Images
Presentation
The charts of 60 patients who presented to the emergency room with the diagnosis of epistaxis and who required medical management were reviewed. Sixty-five percent of these patients were successfully managed with oxymetazoline as their sole therapy. [ncbi.nlm.nih.gov]
Entire Body System
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Gangrene
Development of gangrene necessitated a disarticulation at the wrist joint. Diagnosis, complications, and therapeutic measures of acute hand ischemia secondary to intra-arterial drug injection are discussed. [ncbi.nlm.nih.gov]
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Burning Pain
This resulted in severe burning pain, and cyanotic, cold, and pulseless hand, suggestive of acute ischemia. [ncbi.nlm.nih.gov]
Cardiovascular
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Hypertension
Severe hypertension with reflex bradycardia progressed to sinus arrest and was successfully treated with alropine and cardiopulmonary resuscitation. Decreasing the dose of oxymetazoline and pretreatment with an anticholinergic is recommended. [ncbi.nlm.nih.gov]
Category: Decongestant Description: Topical decongestant Indications: Nasal congestion Precautions: Pregnancy category C Children Hyperthyroidism, heart disease Hypertension, diabetes mellitus Adverse Reactions (Side Effects): CNS: dizziness, headache [medicalcorps.org]
Headache, insomnia, tachycardia, hypertension, nervousness, nausea, dizziness, palpitation, arrhythmia. Eye drops: Dryness of eye. Precautions Information Not Available Special Precautions Pregnancy, lactation. [drugsupdate.com]
Hyperthyroidism, diabetes, use of a monoamine oxidase inhibitor within 14 days, or known hypersensitivity to this drug prohibits its use. adverse effects Among the more serious adverse effects are rebound congestion, central nervous system stimulation, hypertension [medical-dictionary.thefreedictionary.com]
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Hypotension
Advise patients with cardiovascular disease, orthostatic hypotension, and/or uncontrolled hypertension/hypotension to seek immediate medical care if their condition worsens. [prnewswire.com]
Gradman Bradycardia, hypotension, and near‐syncope associated with afrin (oxymetazoline) nasal spray N Engl J Med, 309 (1983), pp. 73 [2] A. Khan, N. [elsevier.pt]
Because of his urinary retention, he was placed on the 1 antagonist tamsulosin but he could not tolerate it because of worsening of orthostatic hypotension. [web.archive.org]
oxymetazoline, naphazoline, tetrahydrozoline) in children has resulted in serious adverse events requiring hospitalization, including nausea, vomiting, lethargy, tachycardia, decreased respiration, bradycardia, hypotension, hypertension, sedation, [drugs.com]
Neurologic
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Stupor
[…] naphazoline, tetrahydrozoline) in children has resulted in serious adverse events requiring hospitalization, including nausea, vomiting, lethargy, tachycardia, decreased respiration, bradycardia, hypotension, hypertension, sedation, somnolence, mydriasis, stupor [drugs.com]
Fifty-three cases reported hospitalization due to symptoms including nausea, vomiting, lethargy, tachycardia, decreased respiration, bradycardia, hypotension, hypertension, sedation, somnolence, mydriasis, stupor, hypothermia, drooling, and coma. [fda.gov]
Workup
Microbiology
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Gram-Positive Bacteria
It is considered important in nasal defence as it enzymatically hydrolyses peptidoglycan bonds in bacterial cell walls and has specific activity against Gram-positive bacteria in vitro. [ncbi.nlm.nih.gov]
Rhythm
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Sinus Arrest
Severe hypertension with reflex bradycardia progressed to sinus arrest and was successfully treated with alropine and cardiopulmonary resuscitation. Decreasing the dose of oxymetazoline and pretreatment with an anticholinergic is recommended. [ncbi.nlm.nih.gov]
Treatment
NAR and VAS measurements were also made following withdrawal of treatment on Days 8 and 9. [ncbi.nlm.nih.gov]
Areas covered : Current treatment options for the treatment of rosacea include metronidazole, azelaic acid, sodium sulfacetamide-sulfur, and brimonidine. [doi.org]
Pathophysiology
The pathophysiology of this syndrome is discussed in light of locus ceruleus neuropharmacology. This may be the first report of such a withdrawal syndrome. [ncbi.nlm.nih.gov]
Szenborn, Pathophysiology of Clinical Symptoms in Acute Viral Respiratory Tract Infections, Pulmonary Infection, 10.1007/5584_2015_110, (25-38), (2015). [doi.org]
Prevention
The alpha-adrenergic agonist oxymetazoline was compared to cocaine and to lidocaine with epinephrine with respect to prevention of epistaxis on nasotracheal intubation. [ncbi.nlm.nih.gov]
[…] and oxymetazoline was 86% effective in preventing bleeding during this procedure. [intranasal.net]
Efficacy of pseudoephedrine for the prevention of barotrauma during air travel. Ann Emerg Med. 1994; 23:1324-7. 101. Jones JS, Sheffield W, White LJ et al. [drugs.com]