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Jacqueline Sed
NUR 600: Benzonatate Annotated Bibliography
St. Thomas University
Dr. Delia Leal
March 24, 2024
2
Stephens, R. J., Filip, A. B., Baumgartner, K. T., Schwarz, E. S., & Liss, D. B. (2022). Benzonatate Overdose Presenting as Cardiac Arrest with Rapidly Narrowing QRS Interval. Journal of medical toxicology: official journal of the American College of Medical Toxicology
, 18(4), 344–349. https://doi.org/10.1007/s13181-022-00904-4
A popular prescription drug in the United States for an antitussive that isn't an opioid is benzonatate. The brand name Tessalon Perles is commonly used to sell it. Through antagonistic interactions with sodium channels in neurons, it is hypothesized to anesthetize stretch receptors in the respiratory tree. By plasma butyrlcholinesterase, it is quickly broken down. When voltage-gated sodium channels are antagonistic, overdose symptoms include cardiac and cerebral toxicity that can result in arrhythmia, agitation, convulsions, coma, and even death.
In this article, there is a case that is mentioned on A family member discovered the 14-year-old girl, who had a history of anxiety and asthma, in cardiac arrest in her bedroom. Before being discovered unconscious, she had been observed in her normal condition of health ten minutes earlier. Her relatives called EMS and began cardiopulmonary resuscitation (CPR). When paramedics arrived, the patient was in asystole, pulseless, apneic, and diaphoretic; CPR was maintained. This occurred around six minutes after CPR started. The patient underwent intraosseous cannulation and was given three 2-mg doses of naloxone and one milligram of epinephrine. About ten minutes
after emergency medical services arrived, the patient showed signs of sinus rhythm on the
cardiac monitor and returned spontaneous circulation (ROSC) during the resuscitation. Hypertonic saline or sodium bicarbonate were not given (Stephens et al., 2022).
3
Yang, S., Hincapie-Castillo, J. M., Ke, X., Schelfhout, J., Ding, H., Sher, M. R., Zhou, L., Chang,
C. Y., Wilson, D. L., & Lo-Ciganic, W. H. (2022). Evaluation of Cough Medication Use Patterns
in Ambulatory Care Settings in the United States: 2003-2018. Journal of clinical medicine
, 11(13), 3671. https://doi.org/10.3390/jcm11133671
There were increasing trends in the accidental intake of benzonatate by children aged 0 to
5 and the purposeful ingestion of benzonatate by children aged 10 to 16. The hazards connected with benzonatate exposure may be decreased by rational prescription and increased provider and caregiver knowledge of the harmful consequences of benzonatate.
3727 instances (80%) of the 4689 pediatric benzonatate exposure cases that US poison control centers received reports of between 2010 and 2018 had exposures to a single chemical. Of these, 3590 instances (77%) included inadvertent exposures, and the majority (2718 cases, 83%), involved children under the age of five. Cases of deliberate exposure to benzonatate rose among youth aged 10 to 16, with a higher rise in cases involving exposure to several substances. Children aged 10 to 16 made up the majority of
instances involving overuse or abuse of benzonatate.
The decline in prescriptions for antitussive drugs containing codeine and hydrocodone over the same research period suggests that the rise in benzonatate consumption may be a
byproduct of public health initiatives to reduce improper narcotic prescription use. A possible explanation for the increase in benzonatate use seen in this study is patients' dedication to seeking pharmaceutical alleviation for their cold and cough symptoms (Yang et al., 2022).
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