Overdose with drops in the nose. What dosage is considered safe? Consequences of improper treatment

Some vasoconstrictor nasal drops (naphthyzin, naphazoline, sanorin), often referred to in the treatment of ARVI and uncontrollably used by parents as a harmless, in their opinion, means, if used incorrectly, can cause a number of complications and even

Some vasoconstrictor nasal drops (naphthyzine, naphazoline, sanorin), often called in the treatment of ARVI and uncontrollably used by parents as a harmless, in their opinion, means, if used incorrectly, can cause a number of complications and even poisoning, since it happens that children drink the medicine ... The peak of accidents occurs between one and three years of age. How to help a child in case of poisoning. First you need to call an ambulance. Before help arrives, the child must be put to bed, warmed, and given a warm drink. The first signs of poisoning appear 30-40 minutes after contact with the drug. Lethargy, drowsiness, decreased appetite, pallor of the skin, cold sweat appear. The heart rate also decreases. The body temperature decreases. In case of severe poisoning, in addition to the above, consciousness is impaired, up to coma, blood pressure decreases to critical numbers.
To avoid such dire consequences, use only those drugs that your doctor has prescribed for you. Do not drip more and more often than prescribed by the doctor or written in the instructions, but in general - no more than 3-5 days. Buy the drug by age, and do not try to treat the child with the available “adults”. Keep nasal drops, like all medicines, out of the reach of children.
Be as careful and attentive as possible, because the health of your child is at stake!

Roszdravnadzor is sounding the alarm: due to improper use, popular nasal drugs can lead to serious problems with health in young patients.

According to Life, well-known pharmaceutical companies and Roszdravnadzor in 2016-2017 bombarded Russian pediatricians with warnings. Their content is about the same: children are increasingly poisoned vasoconstrictor drops... We are talking about naphthyzin, sanorin, otrivin and others similar drugs... If you overdo it, your child can get heart problems or even go into a coma. As noted by Roszdravnadzor, many parents do not know this and therefore allow children to bury them uncontrollably. As a result, thousands of children across the country are admitted to hospitals every year.

At the beginning of 2017, one-year-old Seryozha from the city of Tchaikovsky, Perm Territory, caught a cold, and his mother, leaving for work, instructed his grandmother on how to treat the baby. And although the boy sniffed, his mother did not leave any drops. The grandmother decided that this was not a problem, and instilled naphthyzine into her grandson. I didn't even drip it, but, one might say, poured it, so as not to leave the snot a chance. On this day, Vanya fell asleep earlier than usual after lunch.

Grandma woke him up and dripped some more. Then the child slept all day.

The mother, returning from work, could not wake up her son. In a panic, she called an ambulance. The arrived brigade by all possible ways tried to bring the child to life. With a heart rate of about 110-120 beats per minute, Seryozhino's heart beat at a rate of only 30 beats. The boy was pale and reacted only to strong pain stimuli. The hospital said: poisoning with naphthyzine.

The doctors managed to save Seryozha, a day later he was already running around the department, and four days later he was discharged home. The fact that the boy almost died is not to blame for the drops, but the adults who misused them.

How drops work

During the flu and colds, our nose clogs up from the fact that the mucous membrane in the sinuses swells and "swells". To relieve swelling, millions of our compatriots use drops such as naphthyzine. They constrict the vessels of the mucous membrane, the edema subsides, and the nasal passages expand.

Sanorin, naftizin, xylene, rhinostop are drugs of the same pharmacological group, explains the pediatrician, candidate medical sciences Tuyara Zakharova.

The problem is that with an overdose, not only the capillaries in the nose begin to narrow. The action extends to the large vessels that carry blood to the kidneys, heart and brain. It is fraught dangerous consequences: a person's pulse drops, blood pressure rises, signs of anemia appear. An adult's body is able to "swallow" large doses of drops without serious consequences... But for children, overdose is extremely dangerous. The worst thing that can happen is heart problems.

For example, sanorin is used only from the age of two, says Tuyara Zakharova. - This is due to the fact that children early age not even a large number of the drug may cause a spasm in the heart muscle.

Poisoning with medicine

Roszdravnadzor sounded the alarm and from June 2016 to May 2017 has already sent 12 official letters to all regional medical institutions about the dangers of using vasoconstrictors. Their copies are at the disposal of Life. These documents are prescribed to be distributed in all pharmacies and among pediatricians. Nine names of drops are mentioned in the letters. This is almost the entire "vasoconstrictor" range of Russian pharmacies.

Analyzing information about side effects [ vasoconstrictor drops and sprays], experts of Roszdravnadzor learned about a significant number of overdoses in pediatric practice, - says the documents of the department. - We recorded a large number of acute and subacute drug poisoning in children under 15 years of age [after using drugs].

A source in the department told Life that they began to study the problem after reports from children's hospitals in the central region.

We received data from one of the children's hospitals. In the department of toxicology, 892 children under the age of 15 were treated in the toxicology department in connection with [vasoconstrictor] poisoning, ”a source told Life. - All poisonings were accidental and occurred due to excess dosages, as well as due to non-observance of contraindications for age. However, the documents do not indicate how many children in Russia were poisoned by drops.

Life sent a request to Roszdravnadzor with a request to provide statistics, but has not received an answer yet. The scale of the problem can be assessed by the example of a particular Moscow hospital. Annually due wrong treatment only to the hospital. N.F. Filatov, 250-300 children under the age of four are enrolled.

In 2015, we received 244 children, and in 2016, 250 children were treated. Basically, in cases of poisoning, all liquid drugs are fixed and even household chemicals... For example, these are vasoconstrictor nasal drops, - Dmitry Dolginov, head of the toxicology department of the hospital, told Life.

Parents can recognize vasoconstrictor poisoning by several main signs.

The main symptom of vasoconstrictor poisoning is changes in the nervous system. The child becomes restless or, conversely, inhibited, '' Boris Blokhin, the chief freelance pediatrician of the Moscow Department of Healthcare, told Life. - You can avoid poisoning if you strictly follow the recommendations written on the preparations. And to understand that any medicine is not only a child's treatment, but also possible development side effects.

Life sent requests to large pharmaceutical companies in Russia and Germany, which produce drops, with a request to comment on the situation. These are the Moscow Endocrine Plant, German Bayer and Merkle GmbH. At the time of publication, only representatives of Bayer, which produces Nazol drops, responded.

To provide correct application drops, Bayer informed doctors and pharmacists about strict adherence to the dosage regimen, contraindications and precautions for use medicines, - the representative of the company Svetlana Meleshko told Life. - Bayer carefully processes all information about cases of misuse of drugs, adverse events and overdoses and provides this information to the regulatory authorities.

Verified and inexpensive remedy from nasal congestion conceals mortal danger, naphthyzine poisoning can have severe consequences for the body! This is especially true for children. To avoid problems, you need to study well the features and indications for its use. Knowing the consequences of "naphthyzine addiction" will not hurt either.

What is this drug?

Naphthyzine composition: naphazoline (main active ingredient), boric acid, purified water This combination has two types of effects: decongestant and vasoconstrictor. In the first case, we are talking about eliminating swelling of the nasal mucosa, in other words, getting rid of the feeling of nasal congestion.

Naphtizin - inexpensive drug from a cold

In the second, the active substance acts on the receptors of the mucous membrane, reducing blood flow to the tissues of the nasal sinuses. Thanks to these two effects, the person with the common cold is able to breathe freely again.

However, this remedy prescribed not only for nasal congestion, but also for treatment allergic rhinitis, sinusitis, laryngitis, acute nasopharyngitis, eustachitis (inflammation auditory tube). They use it during recovery period after operations on the nasopharynx. The dosage is selected on an individual basis, it depends on the type and severity of the disease that caused the need to take them, as well as the age of the patient:

for adolescents from 15 years old and adults: three to four times a day, 1-3 drops (in turn in each nostril);
children from 6 to 15 years old - two drops twice a day;
babies from 12 months to 6 years old - 1-2 drops in the morning and in the evening.

In any case, before using the drug, you must consult a doctor who can change the standard dosage regimen. It is absolutely unacceptable to instill naphthyzine during pregnancy and during breastfeeding. For children preschool age instill a 0.05% solution.

Adults and adolescents can be given a 0.1% solution. Drops must be cleaned before using nasal cavity from mucus. If you are very small, it is better not to bury the remedy for the common cold, but to make lotions: fill cotton swabs with the medicine (for each nostril) and hold it in the nostrils for two minutes (not simultaneously). This will reduce the likelihood that the baby will swallow the drug.

Indications for use and form of release of naphthyzine

Please note that when treating a small patient, a pediatrician may even prescribe a 0.25% solution. To obtain it, you need to dilute a 0.5% solution with distilled water.

Danger of cheap cold drops

Despite the fact that vasoconstrictors are sold in pharmacies without a prescription and are widely used by the population to treat nasal congestion, this drug is quite dangerous if used without a specialist's prescription.

Naphthyzine has contraindications, the main of which is the individual intolerance to naphazoline. This remedy should not be used by people suffering from high blood pressure, thyrotoxicosis and atherosclerosis. The drug is contraindicated in patients diabetes mellitus, hyperthyroidism and severe diseases of the organs of vision. You can not use these medicines for prolonged and chronic rhinitis, when both the nasal and maxillary sinuses are filled with mucus,

Important! Drops cannot be used together with antidepressants, since the naphazonline contained in the drug reacts with their active ingredient. This puts the human psyche at too great a risk. If you are taking antidepressants, you will need another remedy to combat nasal congestion. Which one - ask your doctor. In any case, do not self-medicate!

The specificity of the action of naphthyzine

Side effects

One of the main side effects of Naphthyzin is the addiction of the body to it. Simply put, your nose will not recognize any other cure for the common cold. The processes that occur at this moment in the body can be partly compared with the emergence of drug addiction. At the same time, with prolonged use, several serious side effects can appear at once:

headache, dizziness;
abdominal pain;
cardiopalmus;
nausea;
inflammation and increased edema of the mucous membrane.

Sometimes such side effects appear in the patient after the first day of using the drops. In this case, it is necessary to consult with your doctor about replacing the medicine with a more suitable analogue.

Overdose and poisoning

You can poison yourself with a remedy for nasal congestion with a strong excess of a one-time or daily allowance if you are using naphthyzine during pregnancy. The main symptom- drop in body temperature below 36 degrees. Other signs often appear:

lethargy and drowsiness;
pallor of the skin (especially the face and limbs);
cold sweat;
slow heartbeat (bradycardia).

Important! With a significant excess of the dosage, the effect of this drug on the body is similar to the effect of clonidine. The drug inhibits the central nervous system, therefore, it is unacceptable to take naphthyzine during lactation. If the symptoms described above appear, the patient needs hospitalization!

Contraindications when taking naphthyzine

Overdose relief

If you recognize the problem on early dates and accept emergency measures, poisoning can do without severe consequences for human health.

The sequence of actions for an overdose looks like this:

call an ambulance;
without waiting for the arrival of doctors, measure the body temperature of the victim, estimate the respiratory rate, measure the pulse (all readings must be recorded);
if the victim cannot be in sitting position, he should be helped to lie on a horizontal surface;
the poisoned person must be warmed with a blanket, blanket or warm clothes, you can give him a warm drink;
before the arrival of doctors, it is necessary to ensure that the victim is constantly conscious.

Depending on the patient's condition, doctors may inject him with an antidote (atropine sulfate). All manifestations of intoxication of the body must be stopped within 40-60 minutes. At acute poisoning naphthyzin " Ambulance"Will take the victim to the hospital to have biochemical analysis blood and took an electrocardiogram.

If the test results do not deviate greatly from the norm, the patient may be allowed to go home for treatment. Otherwise, the poisoned person will remain in the hospital until the moment when positive changes begin to be observed in his condition. Inpatient treatment will take one to three days.

Fragment of instructions for the use of naphthyzine

Poisoning in children: features and treatment

Poisoning with naphthyzine in children (with nasal use) manifests itself in the same way as in adults, first aid is provided according to a similar scenario, only in addition to atropine sulfate, doctors can inject prednisone to a small patient. Have child overdose leads to much more dangerous condition : if an adult feels lethargic and drowsy, then the baby may fall into a slight coma.

Another problem is that parents don't always connect feeling unwell baby with taking a drop from a cold. If your son or daughter somehow drank the bottle of medicine, proceed as in acute food poisoning:

call an ambulance;
without waiting for the arrival of doctors, rinse the baby's stomach clean water(in no case use potassium permanganate);
drink the victim after vomiting warm water(it is possible with the addition of Regidron);
wait for the arrival of the ambulance and tell the doctors in detail about the incident.

Important! Naphthyzine is strictly contraindicated during pregnancy, it cannot be used during breastfeeding, as well as given to children under one year old. Babies over 12 months old can only be given this remedy as directed by a doctor.

Consequences for the body

Naphthyzine for children is taken with caution

An overdose of naphthyzine can have serious consequences for the body, sometimes the victim cannot be saved. Therefore, it is very important to start providing assistance and call an ambulance as soon as possible. In toddlers under the age of 2 years, ingestion of 10 mg can be fatal, naphthyzine at breastfeeding prohibited!

The best place to store the vasoconstrictor solution is the refrigerator door, it is there that they will be provided with the necessary temperature regime... Before use, you need to warm the bottle in your hands or leave it for a quarter of an hour at room temperature... Remember that naphazoline is not a medicine per se, it only helps to ease breathing with a runny nose and others respiratory diseases... Many are interested in whether it is possible to drink alcohol at the same time as it? Answer: yes, you can, but by doing this you reduce the effectiveness of the treatment.

Of course, you cannot die from Naphthyzin, but the use of a vasoconstrictor drug alone does not provide a complete cure, so refrain from using the solution on your own and, moreover, from increasing the recommended dosage!

Even with a severe cold, the solution can be taken for no more than 5-7 days in a row. Remember, Naphthyzine is addictive! If nasal congestion persists, other treatments should be sought.

Video

Watch a shocking video about real situations when naphthyzine became a dangerous drug for people.

Today my nephew had something like seizures like in epilepsy, my sister and I talked with the doctor for a long time and realized that one of the things that could cause this is precisely those notorious nasal drops. Trying to protect the nephew from sinusitis, the sister overdid it with vasoconstrictor drops. Now, having rummaged in the internet, I found such an article ... Maybe someone will be interested, but basically a note for myself, so as not to repeat her mistakes ...

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 nasal mucosa and reduce the production of inflammatory serous or mucous secretions. But these substances are easily absorbed into the bloodstream. And then together with the desired local action their pronounced side effect for the whole cardiovascular system... 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: the simple instillation of drops in the nose can cause severe poisoning!

For whom vasoconstrictor nasal drops are most dangerous

How younger child, the less the dose of adrenergic agonist is required so that the baby needs emergency help. That's why the most vulnerable age is children from one to two years(about half of all cases). Second most frequent serious complications take babies up to 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 often wakes up crying at night. It would seem that there is nothing unusual in the fact that after instilling adrenomimetics into the nose, the baby stops sniffling 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, they are skipped by the parents. According to statistics, the most common complaint when asking for help is "the child does not wake up" or "they woke up with difficulty, but falls asleep again."

The more vasoconstrictor drops in the nose are absorbed into the systemic circulation, the more pronounced the general pallor of the skin, blueness around the mouth, sweating, cold extremities will be. 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. V severe cases can develop epileptic seizure or cerebral coma.

Why are nasal drops during pregnancy dangerous?

A 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 vessels feeding the placenta are spasmed. As a result, it becomes easier for the mother to breathe for a short time, and the child at this time suffers from a lack of oxygen.

What vasoconstrictor drops are the most dangerous

Naphazoline. It is part of drugs called Naphazoline Ferein, Naphtizin, Opcon-A, Sanorin, Sanorin with eucalyptus oil .
Xylometazoline. These are Brizolin, Galazolin, Grippostad Rino, Dlyanos, Doctor Theiss Nazolin and Rinotays, Influrin, Xylen, Xylobene, Xymelin, Nosolin, Olint, Rizaxil, Rinomaris, Rinostop, Suprima-NOZ.
Oxymetazoline. These are 4-Way, Afrin, Nazivin, Nazol and Nazol Advance, Nazosprey, Nesopin, Noxprey, Fazin, Fervex spray for rhinitis.

When nose drops cause poisoning in a child

The main reason is overdose medicinal product... When this happens:

a solution is used containing a greater concentration of adrenomimetic than is allowed at a certain age. Typical mistake- sprinkle "adult" drops into the baby's nose;
the drug is used with the correct dosage for children, but in a very large volume. For example, after instilling drops from the nose, mucus is removed and the medicinal spray is immediately reused;
the medicine is used more often than recommended in the instructions for the medicine.

Accidental poisoning occurs in children when the spray bottle is left within reach, and the child drinks the 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 the 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 from the pharmacy. Remember that vasoconstrictor drops do not cure a runny nose, but only facilitate nasal breathing with swelling of the mucous membrane. This occurs, as a rule, in the first 1-3 days. viral infection... Before you drip an adrenergic agonist, you need to clear the nasal passages from mucus using saline solution or sea water and suction pears. Perhaps this procedure will already be enough to baby nose"Breathed".

Nazivin is liquid solution clinically related - pharmacological group decongestant, vasoconstrictor drugs for local (nasal) use.

Active substance(oxymetazoline) helps relieve nasal congestion by making breathing easier. The advantage of the drug is the lack of absorption into the bloodstream, systemic effects.

Oxymetazoline - the main active ingredient - is an imidazoline derivative, belongs to the 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 blood vessels, due to which the swelling of the mucous membrane is eliminated. As a result, breathing is facilitated with rhinitis, sinusitis and other diseases due to the opening, expansion of the excretory canals 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. Active substance suppresses the activity of pathogenic viruses that are pathogens colds, runny nose.

Forms of release and chemical composition

The drug is presented in the form of nasal drops or spray various dosages- for adults and children. A clear solution either has no color at all, or is colored in 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 spray.

The drug is dispensed 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, ARVI, 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 tests.

Limitations and contraindications for use

The main contraindications include:

individual intolerance to the constituents 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.

The restrictions on admission apply to patients with diseases:

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

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

Common adverse reactions

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

Among side effects you can note:

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

Rarely observed:

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

When the appearance similar symptoms the use of the remedy should be suspended until true reasons deterioration of health.

Interaction with other medicines

monoamine oxidase inhibitors (MAOIs);
antidepressants of the tricyclic type.

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

Combination with products 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 the age:

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

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

Duration 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.

The clinical picture of an overdose

Exceeding the recommended doses of Nazivin occurs, as a rule, by accident. Either when you collect an excess amount of funds into a pipette, or as a result of intense pressure on the nebulizer. Atypical use also happens - orally, by mouth, or, by mistake, as eye drops.

Overdose has characteristic features:

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

Most victims of Nazivin overdose are observed:

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

In case of untimely appeal for medical help pathological phenomena can progress rapidly, lead to sudden stop breathing.

First aid at home

The first thing that needs to be done to help the victim of an overdose of Nazivin is to provide access fresh air and horizontal position. To facilitate breathing, the neck should be freed from the compression 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 oral administration, it is carried out:

gastric lavage with clean water, or weak solution potassium permanganate (the total volume of liquid is at least 1 liter);
reception of 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 fluids will help you cope with poisoning faster. Arriving qualified specialists should be informed about the expected excess of the dose, the method of using 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, plentiful drink allow you to eliminate the manifestations of poisoning. Improvement occurs over a longer period of time. Doctor's supervision is recommended. Hospitalization in satisfactory condition is not required.
In case of severe poisoning with Nazivin, the victim is taken to the hospital, where intensive care, aimed at eliminating symptoms. Treatment is selected individually for each specific clinical case.

Conclusion

An overdose of Nazivin is a common occurrence, especially among children. Self-application a child, mistaken use as eye drops or accidentally exceeding the amount of the injected drug can cause significant, sometimes irreparable harm to health. With absence emergency serious complications may develop, including falling into a coma and even death.