Avaliação do colírio de brimonidina 0, 2% em comparação à nafazolina 0,025% + feniramina 0,3% nas cirurgias de estrabismo / Evaluation of 0.2% brimonidine eye drops compared to 0.025% naphazoline + 0.3% pheniramine in strabismus surgery

RESUMO Objetivo: Avaliar o efeito do colírio de brimonidina 0,2% na redução da hiperemia e do sangramento ocular durante as cirurgias de estrabismo, em comparação com o colírio de nafazolina 0,025% + feniramina 0,3%. Métodos: Foram avaliados 14 pacientes com estrabismo e indicação de correção cirúrgica bilateral. Foi instilado antes do procedimento, de forma aleatória, um colírio em cada olho dos pacientes avaliados. A análise subjetiva da hiperemia conjuntival e do sangramento perioperatório foi realizada de forma duplo-cega, por dois cirurgiões. A avaliação objetiva do nível de hiperemia conjuntival foi realizada por análise das imagens obtidas por meio do software ImageJ®. Resultados: A análise de modelos multivariados de efeito misto indicou diferenças estatisticamente significantes entre os grupos em relação à hiperemia (avaliador 2) e ao sangramento intraoperatório (avaliadores 1 e 2), com maiores escores nos casos tratados com colírio de nafazolina + feniramina. Entretanto, não houve diferença estatística na análise objetiva realizada por meio da saturação de cores obtidas pelo programa ImageJ®. Conclusão: O colírio de brimonidina pode ser superior ao colírio de nafazolina + feniramina na redução do sangramento, levando-se em conta apenas a análise subjetiva.

ABSTRACT Objective: To evaluate the effect of 0.2% brimonidine eye drops in reducing hyperemia and ocular bleeding during strabismus surgeries, in comparison with 0.025% naphazoline + 0.3% pheniramine eye drops. Methods: Fourteen patients with strabismus and indication for bilateral surgical correction were evaluated. Before the procedure, the eye drops were instilled randomly in each eye of the evaluated patients. The subjective analysis of conjunctival hyperemia and perioperative bleeding was performed in a double-blind manner, by 02 surgeons. The objective assessment of the level of conjunctival hyperemia was performed by analyzing the images obtained using the ImageJ® software. Results: The analysis of multivariate mixed effect models indicated statistically significant differences between the groups in relation to hyperemia (rater 2) and intraoperative bleeding (raters 1 and 2) with higher scores in cases treated with naphazoline + pheniramine eye drops. However, there were no statistically significant differences in the objective analysis of color saturation obtained by the ImageJ® program. Conclusion: Brimonidine eye drops may be superior to naphazoline + pheniramine eye drops in reducing bleeding, taking into account the subjective analysis only.

Intoxicación grave con nafazolina: puesta al día a partir de un error terapéutico / Severe poisoning with naphazoline: update from a therapeutic error

La nafazolina es un fármaco utilizado como descongestivo, generalmente, en pacientes adultos. Su indicación en pediatría no es frecuente; su uso está aprobado a partir de los 12 años por los efectos tóxicos que posee. La intoxicación en niños genera un cuadro clínico potencialmente grave. Se caracteriza por la aparición inmediata de hipotonía, deterioro del sensorio, hipotermia y bradicardia con grado variable de compromiso clínico. Si bien es una intoxicación infrecuente, la anamnesis y el manejo inicial del paciente son la clave en su evolución. Se presenta a un niño de 4 años que, por un error terapéutico, recibió este fármaco y se destaca la instauración rápida y potencialmente grave del cuadro clínico.

Naphazoline is a drug commonly used as a decongestant in adult patients. Its indication in Pediatrics is not frequent, being approved its use from the age of 12 for the toxic effects it possesses. Intoxication in children generates a potentially serious clinical picture. It is characterized by the immediate appearance of hypotonia, deterioration of the sensory, hypothermia and bradycardia of variable degree of clinical compromise. Although it is an infrequent intoxication, the anamnesis and the initial management of the patient are the key in the evolution. We present a 4-year-old boy who, as a therapeutic error, receives this drug, emphasizing the rapid and potentially severe establishment of the clinical picture.

[Severe poisoning with naphazoline: update from a therapeutic error]. / Intoxicación grave con nafazolina: puesta al día a partir de un error terapéutico.

Naphazoline is a drug commonly used as a decongestant in adult patients. Its indication in Pediatrics is not frequent, being approved its use from the age of 12 for the toxic effects it possesses. Intoxication in children generates a potentially serious clinical picture. It is characterized by the immediate appearance of hypotonia, deterioration of the sensory, hypothermia and bradycardia of variable degree of clinical compromise. Although it is an infrequent intoxication, the anamnesis and the initial management of the patient are the key in the evolution. We present a 4-year-old boy who, as a therapeutic error, receives this drug, emphasizing the rapid and potentially severe establishment of the clinical picture.

La nafazolina es un fármaco utilizado como descongestivo, generalmente, en pacientes adultos. Su indicación en pediatría no es frecuente; su uso está aprobado a partir de los 12 años por los efectos tóxicos que posee. La intoxicación en niños genera un cuadro clínico potencialmente grave. Se caracteriza por la aparición inmediata de hipotonía, deterioro del sensorio, hipotermia y bradicardia con grado variable de compromiso clínico. Si bien es una intoxicación infrecuente, la anamnesis y el manejo inicial del paciente son la clave en su evolución. Se presenta a un niño de 4 años que, por un error terapéutico, recibió este fármaco y se destaca la instauración rápida y potencialmente grave del cuadro clínico.

Effect of Low-Concentration, Nonmydriatic Selective Alpha-Adrenergic Agonist Eyedrops on Upper Eyelid Position.

BACKGROUND: Ptosis after botulinum toxin injection is a disturbing complication. Decongestant and antiglaucoma eyedrops are frequently prescribed for temporary improvement of eyelid ptosis. Although frequently cited on informal communications, the effect of these drugs on eyelid position has never been compared in a formal study. OBJECTIVE: To measure the effect of low-concentration, nonmydriatic selective alpha agonist eyedrops on upper eyelid position. METHODS AND MATERIALS: This nonrandomized clinical trial enrolled 20 healthy subjects aged 18 to 50 years. The upper margin-reflex distance (MRD1) was measured before, 30, 60, and 120 minutes after administration of 1 drop of brimonidine 0.2%, phenylephrine 0.12%, or naphazoline 0.05% to the left eye. RESULTS: There was no statistically significant difference in mean MRD1 between the brimonidine and phenylephrine groups when comparing baseline to all other study time points. After administration of naphazoline 0.05%, MRD1 had a mean increase of 0.56 ± 0.11 mm (p < 0.001) after 30 minutes, 0.47 ± 0.12 mm (p = 0.001) after 60 minutes, and 0.26 ± 0.09 mm (p = 0.028) after 120 minutes when compared with baseline. CONCLUSION: Brimonidine 0.2% and phenylephrine 0.12% have no effect on eyelid aperture, but naphazoline 0.05% eyedrops could be useful for temporary relief of upper eyelid ptosis in selected patients.

A sub-minute electrophoretic method for simultaneous determination of naphazoline and zinc.

This paper reports for the first time, a method for simultaneous determination of naphazoline (NPZ) and zinc (Zn) using an analytical separation technique (capillary electrophoresis with capacitively coupled contactless conductivity detection -CE-C4D). A single run is possible every 55s (sampling rate=65h-1). The separation by CE-C4D was achieved on a fused silica capillary (50cm length - 10cm effective, 50µm i.d.) with a background electrolyte (BGE) composed by 20mmolL-1 of 2-(morpholin-4-yl)ethane-1-sulfonic acid (MES) and 20mmolL-1 of histidine (HIS) (pH 6.0). Detection limits were estimated at 20 and 30µmolL-1 and recovery values for spiked samples were 98 and 102% for NPZ and Zn, respectively. The developed procedure was compared to HPLC (NPZ) and FAAS (Zn) and no statistically significant differences were observed (95% confidence level).

Determinación de clorhidrato de nafazolina por cromatografía líquida de alta resolución en una solución oftálmica / Naphazoline hydrochloride assay by high performance liquid chromatography in an ophthalmic solution

Introducción: la Farmacopea de los Estados Unidos orienta cómo valorar clorhidrato de nafazolina en una solución oftálmica, pero indica el uso de una columna con grupos nitrilos unidos a sílice porosa, de uso poco frecuente. Objetivo: desarrollar y validar un método alternativo por cromatografía líquida de alta resolución (CLAR) para la cuantificación de clorhidrato de nafazolina en una solución oftálmica. Métodos: el método desarrollado fue de separación isocrática con columna Zorbax SB-C18 (4,6 x 150 mm, 5 µm) y detección ultravioleta a 225 nm. Como fase móvil se empleó solución amortiguadora y acetonitrilo (proporción 85:15, v/v) y la solución amortiguadora fue de KH2PO4 (22 mM) y trietilamina (30 mM), ajustada a pH 3 con ácido fosfórico concentrado. La validación del método se realizó siguiendo las indicaciones de la Guía Q2(R1) de la Conferencia Internacional sobre la Armonización. Se evaluaron los parámetros siguientes: especificidad, precisión, exactitud, linealidad y rango. También se determinó la incertidumbre del método. Resultados: en la especificidad, el placebo no tuvo señal en la zona de clorhidrato de nafazolina; los coeficientes de variación obtenidos para la precisión intermedia resultaron inferiores a 1,5 por ciento; en la exactitud el recobrado fue de 101,52 por ciento y en la linealidad se demostró la ausencia de curvatura en el intervalo 50 a 150 por ciento. La incertidumbre expandida calculada fue un 3 por ciento de la cantidad declarada. Conclusiones: todos los parámetros de validación evaluados se encuentran dentro los límites de aceptación establecidos, por lo que el método es adecuado para los fines propuestos(AU)

Introduction: the United States Pharmacopeia specifies how to titer naphazoline hydrochloride in an ophthalmic solution, but suggests the use of a column with nitrile groups attached to porous silica which is barely used. Objective: to develop and to validate an alternative method by high resolution liquid chromatography for the quantification of naphazoline hydrochloride in an ophthalmic solution. Methods: the developed method was isocratic separation with a Zorbax SB-C18 column (4.6 x 150 mm, 5 µm) and ultraviolet detection set at 225 nm. The mobile phase was buffer and acetonitrile (85:15 ratio, v/v) and the buffer was KH2PO4 (22 mM) and triethylamine (30 mM), adjusted to pH 3 with concentrated phosphoric acid. The validation method was performed pursuant to the Guide Q2(R1) of the International Conference on Harmonization and the following parameters were evaluated: specificity, precision, accuracy, linearity and range. The method uncertainty was also estimated. Results: regarding the specificity, the placebo did not show any signal in the naphazoline hydrochloride zone; the relative standard deviation indexes for intermediate precision were less than 1.5 percent; as to accuracy, the recovery was 101.52 percent and the linearity showed absence of curvature in the 50 to 150 percent range. The estimated expanded uncertainty reached 3 percent of the stated amount. Conclusions: all the validation parameters under evaluation were within the set allowable limits, thus this method is suitable for the intended purposes(AU)

Intoxicación por imidazólicos en pediatría: experiencia del centro de información y asesoramiento toxicológico en niños y adolescentes / Imidazole poisoning in children: experience and poison information center consulting in children and adolescents

Introducción: los derivados imidazólicos del tipo de la nafazolina son utilizados como vasoconstrictores locales, descongestivos nasales y oftálmicos. Su utilización en niños puede ocasionar una intoxicación aguda potencialmente grave. Conocer la epidemiología de esta enfermedad, los aspectos toxicológicos y la forma de presentación clínica puede contribuir a disminuir su incidencia. Objetivos: comunicar la experiencia del Centro de Información y Asesoramiento Toxicológico (CIAT) en menores de 15 años expuestos a imidazólicos y presentar tres casos clínicos de intoxicación por nafazolina asistidos en el Servicio de Emergencia Pediátrica del Hospital Británico (HB).Material y métodos: estudio retrospectivo de las consultas telefónicas por exposición a derivados imidazólicos realizadas al CIAT desde el 1° de enero del 2010 al 31 de diciembre del 2012. Revisión de historias clínicas de tres niños intoxicados por nafazolina asistidos en el 2013 en el HB.Resultados: el CIAT registró 27 casos, edad promedio 2 años y 10 meses. El agente más frecuente fue nafazolina (n=23). La vía intranasal administrado por un familiar, sin indicación médica, y la vía oral por ingesta accidental fueron las circunstancias de exposición más frecuentes. Los tres niños asistidos en el HB se presentaron como pacientes graves. Depresión neuropsíquica, hipotermia, bradicardia, frialdad periférica e hipertensión arterial transitoria o hipotensión, fueron los síntomas predominantes.Conclusiones: el uso de imidazólicos genera riesgo de intoxicación aguda, los niños pequeños son los más afectados, a pesar de la forma típica de presentación clínica puede confundirse con otras patologías. El pediatra es fundamental en la prevención, desaconsejando formalmente su uso.

Introduction: naphazoline type imidazole derivatives are used as local vaso constrictors, nasal and ophthalmic decongestants. Potentially severe acute poisoning in children use is described. Know about the disease epidemiology, toxicological aspects and clinical presentation can contribute to reduce their incidence.Objectives: communicate the experience of the Montevideo Poison Control Center (PCC) in children under 15 years exposed to imidazole derivatives, and present 3 clinical cases of children intoxicated by naphazoline assisted in the pediatric emergency room of the British Hospital (BH). Material and methods: retrospective study of phone consultations by exposure to imidazole derivatives at Montevideo PCC from January 1st of 2010 to December 31st of 2012. Medical records review of 3 poisoned children by naphazoline assisted in 2013 in the BH.Results: Montevideo PCC registered 27 cases, with average age of 2 years and 10 months. Naphazoline was the most frequent agent involved (n = 23). Intranasal route administered by a family member without medical indication, and non-intentional ingestion were the most frequent circumstances of exposure. The three children assisted in the BH emergency department were serious ill patients. Depression of consciousness, altered mental status, peripheral hypoperfusion, hypothermia, bradycardia and transient hypertension or hypotension, were the predominant symptoms. Conclusions: use of imidazolic derivatives generates great risk of acute intoxication. Young children are the most affected despite the typical form of clinical presentation can be confused with other severe diseases. The pediatrician has a critical role in preventing formally and discouraging its use.

Intoxicación por imidazólicos en pediatría. Experiencia del Centro de Información y Asesoramiento Toxicológico en niños y adolescentes / Imidazole poisoning in children. Experience and Poison Information Center Consulting in children and adolescents

Introducción: los derivados imidazólicos del tipo de la nafazolina son utilizados como vasoconstrictores locales, descongestivos nasales y oftálmicos. Su utilización en niños puede ocasionar una intoxicación aguda potencialmente grave. Conocer la epidemiología de esta enfermedad, los aspectos toxicológicos y la forma de presentación clínica puede contribuir a disminuir su incidencia.Objetivos: comunicar la experiencia del Centro de Información y Asesoramiento Toxicológico (CIAT) en menores de 15 años expuestos a imidazólicos y presentar tres casos clínicos de intoxicación por nafazolina asistidos en el Servicio de Emergencia Pediátrica del Hospital Británico (HB).Material y métodos: estudio retrospectivo de las consultas telefónicas por exposición a derivados imidazólicos realizadas al CIAT desde el 1° de enero del 2010 al 31 de diciembre del 2012. Revisión de historias clínicas de tres niños intoxicados por nafazolina asistidos en el 2013 en el HB.Resultados: el CIAT registró 27 casos, edad promedio 2 años y 10 meses. El agente más frecuente fue nafazolina (n=23). La vía intranasal administrado por un familiar, sin indicación médica, y la vía oral por ingesta accidental fueron las circunstancias de exposición más frecuentes. Los tres niños asistidos en el HB se presentaron como pacientes graves. Depresión neuropsíquica, hipotermia, bradicardia, frialdad periférica e hipertensión arterial transitoria o hipotensión, fueron los síntomas predominantes.Conclusiones: el uso de imidazólicos genera riesgo de intoxicación aguda, los niños pequeños son los más afectados, a pesar de la forma típica de presentación clínica puede confundirse con otras patologías. El pediatra es fundamental en la prevención, desaconsejando formalmente su uso.

Online naphazoline quality control by micellar-enhanced spectrofluorimetry.

The aim of this study was to develop a method for online spectrofluorimetric quality control of naphazoline (NPZ) in pharmaceuticals and raw drugs. A combination of a flow-injection analysis (FIA) system with micellar-enhanced fluorescence detection is presented as a powerful alternative for the rapid and sensitive analysis of naphazoline. Since NPZ shows low native fluorescence, the use of an anionic surfactant, such as sodium dodecyl sulphate (SDS), provides a considerable enhancement of fluorescence intensity and the nature of the technique allows a possible and easy adaptation to a FIA system. Using λ(exc) = 280 nm and λ(em) = 326 nm, a good linear relationship (LOL) was obtained in the range 0.003-10 µg mL(-1) with a detection limit (LOD) of 3 × 10(-4) µg mL(-1) (s/n = 3). Parameters related to the nature of the analytical signal and to the FIA manifold were optimized. Satisfactory recoveries were obtained in the analysis of commercial pharmaceutical formulations. The proposed method is simple, accurate and allows for high-speed sampling and considerably shorter analysis times. In addition, it requires inexpensive equipment and reagents and has easy operational conditions and no side effects, thus avoiding environmental pollution through toxic waste.

A comparative kinetic and mechanistic study between tetrahydrozoline and naphazoline toward photogenerated reactive oxygen species.

Kinetic and mechanistic aspects of the vitamin B2 (riboflavin [Rf])-sensitized photo-oxidation of the imidazoline derivates (IDs) naphazoline (NPZ) and tetrahydrozoline (THZ) were investigated in aqueous solution. The process appears as important on biomedical grounds, considering that the vitamin is endogenously present in humans, and IDs are active components of ocular medicaments of topical application. Under aerobic visible light irradiation, a complex picture of competitive interactions between sensitizer, substrates and dissolved oxygen takes place: the singlet and triplet ((3)Rf*) excited states of Rf are quenched by the IDs: with IDs concentrations ca. 5.0 mM and 0.02 mM Rf, (3)Rf* is quenched by IDs, in a competitive fashion with dissolved ground state oxygen. Additionally, the reactive oxygen species: O(2)((1)Delta(g)), O(2)(*-), HO(*) and H(2)O(2), generated from (3)Rf* and Rf(*-), were detected with the employment of time-resolved methods or specific scavengers. Oxygen uptake experiments indicate that, for NPZ, only H(2)O(2) was involved in the photo-oxidation. In the case of THZ, O(2)(*-), HO(*) and H(2)O(2) were detected, whereas only HO(*) was unambiguously identified as THZ oxidative agents. Upon direct UV light irradiation NPZ and THZ generate O(2)((1)Delta(g)), with quantum yields of 0.2 (literature value, employed as a reference) and 0.08, respectively, in acetonitrile.

Influence of the ageing phenomenon on the low-frequency electrical impedance behavior of naphazoline hydrochloride solutions and paracetamol syrup.

The influence of the ageing process on the low frequency behavior of some electrical parameters of naphazoline hydrochloride solutions at 0.5% and 1% in concentration and of 2% paracetamol syrup, is studied. The impedance measurements were performed, in the range between 200 Hz and 1 MHz, using an impedance analyzer and a cell for liquids with plane parallel electrodes whose separation can be changed by using a set of spacers, provided by the manufacturer, in order to get better control of the influence of electrodes polarization effect. The ageing state was artificially generated by dilution and/or heating separated procedures. The results show that this dielectric technique can be used as a good quality complementary control technique.

Hemorrhagic stroke after naphazoline exposition: case report.

Ten percent of all strokes are due to spontaneous cerebral hemorrhages. They are associated to drugs (licit and illicit) in 9.5% of all cases in young adults. This is a case report of a 44-year-old man, without previous morbidities, who presented a sudden onset headache and arterial hypertension 24 hours after use of naphazoline as nasal decongestant. Cranial tomography showed right thalamus hemorrhage. Cerebral angiography showed no aneurisms, vascular malformations or vasculitis. No other risk factors were found during investigation in this patient and the stroke was attributed to naphazoline exposition.

Hemorrhagic stroke after naphazoline exposition: case report

Dez por cento de todos os eventos vasculares encefálicos são devido às hemorragias intracerebrais espontâneas, associados a drogas (lícitas e ilícitas) em 9,5% de todos os casos em adultos jovens. Relatamos o caso de um homem de 44 anos de idade, sem doenças prévias, que apresentou cefaléia súbita e hipertensão arterial 24 horas após o uso de congestionante nasal contendo nafazolina. A tomografia de crânio evidenciou hemorragia talâmica. Durante a investigação não foram encontrados outros fatores de risco e a hemorragia foi atribuída à exposição à nafazolina.

[Acute exposure to imidazoline derivatives in children]. / Exposição aguda a derivados imidazolínicos em crianças.

OBJECTIVES: To study acute exposure to imidazoline derivatives in 72 children younger than 15 years of age, followed-up from January 1994 to December 1999. METHODS: This is a retrospective study of 72 patients with age between 2 months and 13 years (median 2 years; 25-75% = 1 to 3 years old) exposed to naphazoline (N = 48), fenoxazoline (N = 18), oxymetazoline (N = 5) and tetrahydrozoline (N = 1), through oral (N = 46), nasal (N = 24) or unknown (N = 2) routes. RESULTS: Fifty-seven children developed clinical manifestations such as somnolence (N = 34/57), sweating (N = 20/57), pallor (N = 17/57), hypothermia (N = 16/57), bradycardia (N = 13/57), cool extremities (N = 9/57), restlessness (N = 7/57), tachycardia (N = 6/57), vomiting (N = 5/57), irregular respiratory pattern and apnea (N = 5/57), miosis/mydriasis (N = 4/57). Naphazoline was the active ingredient most frequently involved (N = 47), followed by fenoxazoline (N = 5) and oxymetazoline (N = 4). The onset of clinical manifestations was rapid, beginning within 2 hours after exposure in 32/57 children. Only supportive measures were employed, with one child requiring mechanical ventilation after accidental naphazoline ingestion. In most of the children resolution of symptoms occurred within 24 hours (N = 39/57). No deaths were observed. Patients exposed to naphazoline (N = 47/48) presented a higher frequency of clinical signs of poisoning in comparison with those exposed to fenoxazoline (N = 5/18) (p < 0.001). There were no significant differences in the frequency of patients who presented clinical manifestations considering the route of exposure [oral (N = 34/46), nasal (N = 21/24); p = 0.31]. CONCLUSIONS: Most children (especially those younger than 3 years) exposed to imidazoline derivatives (especially naphazoline) presented early signs of poisoning regardless of the exposure route (nasal or oral). The main signs observed were nervous system, cardiovascular and respiratory depression. Most children showed complete resolution of the symptoms within 24 hours.

Exposiçäo aguda a derivados imidazolínicos em crianças / Acute exposure to imidazoline derivatives in children

OBJETIVOS: Estudar a exposiçäo aguda a derivados imidazolínicos em crianças com idade inferior a 15 anos, atendidas no período de janeiro de 1994 a dezembro de 1999. MÉTODOS: Neste estudo retrospectivo foram avaliadas 72 crianças com idades entre dois meses e 13 anos, mediana de dois anos (25 por cento a 75 por cento; um a três anos), expostas a nafazolina (n = 48), fenoxazolina (n = 18), oximetazolina (n = 5) e tetrizolina (n = 1); por via oral (n = 46), nasal (n = 24) ou desconhecida (n = 2). RESULTADOS: No total, 57 crianças desenvolveram manifestações clínicas: sonolência (n = 34), sudorese (n = 20), palidez (n = 17), hipotermia (n = 16), bradicardia (n = 13), extremidades frias (n = 9), agitaçäo (n = 7), taquicardia (n = 6), vômitos (n = 34), respiraçäo irregular e apnéia (n = 5), miose/midríase (n = 4), sendo a nafazolina (n = 47), a fenoxazolina (n = 5) e a oximetazolina (n = 4) os princípios ativos mais envolvidos. O início das manifestações clínicas foi rápido, iniciando-se, em 32/57 crianças, até duas horas após a exposiçäo. Somente medidas de suporte foram empregadas, com uma criança necessitando de ventilaçäo mecânica após exposiçäo à nafazolina. Na maioria dos pacientes, o quadro clínico remitiu até 24 horas após a exposiçäo (n = 39/57). Näo houve evoluçäo letal. Pacientes expostos à nafazolina (n = 47/48) apresentaram maior freqüência de manifestações clínicas de intoxicaçäo em comparaçäo com aqueles expostos à fenoxazolina (n = 5/18) (p < 0,001). Comparando-se a freqüência de pacientes que desenvolveram manifestações clínicas de acordo com a via de exposiçäo (oral, n = 34/46; nasal, n = 21/24), näo foi encontrada uma diferença estatisticamente significante (p = 0,31). CONCLUSÕES: Na maioria dos casos de exposiçäo a derivados imidazolínicos, principalmente à nafazolina e em crianças com menos de três anos de idade, ocorreu, independentemente da via (oral ou nasal), o aparecimento precoce de manifestações clínicas de intoxicaçäo, destacando-se as depressöes neurológica, cardiovascular e respiratória, que regrediram até 24 horas após a exposiçäo

Simultaneous determination of naphazoline, diphenhydramine and phenylephrine in nasal solutions by capillary electrophoresis.

A capillary zone electrophoresis (CZE) method has been developed to separate and quantitate naphazoline (NAPH), dyphenhydramine (DIP) and phenylephrine (PHE) in nasal solutions. Samples were diluted 1:25 in ultrapure water and injected at the anodic end. A central composite design has been used to optimise the experimental conditions for a complete and fast separation of the active ingredients studied. Critical parameters such as voltage, pH and buffer concentration have been studied to evaluate how they affect responses such as resolution and migration times. Separation was performed on a silica capillary with 75 microm I.D. and 70 cm total length at an applied voltage of 17.7 kV with a phosphate run buffer of pH 3.72 and 0.063 mol l(-1). Calibration curves were prepared for NAPH, DIP and PHE. For each analyte, the correlation coefficients were >0.999 (n=15). The RSD% of six replicate injections for each analyte were reasonably good. The method was applied to the quantitation of the three components in a commercial dosage form. The proposed method has the advantage of needing a very simple sample pretreatment and being faster than a typical HPLC chromatographic method.

Complementary use of partial least-squares and artificial neural networks for the non-linear spectrophotometric analysis of pharmaceutical samples.

The complementary use of partial least-squares (PLS) multivariate calibration and artificial neural networks (ANNs) for the simultaneous spectrophotometric determination of three active components in a pharmaceutical formulation has been explored. The presence of non-linearities caused by chemical interactions was confirmed by a recently discussed methodology based on Mallows augmented partial residual plots. Ternary mixtures of chlorpheniramine, naphazoline and dexamethasone in a matrix of excipients have been resolved by using PLS for the two major analytes (chlorpheniramine and naphazoline) and ANNs for the minor one (dexamethasone). Notwithstanding the large number of constituents, their high degree of spectral overlap and the occurrence of non-linearities, rapid and simultaneous analysis has been achieved, with reasonably good accuracy and precision. No extraction procedures using non-aqueous solvents are required.

Angina variante asociada al uso de un descongestionante nasal / Varying angina associated to the use of a nasal anticongestive agent

Se comunica la observación de un paciente que hace episodios de angina variante con taquicardia ventricular polimorfa, en relación a inhalación de nafazolina, como descongestionante nasal. Este caso plantea la eventualidad de que un medicamento de uso corriente, como estos preparados de pretendida acción local, pueda desencadenar arritmias severas, consecutivo a un espasmo coronario en individuos susceptibles, particularmente si presentan lesiones coronarias, por discretas que éstas sean

Histochemical study on the behavior of glycogen and total lipids in pregnant albino rats and their progenies treated with naphazoline

The histochemical study of 25 pregnant rats liver submitted to nasal drop instillation of saline and naphazoline at increasing concentrations, at the 19th day pregnancy, showed glycogen decrease and total lipid increase, only at a concentration of 1:1,000 of naphazoline. In this group occured also an increase of fetal liver lipids.