Hemodynamic effects following ingestion of an imidazoline-containing product.

Toxic ingestions constitute a major health problem for infants and young children, with an estimated 500,000 poisonings in 1980, 90% of them in children less than five years old. Mortality and associated expense are considerable. Sympathetic amines, while less commonly involved in pediatric poisonings, deserve special attention because of their potent cardiovascular side effects, eg, tachycardia and hypertension. Tetrahydrozoline, the active ingredient in several nasal and ophthalmologic over-the-counter medications, has previously been implicated in childhood ingestions. We report a case of tetrahydrozoline ingestion in which, paradoxically, lethargy, bradycardia, and hypotension were noted.