Camphor is one of several essential oils (volatile oils) derived from natural plant products that have been used for centuries as topical rubefacients for analgesic and antipruritic purposes (Table II–18). Camphor and other essential oils are found in over-the-counter remedies such as BenGay, Vicks VapoRub, and Campho-Phenique. In addition, camphor is used for religious, spiritual, aromatic, folk medicinal, and insecticidal purposes, often in powder or cube form. Toxic effects have occurred primarily when essential oils have been intentionally administered orally for purported therapeutic effects and in accidental pediatric ingestions.
Table II-18 Essential Oilsa |Favorite Table|Download (.pdf)
Table II-18 Essential Oilsa
Contains 98% methyl salicylate (equivalent to 1.4 g of aspirin per milliliter; see “Salicylates”).
Pediatric toxic dose 1 g (see text).
A potent sensitizing agent causing erythema, dermatitis, and stomatitis. A 7.5-year-old boy ingested 2 oz, which resulted in oral irritation, vomiting, diplopia, dizziness, vomiting, and CNS depression that resolved within 5 hours.
Contains 80–90% eugenol. Metabolic acidosis, CNS depression, seizures, coagulopathy, and hepatotoxicity after acute ingestion. Fulminant hepatic failure in a 15-month-old boy after a 10-mL ingestion. N-Acetylcysteine may be beneficial in preventing or treating the hepatotoxicity. Smoking clove cigarettes may cause irritant tracheobronchitis, hemoptysis.
Contains 70% eucalyptol. Toxic dose is 5–10 mL. Ingestion causes epigastric burning, vomiting, hypoventilation, ataxia, seizures, or rapid CNS depression.
Mild headache, constipation, and reversible gynecomastia (in prepubertal boys) reported with chronic dermal application.
Tea tree oil. Toxic dose in children is 10 mL. Sedation, confusion, ataxia, and coma are reported after ingestion. Onset in 30–60 minutes. Contact dermatitis with dermal contact.
An alcohol derived from various mint oils. Ingestion may cause oral mucosal irritation, vomiting, tremor, ataxia, and CNS depression.
Myristica oil. Used as a hallucinogen and purported to have amphetamine-like effects; 2–4 tablespoons of ground nutmeg can cause psychogenic effects. Symptoms: abdominal pain, vomiting, lethargy, delirium, dizziness, agitation, hallucinations, miosis or mydriasis, tachycardia, and hypertension. Fatality reported with co-ingestion of flunitrazepam.
Moderate to severe toxicity with ingestion of more than 10 mL. Vomiting, abdominal cramping, syncope, coma, centrilobular hepatic necrosis, renal tubular degeneration, disseminated intravascular coagulation, multiple-organ failure, and death. N-Acetylcysteine may be effective in preventing hepatic necrosis.
Contains 50% menthol. Oral mucosal irritation, burning, and rarely mouth ulcers reported. Intravenous injection resulted in coma, cyanosis, pulmonary edema, and ARDS. Allergic contact dermatitis with dermal exposure. Nasal instillation in 2-month-old resulted in dyspnea, stridor, hyperextension, coma, and metabolic acidosis.
Used as an antiseptic (see “Phenol”). May cause allergic contact dermatitis.
Contains methyl salicylate 98% (equivalent to 1.4 g of aspirin per milliliter; see “Salicylates”).
Absinthe. Euphoria, lethargy, confusion, agitation, hallucinations, seizures, rhabdomyolysis, renal failure, bradycardia, arrhythmias.