ABSTRACT
La nafazolina es un fármaco utilizado como descongestivo, generalmente, en pacientes adultos. Su indicación en pediatría no es frecuente; su uso está aprobado a partir de los 12 años por los efectos tóxicos que posee. La intoxicación en niños genera un cuadro clínico potencialmente grave. Se caracteriza por la aparición inmediata de hipotonía, deterioro del sensorio, hipotermia y bradicardia con grado variable de compromiso clínico. Si bien es una intoxicación infrecuente, la anamnesis y el manejo inicial del paciente son la clave en su evolución. Se presenta a un niño de 4 años que, por un error terapéutico, recibió este fármaco y se destaca la instauración rápida y potencialmente grave del cuadro clínico.
Naphazoline is a drug commonly used as a decongestant in adult patients. Its indication in Pediatrics is not frequent, being approved its use from the age of 12 for the toxic effects it possesses. Intoxication in children generates a potentially serious clinical picture. It is characterized by the immediate appearance of hypotonia, deterioration of the sensory, hypothermia and bradycardia of variable degree of clinical compromise. Although it is an infrequent intoxication, the anamnesis and the initial management of the patient are the key in the evolution. We present a 4-year-old boy who, as a therapeutic error, receives this drug, emphasizing the rapid and potentially severe establishment of the clinical picture.
Subject(s)
Humans , Male , Child, Preschool , Nasal Decongestants/poisoning , Medication Errors , Naphazoline/poisoning , Nasal Decongestants/administration & dosage , Severity of Illness Index , Naphazoline/administration & dosageABSTRACT
Objective@#To observe the process of nasal mucosa injury and repair induced by nasal decongestants in guinea pigs @*Methods@#Sixty-five male guinea pigs were randomly divided into 4groups by digital random method.The guinea pigs in Group A (20 guinea pigs)were treated with 2 sprays of 0.1% Naphazoline 6 times a day for 2 weeks; Group B (20 guinea pigs)with 2 drops of 1% Ephedrine 6 times a day for 2 weeks; Group C(20 guinea pigs) with 2 sprays of Naphazolin hydrochloride and Chlorphenamine Maleate Nasal Spray 8 times a day for 2 weeks.Group D (5guinea pigs)did not do any intervention as a control group.At the end of first and second weekend, 6 guinea pigs randomly selected from each group were observed the morphological changes of the nasal cavity with nasal endoscope and pathological microscope.Two weeks after stopping use of decongestant, 24 animals were grouped.Three guinea pigs were selected randomly from each group to form Group E (n=9) and Group F (n=9)respectively. The 6 remaining guinea pigs falled into Group G. Group E received 2 sprays of Mometasone Furoate Nasal Spray once a day for 2 weeks; Group F received 1 ml 2.3% saline to wash the nasal cavities once a day for 2 weeks.Group F was used to show the natural progess without any treatment.At the end of the third and fourth weekend, nasal endoscopic and pathological microscopes were used to observe the nasal cavity structure and the pathological changes of nasal mucosa. @*Results@#Nasal mocusa congestion and edema were observed with nasal endoscopy after 2 weeks of using nasal decongestant. Cell edema, blood vessel expansion, acute and chronic inflammatory cell infiltration, cilium lodging or loss were observed under the pathological microscope in GroupA, B, C. After using MometasoneFuroate Nasal Spray and 2.3% saline for 2 weeks, the above changes were all recovered in Group E and F. No recovery was found in Group G. @*Conclusions@#Short-term and over dose of nasal decongestant can result in the injury of nasal mucosa in guinea pigs, and the injury is much severe as using decongestant last longer.MometasoneFuroate nasal spray and 2.3% saline can repair the injury.
ABSTRACT
Objective To assess the clinical efficiency and side effects of topical mometasone furoate aqueous nasal spray for patients with naphazoline-induced rebound rhinitis. Methods A prospective, non-randomized and self-controlled study was applied. A total of 22 patients with naphazoline-induced rhinitis received two spray-puffs of 50 μg mometason furoate twice daily to each nostril in the morning for one week, followed by two spray-puffs of 50 μg mometason furoate once daily to each nostril every morning for another three weeks after withdrawn of naphazoline therapy. Nasal congestion was evaluated by visual an-alogue scale (VAS) recorded before and after treatment. Side effects like nose bleeding and perforation of the nasal septum was detected with rhinoscope. Results The statistical difference of VAS before and after treatment was significant. No adverse reac-tions as nose bleeding and perforation of the nasal septum were observed by the end of treatment. Conclusion It is safe and effective to use mometasone furoate aqueous nasal spray for treating rebound rhinitis induced by misuse of naphazoline nasal drop.
ABSTRACT
Introducción: la Farmacopea de los Estados Unidos orienta cómo valorar clorhidrato de nafazolina en una solución oftálmica, pero indica el uso de una columna con grupos nitrilos unidos a sílice porosa, de uso poco frecuente. Objetivo: desarrollar y validar un método alternativo por cromatografía líquida de alta resolución (CLAR) para la cuantificación de clorhidrato de nafazolina en una solución oftálmica. Métodos: el método desarrollado fue de separación isocrática con columna Zorbax SB-C18 (4,6 x 150 mm, 5 µm) y detección ultravioleta a 225 nm. Como fase móvil se empleó solución amortiguadora y acetonitrilo (proporción 85:15, v/v) y la solución amortiguadora fue de KH2PO4 (22 mM) y trietilamina (30 mM), ajustada a pH 3 con ácido fosfórico concentrado. La validación del método se realizó siguiendo las indicaciones de la Guía Q2(R1) de la Conferencia Internacional sobre la Armonización. Se evaluaron los parámetros siguientes: especificidad, precisión, exactitud, linealidad y rango. También se determinó la incertidumbre del método. Resultados: en la especificidad, el placebo no tuvo señal en la zona de clorhidrato de nafazolina; los coeficientes de variación obtenidos para la precisión intermedia resultaron inferiores a 1,5 por ciento; en la exactitud el recobrado fue de 101,52 por ciento y en la linealidad se demostró la ausencia de curvatura en el intervalo 50 a 150 por ciento. La incertidumbre expandida calculada fue un 3 por ciento de la cantidad declarada. Conclusiones: todos los parámetros de validación evaluados se encuentran dentro los límites de aceptación establecidos, por lo que el método es adecuado para los fines propuestos(AU)
Introduction: the United States Pharmacopeia specifies how to titer naphazoline hydrochloride in an ophthalmic solution, but suggests the use of a column with nitrile groups attached to porous silica which is barely used. Objective: to develop and to validate an alternative method by high resolution liquid chromatography for the quantification of naphazoline hydrochloride in an ophthalmic solution. Methods: the developed method was isocratic separation with a Zorbax SB-C18 column (4.6 x 150 mm, 5 µm) and ultraviolet detection set at 225 nm. The mobile phase was buffer and acetonitrile (85:15 ratio, v/v) and the buffer was KH2PO4 (22 mM) and triethylamine (30 mM), adjusted to pH 3 with concentrated phosphoric acid. The validation method was performed pursuant to the Guide Q2(R1) of the International Conference on Harmonization and the following parameters were evaluated: specificity, precision, accuracy, linearity and range. The method uncertainty was also estimated. Results: regarding the specificity, the placebo did not show any signal in the naphazoline hydrochloride zone; the relative standard deviation indexes for intermediate precision were less than 1.5 percent; as to accuracy, the recovery was 101.52 percent and the linearity showed absence of curvature in the 50 to 150 percent range. The estimated expanded uncertainty reached 3 percent of the stated amount. Conclusions: all the validation parameters under evaluation were within the set allowable limits, thus this method is suitable for the intended purposes(AU)
Subject(s)
Humans , Naphazoline/therapeutic use , Chromatography, High Pressure Liquid/methods , Validation Studies as Topic , HondurasABSTRACT
The construction and performance characteristics of new sensitive and selective in situ modified screen printed (ISPE) and carbon paste (ICPE) electrodes for determination of naphazoline hydrochloride (NPZ-HCl) have been developed. The electrodes under investigation show potentiometric response for NPZ-HCl in the concentration range from 7.0 ? 10-7 to 1.0 ? 10-2 M at 25 1C and the electrode response is independent of pH in the range of 3.1-7.9. These sensors have slope values of 59.770.6 and 59.270.2 mV decade?1 with detection limit values of 5.6 ? 10-7 and 5.9 ? 10-7 M NPZ-HCl using ISPE and ICPE, respectively. These electrodes show fast response time of 4-7 s and 5-8 s and exhibits lifetimes of 28 and 30 days for ISPE and ICPE, respectively. Selectivity for NPZ-HCl with respect to a number of interfering materials was also investigated. It was found that there is no interference from the investigated inorganic cations, anions, sugars and other pharmaceutical excipients. The proposed sensors were applied for the determination of NPZ-HCl in pharmaceutical formulation using the direct potentiometric method. It showed a mean average recovery of 100.2%and 102.6%for ISPE and ICPE, respectively. The obtained results using the proposed sensors were in good agreement with those obtained using the official method. The proposed sensors show significantly high selectivity, response time, accuracy, precision, limit of detection (LOD) and limit of quantification (LOQ) compared with other proposed methods.
ABSTRACT
Naphazoline,Diphenoxylate, Over-the-counter (OTC) cough and cold medications, widely used for the symptomatic relief of nasal obstruction, diarrhea or common cold symptoms. But these medicines might cause poisoning even if utilized in recommended doses for treatment. The side effects of these medicines were neglected when they were used much more commonly. The clinical manifestation of these medicine poisoning were delitescence and children' s parents couldn't provide the whole history, so these medicine poisoning were often misdiagnosis, even lead to treatment failure. We explore the toxicities of these medicines ,discuss their mechanisms and clinical manifestation, and suggest why physicians should be more vigilant in specifically inquiring about them when evaluating an ill child.