An Atypical Adult Presentation of Acute Clonidine Intoxication: A Case Report

Clonidine is drug which was initially used as a nasal decongestant and now commonly used in the treatment of several conditions both in adults and children. Even though there is no minimum toxic dose for this drug, low-dose clonidine poisonings are commonly seen in children. Accidental ingestion of this drug or transdermal exposure can cause altered sensorium, hypertension, hypotension and bradycardia because of various mechanism of action. Key words: Clonidine, intoxication, hypotension, miosis.

Acute Dystonic Reaction in a 14-Year-Old Boy after Accidental Overuse of Nasal Metoclopramide

We present the case of a 14-year-old boy who developed an acute dystonic reaction 5 h following the overuse of a nasal metoclopramide spray that his mother gave him thinking it was a nasal decongestant. The patient had torticollis and intense motor restlessness, while he was fully conscious and hemodynamically stable. All laboratory investigations were normal. He was treated with a single dose of biperiden intravenously with direct disappearance of the symptoms. Children are particularly susceptible to the extrapyramidal side effects of metoclopramide that can occur irrespective of the route of administration.

Can Sex Improve Nasal Function?—An Exploration of the Link Between Sex and Nasal Function

Objectives: This study was conducted to examine the impact of sexual activity on nasal breathing and compare such effect to that of a nasal decongestant. Methods: We evaluated nasal breathing at 5 different times: (1) before sexual activity (baseline), (2) immediately after sexual activity, (3) 30 minutes, (4) 1 hour (5), and 3 hours after sexual climax. Same measurements were taken on the second day following application of nasal decongestant spray. For evaluation of nasal breathing, we used a visual analogue scale (VAS). Additionally, we used a portable rhinometric device to measure resistance and nasal flow. Results: Nasal breathing improved significantly after sexual intercourse with climax to the same degree as after application of nasal decongestant for up to 60 minutes, as measured subjectively with the VAS (sex −3.6, P < .001; spray −3.2, P < .001). This was confirmed in the objective rhinometric data as mean nasal flow (mL/s) increased while resistance decreased immediately (flow sex +214, P < .001; flow spray +235, P < .001), 30 (flow sex +249, P < .001; flow spray +287, P < .001), and 60 minutes (flow sex +180, P < .001; flow spray +287, P < .001) post-intervention. Nasal breathing was back to the baseline level after 3 hours following sexual intercourse, while it continued to be improved for longer after application of nasal decongestant. Only participants having nasal obstruction (Nasal Obstruction Symptom Evaluation score >30) showed nasal function improvement after sex. Conclusions: Sexual intercourse with climax can improve nasal breathing to the same degree as application of nasal decongestant for up to 60 minutes in patients having nasal obstruction.