Camphor and Mothballs

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CAMPHOR AND MOTHBALLSANGELICA GRACE L. CRUZ

BSP4A



CAMPHOR



Synonyms 2-Camphanone

Anemone Camphor

Formosa Camphor

Gum Camphor

Huile de Camphre

Kampfer

Laurel Camphor

Matri-caria Camphor



Uses Plasticizer

moth repellent

preservative in pharmaceuticals cosmetics

in lacquers and varnishes

explosives, and pyrotechnics

___

used as an antipruritic, topical rubefacient,aphrodisiac, abortifacient, contraceptive, coldremedy, suppressor of lactation, and antiseptic



Pathophysiology

Stimulant of cerebral cortex



Adverse Reactions Cardiovascular: Tachycardia, Reye’s syndrome, sinus

tachycardia

Central nervous system: Headache, dizziness, delirium,seizures, coma

Dermatologic: Nonimmunologic contact urticaria,eczema

Gastrointestinal: Nausea, vomiting

Hepatic: Elevated liver function tests

Neuromuscular & skeletal: Myoclonus, fasciculations

Ocular: Mydriasis, strabismus

Renal: Albuminuria

Respiratory: Tachypnea



Signs and Symptoms of Overdose A distinctive oral odor may be

apparent;

tachycardia

CNS depression

renal failure

Convulsions may occur suddenlywithout warning or may bepreceded by dementia

fasciculations

hyperventilation,

irritability

mental confusion

neuromuscular

hyperactivity

tremors, and jerky extremitymovement

Seizures may be followed bycoma and apnea

Vomiting may occur shortly

after ingestion (agastrointestinal irritant).

Hepatic transaminases may bemildly and briefly elevated.

Most symptoms occur within 30minutes. Chronic ingestion

may cause granulomatoushepatitis.



Monitoring Parameters Liver/renal function; monitor neurologic status



Overdosage/Treatment Decontamination:

Lavage (within 1 hour for ingestions >30 mg/kg)

Eye: Irrigate with room temperature tap water for 15minutes

Dermal: Wash affected area thoroughly with soapand water; systemic toxicity from dermal exposure isunlikely



Overdosage/Treatment

(cont.) Supportive therapy:

Treat seizures with benzodiazepines; if seizures arerefractory, phenobarbital or pentobarbital shouldbe initiated; ventilatory support may be required;do not give alcohols, oils, or fats because this willincrease absorption

Enhancement of elimination:

Lipid hemoperfusion and resin hemoperfusion hasbeen reported to decrease levels in patients withrefractory seizures; hemodialysis is ineffective;charcoal hemoperfusion may be helpful, althoughnot as clear a benefit as resin hemoperfusion; all ofthese techniques are somewhat controversial



PARADICHLOROBENZENE



Applies to: Fumigant (Mold/Mildew)

Moth Repellent

Pesticide

Toilet Deodorant



Uses Toilet/refuse deodorant

mold and mildew fumigant

moth repellent

diaper pail repellent

pesticide (for tree boring insects and ants)

control blue mold in tobacco seed beds



Pathophysiology Mucosal irritant due to necrosis of tissue proteins

by epoxide intermediates which are nephrotoxicand hepatotoxic by promoting cellular

degeneration and vacuolation



Adverse Reactions Central nervous system: Cerebellar ataxia

Dermatologic: Allergic purpura, dermal burns,

skin edema, hyperpigmentation

Hematological: Hemolysis/methemoglobinformation (especially in children), granulomadevelopment

Hepatic: Hepatitis and hepatic necrosis withcirrhosis

Ocular: Eye irritation (at 80-160 ppm)

Renal: Glomerulonephritis, alpha 2u-globulinnephropathy



Signs and Symptoms of Overdose

Acute hemolytic anemia

ataxia

cirrhosis

diarrhea

dyspnea

headache

hepatic necrosis

jaundice

Methemoglobinemia

nausea

oral burning

petechiae

pulmonary granulomas(upon inhalation)

purpura

slurred speech

vomiting



Monitoring Parameters Methemoglobin level, CBC, liver function test




Oral: Emesis within 30 minutes (>5 g ingestion) or lavage (within 1 hour) in conjunction with activated

charcoal may be utilized. Do not dilute with milk.

Dermal: Wash with soap and water; removecontaminated clothing.

Ocular: Irrigate with saline.

Supportive therapy: Treat symptomatic methemoglobinemia (or methe-

moglobinemia >30%) with methylene blue.



Antidote Methylene Blue



Naphthalene



Synonyms Camphor Tar

Moth Balls

Moth Flakes

Naphthalin

Naphthene

White Tar



Uses Moth repellents

toilet bowel deodorizers

in scintillation counters,

In the manufacture of phallic anhydride,naphthol, hydrogenated naphthalenes, andhalogenated naphthalenes

formerly used as an antihelmintic



Pathophysiology Hemolysis caused by oxidation products of

naphthalene; in patients with G6PD deficiency,metabolites cause instability of erythrocyte

glutathione



Adverse Reactions Cardiovascular: Sinus tachycardia

Hematologic: Glucose-6-phosphate

dehydrogenase deficiency-induced hemolyticanemia



Signs and Symptoms of Overdose

Anemia

coma

drowsiness

fever,

headache

hematuria

hemolysis

hyperkalemia

methemoglobinemia,

restlessness

seizures

urine discoloration(black) and vomitingmay develop in severeintoxications.

Tachycardia or

hypotension may alsooccur.

Hepatocellular injury israre, but may occur in3-5 days after

exposure




Oral: Emesis or lavage within 2 hours; activatedcharcoal. Avoid milk for 2-3 hours in that absorption

may increase.

Dermal: Wash with soap and water; avoid oil-basedcompounds.

Ocular: Copious irrigation with saline



Overdosage/Treatment

(cont.) Supportive therapy:

Alkaline diuresis may be needed if hemolysis occurs(use Ringer ’s lactate or I.V. sodium bicarbonate to

keep urine pH >7.5). Mannitol or furosemide may berequired to promote urine flow. Methylene blue: 1-2mg/kg of 1% if the patient is symptomatic or has amethemoglobin level >30%. Transfusion for severeanemia. Dialysis has been used for supportive care.Exchange transfusion has been used for supportivecare, but is not routinely recommended.

For inhalation injuries, nebulized budesonide (0.5 mgevery 12 hours for 4 days - pediatric dose) was foundto be helpful



Antidote Methylene Blue

Camphor and Mothballs

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