The article was professionally consulted by Pharmacist Dinh Thi My Hanh - Faculty of Pharmacy - Vinmec Central Park International Hospital
In 2012, the United States Food and Drug Administration (FDA) issued a warning of OTC (over-the-counter) nasal drops that can cause poisoning in young children, especially those under 3 years old, or even 2 months old, often leading to severe complications. Due to the seriousity of the potential side effects if young children are exposed to these products, parents and caregivers need to be aware of these risks.
1. When are children poisoned with nasal drops?
Most cases of nasal drop poisoning in children are caused by Naphazoline - a nasal drop widely used. The use of Naphazoline is to constrict blood vessels in the lining of the nose, helping to reduce swelling and congestion. Besides Naphazoline, there are other nasal drops such as Xylometazolin, Oxymetazoline, Tetrahydrozoline, and Fenoxazolin that can also cause poisoning in infants and young children. However, the rate of poisoning is lower. Typically, these nasal drops come in concentrations of 0.025% to 0.1% and are not packaged in a childproof bottle.
When used as prescribed, Naphazoline is for topical use only. But when children swallow mistakenly, the drug quickly spreads throughout the body. If used improperly (the child is not yet old enough to use), overdosed or for a long time, or let the child self-administer the drug, the drug can cause poisoning and lead to dangerous complications for young patients.
2. Symptoms of nose drop poisoning in children
After 30 minutes to 2 hours of using, if the child is poisoned with nasal drops, the child may have some of these symptoms:
Nervousness: headache, lethargy, tremor, coma 
Digestive: nausea , vomiting 
Heart: cold hands and feet, pale body, fast or slow heart rate, blood pressure changes (high at first, low later) 
Respiratory: slow breathing, irregular breathing, shortness of breath, intermittent pauses in breathing 
With severe signs, the child may have hypothermia and fall into lethargy.
If not diagnosed and treated promptly, children can have many serious complications.
After using nose drops, a child is lethargic and comatose.
3. Treatment of nose drop poisoning in children
When dangerous signs are recognized, parents and family members should take the child immediately to the nearest healthcare facility for timely treatment. Below are treatments when children poisoned with nasal drops:
Monitor the child's vital signs 
Intravenous fluids, oxygen, warming 
In severe cases, if the child stops breathing for a long time with blue discoloration of the skin, intubation is required to keep the airway open 
Closely monitor to detect and manage complications
Most nasal drop poisoning cases in children are mild, they only need supportive treatment and will recover on their own within 12-24 hours.
Treat nasal drops poisoning by intravenous fluids
4. Prevention of nose drop poisoning in children
When children have a stuffy nose, runny nose, parents and caregivers need to pay attention to these things to prevent poisoning with nasal drops in children:
Do not use nose drops in children without doctors’ prescription, especially in infants and children under 6 years old. 
For young children, you can help children clear their noses by rolling up tissue and dipping into normal saline 0.9% (sodium chloride), letting them eat liquid foods, and drink lots of water. 
Store medicine in a safe place where small children cannot reach or see it. 
If a pill container has a childproof cap, screw it back tightly after each use.
Nasal drop poisoning in children can occur due to the negligence of parents and caregivers. However, most of the symptoms are mild, if detected in a timely manner and treated properly, children can recover on their own within 12-24 hours.
Parents should take the children immediately to the nearest healthcare facility once there is any symptom.
Vinmec International General Hospital examines and treats common nasopharyngitis diseases, head and neck tumors, congenital malformations of the ear, nose and throat with the most optimal internal medicine or surgery for patients, both children and adults. A5 Vinmec International General Hospital, patients will get professional face-to-face medical examinations from a team of qualified, experienced and dedicated medical staff.
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References source: fda.gov, pharmacytoday.org, webmd.com,mountsinai.org
