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Imidazoline intoxication in children

L M Mahieu1, R P Rooman, E Goossens

  • 1Department of Paediatrics, Antwerp University Hospital, Belgium.

European Journal of Pediatrics
|November 1, 1993
PubMed
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Nasal naphazoline, an imidazoline derivative, can cause severe central nervous system (CNS) depression in young children, even with therapeutic use. Caution is advised when prescribing these vasoconstrictor solutions and they must be kept away from children.

Area of Science:

  • Pharmacology
  • Toxicology
  • Pediatrics

Background:

  • Nasal vasoconstrictors containing imidazoline derivatives are commonly used for rhinopharyngitis.
  • Naphazoline is an imidazoline derivative frequently found in over-the-counter nasal solutions.

Observation:

  • A 15-month-old girl experienced profound CNS depression, hypothermia, hypoventilation, and bradycardia after naphazoline nasal spray use.
  • Symptoms resolved within 24 hours.
  • Eighteen additional pediatric cases of naphazoline exposure reported to a national poison center were reviewed.

Findings:

  • Imidazoline intoxication from naphazoline is a significant risk in children, occurring with overdose, accidental ingestion, or therapeutic use.
  • Severe CNS depression is a primary concern, particularly in infants and very young children.

Related Experiment Videos

  • The Belgian National Poison Centre data highlights the frequency of such exposures.

    • Implications:

    • Healthcare providers should exercise caution when prescribing imidazoline-containing nasal solutions for pediatric patients.
    • Strict adherence to keeping these medications out of children's reach is crucial to prevent accidental poisoning.
    • Increased awareness and education regarding the potential toxicity of topical imidazoline derivatives in children are warranted.