The Prevention of Cardiac Arrhythmias Produced in an Animal Model by the Topical Application of a Phenol Preparation in Common Use for Face Peeling

Wexler, Menachem R.; Halon, David A.; Teitelbaum, Aliza; Tadjer, Georg; Med, Vet; Peled, Isaac J.; Wexler, Ron

doi:10.1097/00006534-198404000-00013

Cited by 42 publications

(17 citation statements)

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“…Management begins with basic resuscitation principles, as exposure to phenol can lead rapidly to respiratory failure, coma, dysrhythmia, and death. In chemical face peeling, brisk diuresis with intravenous furosemide during and after phenol chemical peels has been shown to decrease incidence and duration of dysrhythmias (58). It follows, therefore, that rapid infusion of intravenous fluids with the consideration of diuretic use to maintain high urine flow rates to excrete unconjugated phenol is appropriate per exposure.…”

Section: Phenolmentioning

confidence: 99%

Special Considerations in Hazardous Materials Burns

Robinett

Shelton

Dyer

2010

The Journal of Emergency Medicine

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Section: Phenolmentioning

confidence: 99%

Special Considerations in Hazardous Materials Burns

Robinett

Shelton

Dyer

2010

The Journal of Emergency Medicine

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“…There are no reported fatalities associated with the use of TCA. Phenol, however, in higher doses can be cardiotoxic, hepatotoxic, and nephrotoxic; Wixler et al 23 reported that 70% of phenol applied to the skin is absorbed within 30 minutes. After phenol is absorbed, 75% is either conjugated with glycuronic acid and sulfuric acid and excreted by the kidney, excreted unchanged by the kidney, or detoxified by oxidation in the liver to hydroquinone and pyrocatechin.…”

Section: Cardiac Arrhythmiasmentioning

confidence: 99%

“…However, peeling segments of the face in intervals with diuresis will allow metabolism and excretion of phenol and reduce arrhythmias. A brisk diuresis during and following phenol application in rabbits reduced cardiac arrhythmias substantially, 23 and this is effective in decreasing cardiotoxicity as well as the likelihood of hepatorenal toxicity.…”

Section: Cardiac Arrhythmiasmentioning

confidence: 99%

Complications of Chemical Peeling

Brody

1989

The Journal of Dermatologic Surgery and Oncology

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“…It is well known that phenol and cresol are toxic to humans in certain amounts (5,(14)(15)(16)(17)(18)(19). Repeated exposure may cause harmful effects on the liver and kidney.…”

Section: Introductionmentioning

confidence: 99%

What is the optimum concentration of m-cresol in antivenoms?

Abd-Elsalam¹,

Abdoon²,

Al-Ahaidib³

2011

J. Venom. Anim. Toxins incl. Trop. Dis

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Antivenoms against snake and scorpion envenomations are usually equine in nature and composed mostly of F(ab`)2; additionally, phenol and m-cresol are mainly employed for their preservation. Although there is no study on this subject, m-cresol is utilized by most manufacturers in a concentration that ranges from 0.15 to 0.35 g%. Decreasing the concentration of m-cresol to its minimal effective level may protect victims from its toxic effects and keep the antivenom stable during its shelf life without forming any aggregates. In the present work, different concentrations of m-cresol, ranging from 0.1 to 0.35 g%, were used with some selected batches of snake and scorpion antivenoms. A low concentration of 0.15 g% showed an acceptable preserving result that complies perfectly with antimicrobial specifications stated by the British Pharmacopoeia. Tested antivenoms (in 12 batches), when kept in a cold room for 39 months (more than their shelf life), retained their physical, chemical and microbiological activities according to the specifications of pharmacopeias. The present data demonstrated that reduction of m-cresol concentration to 0.15 g% in case of equine F(ab`)2 antivenoms will improve safety of such preparations and preserve their stability during their shelf life.Key words: antivenoms, preservative, m-cresol, stability. Original PaPer The Journal of Venomous Animals and Toxins including Tropical Diseases ISSN 1678-9199 | 2011 | volume 17 | issue 1 | pages 12-22 INTRODUCTIONAntivenoms are refined and concentrated preparations of equine serum globulins -mostly F(ab`)2 -obtained by fractionating blood from healthy horses that were previously immunized with different type of venoms (1, 2). For more than a century, antivenoms have been used effectively as the only treatment for snakebites and envenomations caused by other poisonous animals including spiders and scorpions (3). Most antivenoms are produced in liquid form to lower their cost and ease their use. Currently, there are eight antimicrobial preservatives commonly used in licensed parenteral products of which m-cresol and phenol are habitually employed by manufacturers as preservatives in antivenom formulations (4-6). Usually, phenol concentrations in antivenoms range from 0.15 to 0.5 g% (7-10). Combinations of phenol and thimerosal in different ratios have also been effectively used in some antivenom preparations (11,12). M-cresol, a phenol derivative, is frequently utilized as preservative in numerous antivenom preparations in concentrations that range between 0.15 and 0.35 g% (4,7,13).Despite their efficacy as additive, the use of these agents involves the possibility of some adverse effects. It is well known that phenol and cresol are toxic to humans in certain amounts (5,(14)(15)(16)(17)(18)(19). Repeated exposure may cause harmful effects on the liver and kidney. Additionally, potential development of multiple organ failure with persistence of organ dysfunction associated with the overdose of injectable phenol was already reported (20). Turbi...

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The Prevention of Cardiac Arrhythmias Produced in an Animal Model by the Topical Application of a Phenol Preparation in Common Use for Face Peeling

Cited by 42 publications

References 0 publications

Special Considerations in Hazardous Materials Burns

Special Considerations in Hazardous Materials Burns

Complications of Chemical Peeling

What is the optimum concentration of m-cresol in antivenoms?

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