Monograph: |
Creosote
A liquid consisting of a mixture of guaiacol, cresol, and other
phenols obtained from wood tar. Commercial creosote used
for timber preservation is obtained from coal tar.
Creosote possesses disinfectant properties and has been used
as an expectorant. It has also been used as the carbonate and
as lactocreosote.
Adverse effects are similar to those of Phenol.
PHENOL
Adverse Effects
When ingested, phenol causes extensive local corro-
sion. with pain, nausea, vomiting, sweating, and di-
arrhoea. Excitation may occur initially but it is
quickly followed by unconsciousness. There is de-
pression of the CNS, with cardiac arrhythmias, and
circulatory and respiratory failure which may lead to
death. Acidosis may develop and occasionally there
is haemolysis and methaemoglobinaemia with cya-
nosis. The urine may become green. Pulmonary
oedema and myocardial damage may develop, and
damage to the liver and kidneys may lead to organ
failure.
Severe or fatal poisoning may occur from the ab-
sorption of phenol from unbroken skin or wounds
and suitable precautions should be taken to prevent
absorption. Applied to skin, phenol causes blanch-
ing and corrosion, sometimes with little pain. Aque-
ous solutions as dilute as 10% may be corrosive.
Toxic symptoms may also arise through absorption
of phenol vapour by the skin or lungs. Phenol throat
spray may cause local oedema.
Cresols and other phenolic substances have similar
effects.
Effects on the heart. A 10-year-old boy developed life-
threatening premature ventricular complexes during the ap-
plication of a solution of phenol 40% and croton oil 0.8% in
hexachlorophane soap and water for chemical peeling of a
giant hairy naevus. Cardiac arrhythmias have been reported
following the use of phenol for chemical face peeling.- They
were also observed in 3 of 16 children who received phenol
5% as a neurolytic.
Effects on the kidneys. A 41-year-old man developed
acute renal failure due to cutaneous absorption of phenol after
falling into a shallow vat of industrial solvent containing 40%
phenol in dichloromethane. No ingestion occurred. Other
symptoms included 50% body-surface bums, cold extremi-
ties. nausea , vomiting and respiratory distress The patient
required haemodialysis for 3 weeks; some abnormalities of
renal function remained one year later.
Eftects on sexual function. A report' of 3 patients who
developed urinary symptoms and impotence which lasted up
to one year after each receiving phenol 5% in arachis oil
sclerotherapy for haemorrhoids.
Effects on the throat. Acute life-threatening epigloltitis
occurred in a 49-year-old woman following the use of a throat
spray containing the equivalent of 1.4% phenol. The reaction
may have been anaphylactic or due to a direct toxic effect of
the spray. In the UK the Committee on Safety of Medicines'
reported in 1990 that it had received 4 reports (probably in-
eluding the one detailed above) of oedema of the epiglottis
and/or larynx leading lo respiratory difficulties. While the
incidence was rare, the effects were severe; one patient died
and 2 survived only after emergency hospital treatment.
Treatment of Adverse Effects
If phenol has been swallowed, activated charcoal
may be useful. Some sources suggest the cautious
of gastric lavage although this is generally inap-
propriate following ingestion of corrosive substanc-
es.
If phenol has been spilled on the skin removal of
contaminated clothing and excess phenol should be
followed by washing of the skin with copious
amounts of water, then a vegetable oil, Macrogol
300 and eucalyptus oil have also been used.
Contamination of the eyes should be treated by
flooding with water only for at least ten minutes.
The patient should be kept warm and given support-
ive treatment.
Precautions
Solutions containing phenol should not be applied to
large areas of skin or large wounds since sufficient
phenol may be absorbed to give rise to toxic symp-
toms.
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