties increases the likelihood of an overdose of Nazivin and the development of pronounced adverse reactions.

Therapeutic doses

There is a special dosage for children depending on age:

• under 1 year, starting from 5 weeks - 0.01% solution, a few drops 2 - 3 times a day;
• from 1 to 6 years - 0.025% 1 - 2 drops 2 - 3 r. per day;
• over 6 - 0.05% according to a similar scheme.

Adults are prescribed the same dosage (0.05% solution) or 1 to 2 intranasal injections several times a day.

The duration of the treatment course is determined by the therapist, based on the severity of the condition, the characteristics of the disease, on an individual basis. Treatment, as a rule, lasts no more than 7 days, since then the intensity of the therapeutic effect decreases.

Clinical picture of overdose

Exceeding the recommended doses of Nazivin usually occurs by accident. Either by putting an excess amount of product into the pipette, or as a result of intense pressure on the sprayer. Atypical use also occurs - orally, orally or, mistakenly, as eye drops.

Overdose has characteristic signs:

• nausea;
• rarely vomiting;
• the appearance of shortness of breath;
• constriction of the pupils;
• cyanosis;
• hyperthermia;
• disturbances of heart rhythm and contraction frequency;
• increased blood pressure;
• collapse;
• pulmonary edema;
• respiratory function disorders.

Most victims of Nazivin overdose experience:

• depression of the central nervous system, manifested by general malaise, apathy, pathological drowsiness, decreased body temperature;
• from the cardiovascular system - bradycardia, arterial hypertension;
• mental disorders, hallucinations;
• coma.

If you do not seek medical help in a timely manner, pathological phenomena can rapidly progress and lead to sudden respiratory arrest.

First aid at home

The first thing that needs to be done to help a victim of an overdose of Nazivin is to provide access to fresh air and a horizontal position. To make breathing easier, you should free your neck from compressive elements. You also need to call a medical team as quickly as possible and wait for their arrival.

In case of an overdose of Nazivin as a result of oral administration, the following is carried out:

• gastric lavage with clean water or a weak solution of potassium permanganate (the total volume of liquid is at least 1 liter);
• taking enterosorbents (activated carbon - 1 tablet for every 10 kg of weight, Polysorb and other absorbent drugs - according to the instructions);
• taking a saline laxative (for example, magnesium sulfate).

Drinking plenty of fluids will help you cope with poisoning faster. Arriving qualified specialists should be informed about the expected excess of the dose and the method of use of the drug.

Qualified medical care

There are three degrees of severity of Nazivin overdose depending on the intensity of pathological manifestations.

• The first degree (mild) in most cases does not require hospitalization. The condition stabilizes after stopping the use of vasoconstrictor drops.
• Moderate, or second, degree is characterized by more severe symptoms. As a rule, emergency procedures, such as gastric lavage and drinking plenty of fluids, can eliminate the manifestations of poisoning. Improvement occurs after a longer period of time. Physician supervision is recommended. Hospitalization is not required if the condition is satisfactory.
• In case of severe Nazivin poisoning, the victim is taken to the hospital, where intensive therapy is carried out aimed at eliminating the symptoms. Treatment is selected individually in each specific clinical case.

Conclusion

Overdose of Nazivin is a common phenomenon, especially among children. Self-administration by a child, erroneous use as eye drops, or accidental excess of the amount of the administered drug can cause significant, sometimes irreparable harm to health. In the absence of emergency assistance, serious complications may develop, including falling into a coma and even death.