Acute pulmonary edema associated with naphazoline ingestion.
In published reports of naphazoline ingestion, clinical effects are hypertension, bradycardia, pallor, diaphoresis, and respiratory distress. We report three cases of acute pulmonary edema after the intentional ingestion of naphazoline-containing antiseptic first aid liquid. These cases presented with altered mental status, hypertension, bradycardia, and diaphoresis. Chest x-ray on admission revealed acute pulmonary edema. Two cases required mechanical ventilation. All of these clinical effects resolved within 24 hours and the patients were discharged with no sequelae. Since naphazoline stimulates the peripheral alpha-2 adrenergic receptor, we speculate that intense vasoconstriction may have elevated cardiac afterload and left atrial-ventricular blood volume and caused acute pulmonary edema.
Fukushima
Hidetada
H
Department of Emergency and Critical Care Medicine, Nara Medical University, 840 Shijou cho, Kashihara City, Japan. hidetada@naramed-u.ac.jp
Norimoto
Kazunobu
K
Seki
Tadahiko
T
Nishiguchi
Takashi
T
Nakamura
Tatsuya
T
Konobu
Toshifumi
T
Nishio
Kenji
K
Okuchi
Kazuo
K
D000328:Adult; D001919:Bradycardia / Q000139:chemically induced; D003863:Depression / Q000150:complications / Q000523:psychology; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009278:Naphazoline / Q000008:administration & dosage / Q000506:poisoning*; D014663:Nasal Decongestants / Q000008:administration & dosage / Q000506:poisoning*; D011605:Psychoses, Substance-Induced / Q000523:psychology; D011654:Pulmonary Edema / Q000139:chemically induced* / Q000000981:diagnostic imaging; D011859:Radiography; D013406:Suicide, Attempted
D014663:Nasal Decongestants; D009278:Naphazoline