2017
DOI: 10.4103/0970-9185.173331
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Xylometazoline nasal drops induced anaphylaxis: An atypical perioperative complication

Abstract: Xylometazoline nasal drops used for nasal decongestion can have side-effect in the form of palpitation, hypertension, headache, and tremors. Anaphylaxis to xylometazoline nasal drops is a relatively unrecognized complication. We encountered a patient posted for tonsillectomy who developed serious anaphylaxis upon administration of a commercially available preparation of xylometazoline nasal drops and required aggressive management for stabilization. Further evaluation and literature search indicated toward the… Show more

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Cited by 3 publications
(4 citation statements)
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“…BAC is commonly used as an bactericidal preservative and is another common excipient associated with anaphylaxis. 17 Anaphylaxis was reported following administration of xylometazoline nasal drops containing BAC, 17 following administration of nebulised salbutamol containing BAC 18 and after insertion of a BAC-coated central venous cannula. 19 There has since been a call to remove BAC from all nebulised solutions.…”
Section: Discussionmentioning
confidence: 99%
“…BAC is commonly used as an bactericidal preservative and is another common excipient associated with anaphylaxis. 17 Anaphylaxis was reported following administration of xylometazoline nasal drops containing BAC, 17 following administration of nebulised salbutamol containing BAC 18 and after insertion of a BAC-coated central venous cannula. 19 There has since been a call to remove BAC from all nebulised solutions.…”
Section: Discussionmentioning
confidence: 99%
“…describe the case of a 23-year-old patient referred for adenotomy who developed severe anaphylactic shock after applying 2 drops to each nostril of a commercially available xylometazoline preparation to reduce nasal mucosal congestion. [20] The patient required prompt intervention to stabilize baseline parameters as there was tachycardia (135 beats/min), hypotension (96/56 mmHg), and a decrease in oxygen saturation (92% for room air). Lung auscultation examination indicated bilateral wheezing.…”
Section: Adverse Side Effects -A Review Of Clinical Casesmentioning
confidence: 99%
“…[20] Xylometazoline hydrochloride (0.1%) as an active ingredient and benzalkonium chloride (BAC) (0.011%) having antiseptic properties, which is known for adverse effects such as anaphylaxis and angioedema, are suspected to be the main cause of the above mentioned symptoms. [20] After observing the aforementioned symptoms and correlating them with a positive skin test, as well as elevated serum tryptase levels-a marker of immune activation-it was concluded that the incident was an anaphylactic reaction to a xylometazoline-containing preparation. [20] Because of the poorly formed blood-brain barrier, neonates and infants are more sensitive to the central side effects of sympathicomimetics.…”
Section: Adverse Side Effects -A Review Of Clinical Casesmentioning
confidence: 99%
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