Fenistil overdose
Fenistil is an antihistamine and antipruritic agent for external and internal use, the international non-proprietary name is dimetindene. It belongs to the drugs of the first generation, compares favorably with other drugs in this group by higher activity and the absence of side sedation.
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The drug is intended to relieve the symptoms of allergies and pruritus by blocking H 1 -histamine receptors. Deprived of the ability to bind to specific receptors, histamine is not able to potentiate the release of biologically active substances from cells that cause allergy manifestations. Despite the fact that Fenistil interrupts the chain of pathological changes characteristic of the allergic process, it does not affect the cause of the disease - when taking the drug, histamine continues to be released into the systemic circulation, but does not have the ability to cause a pathological reaction.
Forms of release of Fenistil - gel [in 1 g of gel 1 mg of active substance (0.1%)], drops (1 mg of dimetindene in 1 ml of solution) and capsules of 4 mg.
The main diseases and conditions for which Fenistil is prescribed:
- chicken pox;
- measles;
- rubella;
- vasomotor and allergic rhinitis (including those caused by plant pollen);
- atopic dermatitis;
- itching of any etiology (including as a symptom of the underlying disease);
- dermatitis of unknown origin;
- hives;
- food allergy;
- angioneurotic edema;
- allergy of unspecified etiology;
- bites (stings) by non-poisonous insects and other non-poisonous arthropods;
- adverse reactions during the therapeutic use of drugs and medicines.
Fenistil for children is allowed in the form of drops from 1 month, however, it must be borne in mind that in children under one year old, the drug, in view of the depressing effect on the central nervous system, can provoke episodes of apnea (respiratory arrest) and cause SIDS (sudden infant death syndrome).
The drug is contraindicated in women under 12 weeks of pregnancy. In the future, both drops and gel are recommended for use, provided that the benefits of taking Fenistil to the mother outweigh the potential risk of complications for the fetus.
Fenistil enhances the inhibitory effect of anti-anxiety, hypnotics and antidepressants. When drinking alcoholic beverages during treatment, the speed of psychomotor reactions is significantly slowed down.
How much Fenistil is needed for an overdose?
The preparation in the form of a gel is applied to small intact skin areas with a thin layer 2–4 times a day, depending on the severity of the symptoms of the disease.
In the form of drops in adults, the recommended daily dosage of Fenistil is 3-6 mg per day (60-120 drops, respectively), depending on the severity of symptoms. The daily dose is divided into 2-3 doses of 20-40 drops.
20 drops of the drug (1 ml of solution) contains 1 mg of active ingredient.
In children, Fenistil is used in a dosage depending on age:
- from 1 month to 1 year, 3-10 drops once, the maximum daily dose is 30 drops;
- 1-3 years - 10-15 drops each, the maximum daily dose is 45 drops;
- in children over 3, but under 12 years old - 15–20 drops per appointment, maximum per day - 60 drops.
The drug in the form of capsules is approved for use by adults and children over 12 years of age, the dosage in this case is the same. As a standard, 1 capsule is prescribed 1 time per day, since the duration of action of Fenistil is 24 hours.
When taking the drug in excess of the recommended doses, acute intoxication may develop.
Signs of overdose
More often, an overdose develops when using Fenistil in drops or capsules. The main symptoms are:
- general lethargy, weak reaction to stimuli, a sharp decrease in spontaneous motor activity, drowsiness (mainly in adults);
- anxiety, motor and speech excitement, hallucinations, persistent dilation of the pupils, sometimes the development of psychosis (more often in children);
- violation of coordination of movements;
- tachycardia, hypotension;
- tonic or clonic seizures;
- dry mouth, thirst;
- hyperemia of the skin of the face, neck and décolleté;
- a sharp decrease in urination, complete urinary retention is possible;
- increased body temperature.
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Despite the fact that at the moment in Russia not a single fatal outcome of an overdose of Fenistil has been registered, theoretically it is possible as a result of paralysis of the respiratory and / or vasomotor center.
First aid for overdose with Fenistil
In case of an overdose, you must immediately take action:
- Gastric lavage (drink a large amount (1–1.5 l) of warm water or a slightly pink solution of potassium permanganate (potassium permanganate) and provoke an emetic urge by pressing on the root of the tongue). Attention! This method cannot be used in children of the first 3 years of life! In this case, gastric lavage is performed using a gastric tube in a hospital setting.
- Take a saline laxative (magnesium sulfate);
- Take an enterosorbent (for example, Atoxil, Polysorb according to the scheme or activated carbon at the rate of 1 tablet per 10 kg of body weight).
Antidote
There is no specific antidote to Fenistil.
When is medical attention required?
Medical assistance is needed if:
- a child, pregnant woman or elderly person is injured;
- after providing first aid, the victim's condition does not improve or worsens;
- active neurological symptoms (uncontrolled agitation, convulsions, disorientation, discoordination, etc.);
- the victim is unavailable or has limited access to contact;
- persistent fever not relieved by antipyretics;
- sharp tachycardia or a decrease in blood pressure below 80/50 mm Hg. Art.;
- acute urinary retention.
If necessary, by the ambulance team, the victim is hospitalized in the specialized department of the hospital, where he continues to receive medical assistance:
- artificial lung ventilation, oxygen therapy;
- forced diuresis (taking diuretics in combination with water load with alkaline drink (up to 5 liters per day) to activate the excretion of the drug by the kidneys);
- symptomatic treatment of developed neurological complications;
- the introduction of vasoconstrictor drugs with a sharp decrease in blood pressure (norepinephrine, Dopamine);
- with tachycardia - β-blockers.
Possible consequences
The consequences of an overdose with Fenistil can be:
- acute renal failure;
- anuria;
- acute psychosis;
- collapse, shock.
Lethal outcome is not excluded.
Prevention
To prevent an overdose of Fenistil it is necessary:
- do not leave the drug in places accessible to children;
- do not combine taking Fenistil with anxiolytics, sedatives;
- refuse to take alcohol during treatment;
- for the treatment of children, use only the drug in the form of drops or gel, in strict accordance with the recommended dosage regimen;
- to reduce the risk of developing apnea and SIDS in children of the first year of life, it is preferable to use drugs of the 2nd or 3rd generation to relieve allergy symptoms.
Olesya Smolnyakova Therapy, clinical pharmacology and pharmacotherapy About the author
Education: higher, 2004 (GOU VPO "Kursk State Medical University"), specialty "General Medicine", qualification "Doctor". 2008-2012 - Postgraduate student of the Department of Clinical Pharmacology, KSMU, Candidate of Medical Sciences (2013, specialty "Pharmacology, Clinical Pharmacology"). 2014-2015 - professional retraining, specialty "Management in education", FSBEI HPE "KSU".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
