Vitezić D, Rozmanić V, Franulović J, Ahel V, Matesić D
Department of Pharmacology, Medical School, University of Rijeka, Croatia.
Arh Hig Rada Toksikol. 1994 Mar;45(1):25-9.
Naphazoline, a sympathomimetic and an imidazoline derivative, is used as 0.05-0.1% solution for local decongestion of the nasal and ocular mucosa. In excessive dosage, or if ingested by accident, may cause depression of the central nervous system (disturbances of consciousness progressing to coma), hypothermia, bradycardia and sweating. These naphazoline effects are particularly strongly pronounced in children. Anglo-Saxon pharmacotherapy excludes the application of naphazoline nasal drops in children younger than six years, whereas the Croatian pharmacotherapeutic literature (and practice) allows its use even in infancy. At the Kantrida Paediatric Clinic, Clinical Hospital Centre in Rijeka, 11 children with signs of intoxication with naphazoline nasal drops were hospitalized from 1990 to 1992. The symptoms pertaining to the central nervous system i.e. disturbances of consciousness in the form of somnolence were clearly marked in all children. Some children developed skin pallor, bradycardia, bradypnoea and hypothermia. Resolution occurred within 24 hours and the findings returned to normal values. Clinical picture followed by rapid resolution and normal findings, with a personal history of drug taking, is a safe indication for diagnosis. There are several reasons to account for intoxication (drops difficult to use with children, containers inadequate for proper dosage), but the major factor is the age of the patient--all hospitalized children were younger than six years. It is pointed out that administration of naphazoline drops at an early age is not advisable.
萘甲唑啉是一种拟交感神经药和咪唑啉衍生物，其0.05 - 0.1%的溶液用于鼻和眼黏膜的局部减充血。过量使用或意外摄入可能会导致中枢神经系统抑制（意识障碍发展至昏迷）、体温过低、心动过缓和出汗。这些萘甲唑啉的作用在儿童中尤为明显。盎格鲁 - 撒克逊药物治疗法禁止对6岁以下儿童使用萘甲唑啉滴鼻剂，而克罗地亚的药物治疗文献（及实践）甚至允许在婴儿期使用。在里耶卡临床医院中心的坎特里达儿科诊所，1990年至1992年期间有11名出现萘甲唑啉滴鼻剂中毒症状的儿童住院。所有儿童都有明显的中枢神经系统症状，即嗜睡形式的意识障碍。一些儿童出现皮肤苍白、心动过缓、呼吸浅慢和体温过低。症状在24小时内缓解，各项指标恢复正常。伴有快速缓解和正常指标的临床表现，且有用药史，是诊断的可靠依据。中毒有多种原因（儿童使用滴鼻剂困难、容器剂量不合适），但主要因素是患者年龄——所有住院儿童都不到6岁。需指出的是，早期使用萘甲唑啉滴鼻剂是不可取的。
