Use of tetrahydrozoline for chemical submission

Stillwell, Matthew E.; Saady, Joseph J.

doi:10.1016/j.forsciint.2012.04.004

Cited by 13 publications

(12 citation statements)

References 33 publications

(41 reference statements)

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“…Thus, it is important to make sure the patient and law enforcement understand that the absence of detectable drugs does not rule out the possibility of DFSA. As indicated in the case reports by Spiller and Siewert (2012) and Stillwell and Saady (2012), victims with late presentation may still have detectable levels of THZ in their urine.…”

Section: Treatmentmentioning

confidence: 93%

“…Blood and urine were collected approximately 20 hours after the assault and was identifiable in the urine, but not the blood, of both victims. Stillwell and Saady (2012) reported on two sexual assault patients who ingested THZ orally in alcoholic beverages. Both reported no symptoms, and despite the difference in the time since ingestion (7 hours and 23 hours), the substance was still identifiable in their urine.…”

Section: ▪ Summary Of Key Findingsmentioning

confidence: 99%

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Drug-Facilitated Sexual Assault With Tetrahydrozoline (Visine)

Edwards

Tilley

Ayala

2023

Journal of Forensic Nursing

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This is a case presentation of an 18-year-old male victim who experienced a drug-facilitated sexual assault (DFSA). The drug used to incapacitate him was tetrahydrozoline (Visine) given rectally. Tetrahydrozoline, intended for ophthalmic administration, is in the class of drugs known as imidazoline receptor agonists and has been used as an agent for DFSA since the 1940s. DFSA is increasing, particularly among young men. Care of victims of DFSA is discussed with particular attention to mental health sequelae in this patient population.

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Section: Treatmentmentioning

confidence: 93%

Section: ▪ Summary Of Key Findingsmentioning

confidence: 99%

Drug-Facilitated Sexual Assault With Tetrahydrozoline (Visine)

Edwards

Tilley

Ayala

2023

Journal of Forensic Nursing

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“…The tenfold 1 ml therapeutic dose of a 0.05 % oxymetazoline solution (about 0.5 mg substance) already caused bradycardia and respiratory depression [11]. Together with alcoholic beverages tetryzoline is often misused as a so-called rape drug [12]. In 2018, there was actually a case in South Carolina, USA, where for three days a wife put large amounts of over-the-counter eye drops with tetryzoline into the drinks of her unfaithful husband.…”

Section: Toxicitymentioning

confidence: 99%

<strong>How Toxic indeed is Oxymetazoline? Collection and Comparison of Toxicological Data of Pharmacologically Active Imidazoline Derivatives</strong>

Strey¹

2020

Preprint

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Imidazoline derivatives, such as xylometazoline, naphazoline, tetryzoline, tramazoline or oxymetazoline play an important pharmacological role as nasal drops in the symptomatic treatment of rhinitis. When comparing the toxicological data of these substances, it is noticeable that Oxymetazoline has an LD50 value which is two orders of magnitude lower than all other imidazoline derivatives. Thus, ten vials of commercially available oxymetazoline nasal drops already contain a lethal amount. An explanation for this unusually high toxicity has not yet been found.

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“…One case involved naphazoline that was mis-prepared at a compounding pharmacy as 4 % instead of 0.05 % [17]. Other case reports have described the use of imidazolines in drug-facilitated sexual assault [20,21]. Imidazoline derivatives include clonidine, tetrahydrozoline (THZ), tizanidine, naphazoline, and xylometazoline, and ingestion by children can present with similar clinical features of CNS depression and miotic pupils [11-13, 16, 18, 22].…”

Section: Case Continuedmentioning

confidence: 99%

“…Prolonged hypothermia up to 24 h has been reported [44]. Sinoatrial node block lasting up to 20 h has been also reported [20]. A prolonged cardiovascular effect up to 36 h was reported after ingestion of THZ [45].…”

Section: What Is the Expected Onset And Duration Of Imidazoline Toxicmentioning

confidence: 99%

Unintentional Pediatric Ophthalmic Tetrahydrozoline Ingestion: Case Files of the Medical Toxicology Fellowship at the University of California, San Francisco

2014

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An 18-month-old child was brought to the emergency department (ED) by his mother for evaluation of diarrhea, vomiting, and somnolence. He was lethargic, with "pinpoint" pupils. Blood pressure was 125/77 mmHg, heart rate was 70/min, temperature was 36.5°C, respiratory rate was 25/min, and pulse oximetry saturation (SpO 2 ) was 99 % on room air. Blood glucose was 101 mg/dL. Other initial laboratory investigation was unremarkable. Ethanol, acetaminophen, and aspirin were below detection limits. Urine drug screening was negative for amphetamine, methamphetamine, MDMA, barbiturates, benzodiazepines, cocaine, methadone, oxycodone, and opiates. Initial ECG done 3 h after ED arrival showed bradycardia with first-degree heart block. There was no response to 1 mg IV naloxone.

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Use of tetrahydrozoline for chemical submission

Cited by 13 publications

References 33 publications

Drug-Facilitated Sexual Assault With Tetrahydrozoline (Visine)

Drug-Facilitated Sexual Assault With Tetrahydrozoline (Visine)

<strong>How Toxic indeed is Oxymetazoline? Collection and Comparison of Toxicological Data of Pharmacologically Active Imidazoline Derivatives</strong>

Unintentional Pediatric Ophthalmic Tetrahydrozoline Ingestion: Case Files of the Medical Toxicology Fellowship at the University of California, San Francisco

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