title: [Naphazoline intoxication: course and therapy].
abstract: BACKGROUND
  As potent alpha-adrenergic agonists imidazoline derivatives like naphazoline are frequently used drugs because of their vasoconstrictive and decongestant properties. Beside their well-known local side effects also rare systemic ones like hypertension, excitability and nausea are possible. In case of intoxication this can enhance to ischemia of vital organs, bradycardia with arrhythmia, respiratory depression, hypothermia, excitation or marked sedation.
  
  
  METHODS
  Two cases of intoxication after application of naphazoline for haemostasis under the operation, the postoperative course and therapy are reported.
  
  
  RESULTS
  No specific antidote is available but a symptomatic drug therapy with intravenous administration of 5 mg phentolamine, an alpha-adrenoceptor antagonist acts against the vasoconstrictive side effects.
  
  
  CONCLUSIONS
  Because of the serious side effects and the narrow therapeutic to toxic window of naphazoline a strict observance of guidelines and contradictions, such as maximum dose, is necessary.
authors.affiliation: Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg. swenzel@uke.uni-hamburg.de
authors.forename: S
authors.initials: S
authors.lastname: Wenzel
authors.forename: G
authors.initials: G
authors.lastname: Laux
authors.forename: C
authors.initials: C
authors.lastname: Sagowski
authors.forename: W
authors.initials: W
authors.lastname: Kehrl
authors.forename: F U
authors.initials: FU
authors.lastname: Metternich
mesh_terms: D000233:Adenoidectomy; D000287:Administration, Topical; D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D000762:Anesthesia Recovery Period; D001919:Bradycardia / Q000139:chemically induced*; D002648:Child; D005260:Female; D006488:Hemostasis, Surgical; D006801:Humans; D006973:Hypertension / Q000139:chemically induced*; D007022:Hypotension / Q000139:chemically induced; D007431:Intraoperative Complications / Q000139:chemically induced*; D008297:Male; D009278:Naphazoline / Q000008:administration & dosage / Q000009:adverse effects*; D009300:Nasal Septum / Q000601:surgery*; D011183:Postoperative Complications / Q000139:chemically induced*; D012120:Respiration Disorders / Q000139:chemically induced; D014068:Tonsillectomy; D014420:Turbinates / Q000601:surgery*; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000316:Adrenergic alpha-Agonists; D014662:Vasoconstrictor Agents; D009278:Naphazoline