Poisoning with nasal drops (naphthyzinum 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 harm such a simple over-the-counter drug?

Canadian pediatricians presented an analysis of such a case of an overdose of vasoconstrictor drops: a 4-month-old baby was admitted to the intensive care unit after using vasoconstrictor drops in the nose with congestion for 2 days. The baby received 8 drops of xylometazoline in the nose (conc. 0.1%) 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. The child was admitted to the intensive care unit in a coma. The situation ended happily.
The Medline Library has a review 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 can have varying degrees of severity, go unnoticed or simply not documented.
Unfortunately, no minimum non-toxic dose of xylometazoline has been established for these young children. When instilling xylometazoline, pharmacological reference books recommend maintaining an 8-10 hour interval between doses and in children under 6 years of age, use strictly 1 drop of the drug in a children's 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 misuse 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 in ARVI.

Overdose symptoms:
respiratory failure or respiratory arrest;

lethargy, up 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 the limbs.

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

How to avoid such reactions to the drug:
keep medicines out of the reach of children;
do not use vasoconstrictor drops as a self-medication for more than 3 days;
vasoconstrictors do not have a regular intake regimen - this is a means of symptomatic relief, if we are talking about a common cold - there is congestion - we drip. The nose breathes - skip.
With otitis media, the doctor may prescribe a different regimen.
The time interval between doses is of great importance, so for Xylometazoline it is 8-10 hours; Oxymetazoline -12 hours; Phenylephrine - 4-6 hours.
In newborns, without a doctor's prescription, such drugs cannot be used!
It is strictly forbidden to fill in drops for the nose, for example. naphthyzinum, into a nebulizer or other devices and do inhalation!
The release form of vasoconstrictors for children - drops - is much more preferable, so you can definitely see what has got into the nose. Vasoconstrictor drops in the treatment of the common cold are not the most important medicine! Even swelling can be safely removed with hypertonic saline.
Be careful and be healthy!

In any home first aid kit, there will certainly be vasoconstrictor nasal drops. It would seem: these are harmless remedies that quickly save you from nasal congestion with a runny nose. But in Australia they are forbidden for children under 2 years old, in the UK - up to 6, and in some parts of Italy - even up to 12 years. They are also recommended to be used with caution during pregnancy. Reason - they are dangerous for little patients!

What is the threat of vasoconstrictor nose drops for children

Nose drops that quickly relieve swelling and restore nasal breathing contain a drug from the group of so-called alpha-2-agonists. They constrict the blood vessels of the nasal mucosa 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 action, their pronounced side effect on the entire cardiovascular system is manifested. The worst thing is that they affect the brain in such a way that they lower blood pressure up to the development of hypotonic shock. Think about it: just putting drops in your nose can cause severe poisoning!

For whom are vasoconstrictor nasal drops most dangerous?

The younger the child, the less the dose of adrenomimetic is required for the baby to need emergency help. That's why the most vulnerable age is children from one to two years(about half of all cases). The second place in the frequency of serious complications is occupied by infants under one year old and toddlers 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 naughty while eating and playing, during daytime sleep and at night he often wakes up crying. It would seem that there is nothing unusual in the fact that after instillation of adrenomimetics into the nose, the baby stops sniffing and quickly falls asleep. That's why the first signs of a decrease in blood pressure are drowsiness and lethargy- in case of poisoning, as a rule, parents skip. According to statistics, the most common complaint when seeking help is “the child does not wake up” or “they woke up with difficulty, but falls asleep again.”

The more vasoconstrictor drops into the nose are absorbed into the systemic circulation, the more pronounced will be the general pallor of the skin, blue around the mouth, sweating, cold 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 given to them with difficulty. In severe cases, an epileptic seizure or cerebral coma may develop.

What are the dangers of nose drops during pregnancy

Nasal spray with an adrenergic agonist constricts not only the superficial vessels of its mucous membrane. To a lesser extent, but necessarily, the lumen and the vessels feeding the placenta are spasmodic. As a result, the mother briefly becomes easier to breathe, and the child at this time lacks oxygen.

What vasoconstrictor drops are the most dangerous

1. It is part of drugs called Nafazolin ferin, Naphthyzin, Opcon-A, Sanorin, Sanorin with eucalyptus oil.
2. These are Brizolin, Galazolin, Grippostad Rino, Dlyanos, Dr. Theiss Nazolin and Rinotays, Influrin, Xylen, Xylobene, Xymelin, Nosolin, Olint, Rizaksil, Rinomaris, Rinostop, Suprima-NOZ, Tizin xylo.
3. These are 4-Wei, Afrin, Nazivin, Nazol and Nazol Advance, Nazospray, Nesopin, Knoxprey, Fazin, Fervex spray from the common cold.

When drops in the nose cause poisoning in a child

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

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

There are also accidental poisonings in children when a spray bottle is left within reach, and child takes medicine. Even one sip of an adrenergic agonist, especially on an empty stomach, is enough to develop a clinic of severe poisoning.

How to protect your baby from dangerous nose drops

The main rule is to comply with the requirements for age, quantity and frequency of use of the drug indicated in the annotation to the drug. Try not to buy sprays containing naphazoline, xylometazoline and oxymetazoline at the pharmacy. Remember that vasoconstrictor drops do not cure a runny nose, but only facilitate nasal breathing with swelling of the mucous membrane. This is observed, as a rule, in the first 1-3 days of a viral infection. Before instilling an adrenomimetic, it is necessary to clear the nasal passages from mucus with saline or sea water and a suction bulb. Perhaps this procedure will already be enough for the children's nose to “breathe”.

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

Naphthyzine is an effective vasoconstrictor drug

Young parents often ask the question: is it possible to use the drug for babies? Pediatricians are allowed to use naphthyzinum, but if the concentration of drops and dosage are correctly selected. Naphthyzine is produced in the form of drops of 0.05%. A solution of 0.1% is an adult dosage that is strictly forbidden for children to take, as it can cause severe poisoning.

The danger of the drug

Can a child get poisoned by this drug? Of course. Nose drops seem to be harmless, but they are quite capable of harming your baby. Naphthyzine drop poisoning in children is not uncommon. Poisoning with naphthyzinum occurs when inexperienced parents on their own, without the appointment of a pediatrician, treat the child with a runny nose with vasoconstrictor drugs. Young mothers very often turn to medical institutions for help with naphthyzine poisoning.

Reasons why poisoning may occur

Naphthyzinum, like any other drug, can harm the body. Symptoms may appear not only with long-term use, but also with a single use of drops. So, let's see why the most ordinary drops can cause serious poisoning.

• Vasoconstrictor drops called Naphthyzinum are available in plastic bottles. It is not always possible, when pressing on the vial, to drop the required number of drops to the child, the dose in this case may increase several times.
• Parents very often confuse the adult dosage of 0.1% with the children's 0.05%.
• Very often there is a non-compliance with the rules for the use of a medicinal product. The instructions indicate that it is forbidden to use drops for children under one year old, and young mothers use the drug on their own, which risks causing serious harm to the health of the crumbs.
• Naphthyzine is an effective inexpensive drug that is very popular. For kids, its use can threaten sad consequences.

Naphthyzine drop poisoning in children is not uncommon

First symptoms

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

• pronounced weakness and lethargy in the crumbs;
• mood swings, tearfulness;
• spasmodic pain in the head and slight dizziness;
• nausea turning into vomiting;
• decrease in temperature;
• bradycardia;
• hypotension (lowering blood pressure);
• complete refusal of food;
• drowsiness;
• pallor of the skin (skin becomes wet and cold);
• slight constriction of the pupils.

When the first such symptoms are detected, it is urgent to call a qualified medical specialist who will provide the necessary assistance and eliminate the symptoms of an 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 condition of the baby, calm him down and ensure a comfortable position.

• Monitor the general condition of the child.
• Plentiful drink. It can be ordinary boiled water.
• Monitor your baby's pulse and breathing.
• Wrap in a blanket to keep baby warm.

The medicine must be prescribed by a pediatrician in compliance with dosages

Treatment for poisoning

First of all, treatment should be aimed at eliminating the symptoms of naphthyzinum poisoning. Upon the arrival of the ambulance 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 will write out further recommendations for treatment. In severe cases, they are transported to the hospital and treated in a hospital.

Very often it happens that babies use medical preparations on their own. To prevent this from happening, parents should be careful about the storage of all medicines, that is, keep them out of the reach of children.

Note to new parents

• Do not use the drug for infants.
• Drops should be prescribed by a pediatrician in compliance with dosages according to the age of the child.
• Increasing the dose does not increase the effect of the drug, but increases the risk of developing severe poisoning.
• The recommended dose for a child should not exceed 1-2 drops of a 0.05% solution of Naphthyzinum.
• Proper use of the drug will free the child's airways and make it easier for him to breathe through his nose.
• Due to the fact that the drug is addictive, drops can be used no more than once with an interval of 6-7 hours.
• Efficiently apply the pipette to accurately measure the drop. So you can see the amount of the collected drug.
• In order not to cause addiction in a child, it is necessary to alternate naphthyzine with other drops intended for the treatment of colds in babies.

Can a child be poisoned by Naphthyzinum? Yes maybe. Even the most simple and safe-looking nasal drops can lead to serious consequences and harm the health of the child. Drug poisoning in children is not uncommon. Especially often there is poisoning with vasoconstrictor drugs, due to the selection and use of drugs by parents on their own without a doctor's prescription, also due to an incorrectly calculated dose of the drug and incorrect storage.

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

In recent years, the number of Naphthyzinum poisonings has increased. Mothers are increasingly turning to the hospital with similar poisoning in children.

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

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

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

Symptoms

Poisoning with drugs from the common cold is quite common in children. However, in order to accurately determine whether it is poisoning or not, you should observe the well-being of the baby. The main symptoms of poisoning:

• General weakness of the body;
• Bad mood;
• dizziness and headache;
• Pain in the abdomen;
• Nausea, possibly vomiting;
• Decreased body temperature;
• Slow heart rate;
• Pressure drop;
• Lack of appetite;
• Drowsiness;
• Slight constriction of the pupils;
• blanching of the skin;
• The skin is wet and cold.

If symptoms of poisoning are detected in a child, an ambulance should be called urgently., which will provide professional assistance and eliminate the symptoms of an overdose. Carrying out treatment at home is unsafe for the health of the child.

Treatment

Treatment of poisoning consists in the elimination of symptoms. If symptoms of naphthyzine poisoning are found 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 at what dosage.

It happens that the baby himself took the medicine, such cases occur if the medicines are in full view of children's eyes. Therefore, it is advisable to put 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 transfer your panic state to the child. First of all, you should monitor the condition of the child, provide him with a comfortable position, move him to the bed and calm him down.

Actions:

• Make sure the child remains conscious;
• Provide your child with plenty of fluids. For this, cooled boiled water is suitable, up to a liter or more;
• In case of poisoning, it is forbidden to give milk to children, as this contributes to the rapid absorption of the drug into the blood;
• Check breathing and monitor the heart rate;
• Wrap the baby in a blanket or blanket to keep him warm;
• Follow the pulse.

Increasingly, naphthyzine poisoning occurs, the main reasons are the wrong intake or use of drugs 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 amounts will be required for treatment than for new drops.

Degrees of overdose

The presence of various symptoms depends on the dosage at which the drug was taken. An overdose of naphthyzinum has three degrees of severity.

1. With the first degree of overdose, it is not necessary to hospitalize the patient and call an ambulance. Symptoms disappear after stopping the medication. This degree is called easy.
2. With an average degree, it is also not necessary to hospitalize the child. Parents can independently help the baby, stop taking the medicine and monitor the patient's condition. If the symptoms go away, then the doctor does not need to be called.
3. The most dangerous degree is severe. In this case, you should immediately call an ambulance and give the child into the hands of specialists. Hospitalization in this case is mandatory.

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

Can Naphthyzin be given to children?

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

Parents often ask if 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 solution of 0.05%, a solution of 0.1% is contraindicated in children, such a dose in children causes poisoning.

Instruction

The drug should not be used in children under one year old. After a year, naphthyzinum 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 to free the airways and makes breathing easier.

Naphthyzine causes the body to become addicted to the drug and the medicine ceases to act. 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 the rapid addiction, children can use the medicine no more than once every 7 hours. The action of the drug begins in thirty minutes.

Since the plastic vial causes inaccuracies in the dosage of the drug and leads to an excess of the dose and, consequently, to poisoning, it is considered effective to use a pipette to maintain the exact dose. This way you can see how much you have taken.

In order not to cause addiction in the child, the use of naphthyzine should be alternated with other similar drugs, for example,.

Nazivin is a liquid solution belonging to the clinical and pharmacological group of decongestants, vasoconstrictors for topical (nasal) use.

The active substance (oxymetazoline) helps to eliminate nasal congestion, making breathing easier. The advantage of the drug is the absence of absorption into the bloodstream, systemic exposure.

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

Local use of the drug contributes to the narrowing of blood vessels, thereby eliminating the swelling of the mucosa. As a result, breathing is facilitated in rhinitis, sinusitis and other diseases due to the opening, expansion of the excretory channels of the paranasal sinuses, nasal cavities, and Eustachian tubes. A similar mechanism stimulates the drainage function, which significantly reduces the likelihood of developing complications of a bacterial nature.

Oxymetazoline has an antiviral effect. The active substance inhibits the activity of pathogenic viruses that are the causative agents of colds and the common cold.

Forms of release and chemical composition

The drug is presented in the form of nasal drops or spray of various dosages - for adults and children. The clear solution is either completely colorless or has a slight yellowish tinge.

As auxiliary components are used:

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

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

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

Indications for use

The use of Nazivin is advisable for the following pathologies:

• ARI, SARS, accompanied by a runny nose;
• allergic rhinitis;
• vasomotor rhinitis;
• sinusitis.

The drug is also prescribed for the preparation of the nasal mucosa (elimination of edema) before diagnostic studies.

Restrictions and contraindications for use

The main contraindications include:

• individual intolerance to the components of the drug;
• children's age up to 1 year (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 diseases:

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

Nazivin is prescribed with caution to pregnant and lactating women. When using the drug, 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 burning, drying of the nasal mucosa, which was mainly associated with an overdose.

Among the side effects can be noted:

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

Rarely observed:

• headache in the frontal part;
• increased heart rate;
• increase in blood pressure;
• prostration;
• sleep disturbance.

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

Interaction with other medicines

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

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

The combination with drugs with 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:

• younger than 1 year, starting from 5 weeks, - 0.01% solution, a few drops 2-3 times a day;
• from 1 to 6 years - 0.025% for 1 - 2 drops 2 - 3 r. per day;
• older than 6 - 0.05% in a similar way.

Adults are prescribed the same dosage (0.05% solution) or 1-2 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 occurs, as a rule, by accident. Either when collecting an excess amount of funds into the pipette, or as a result of intense pressure on the sprayer. Atypical use also occurs - orally, by mouth or, erroneously, as eye drops.

Overdose has characteristic signs:

• nausea;
• rarely vomiting;
• the appearance of shortness of breath;
• constriction of the pupils;
• cyanosis;
• hyperthermia;
• violations of the heart rhythm and frequency of contractions;
• increased blood pressure;
• collapse;
• pulmonary edema;
• respiratory dysfunction.

Most victims of an overdose of Nazivin observed:

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

If you do not seek medical help in time, pathological phenomena can progress rapidly, leading to sudden respiratory arrest.

First aid at home

The first thing to do to help the victim of an overdose of Nazivin is to provide access to fresh air and a horizontal position. To facilitate breathing, the neck should be freed from squeezing elements. You also need to call the medical team as soon as possible and wait for their arrival.

In case of an overdose of Nazivin as a result of ingestion, 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 (such as magnesium sulfate).

Drinking plenty of water will help you cope with poisoning faster. Arriving qualified specialists should be informed about the alleged excess of the dose, the method of using the drug.

Qualified medical care

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

• The first degree (mild) in most cases does not require hospitalization. The condition stabilizes after the cessation of the use of vasoconstrictor drops.
• Moderate, or second, degree is characterized by more pronounced symptoms. As a rule, emergency procedures, such as gastric lavage, drinking plenty of water, can eliminate the manifestations of poisoning. Improvement occurs over a longer period of time. Physician supervision is recommended. Hospitalization in a satisfactory condition is not required.
• 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

An overdose of Nazivin is a common occurrence, 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 care, serious complications may develop, including falling into a coma and even death.