China 
Africa 
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Eustachian Tube Dysfunction
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
Oestrogen nasal drops or oral administration of saturated solution of potassium iodide has been used to induce swelling of the ET opening. Nasal medication containing diluted hydrochloric acid, chlorobutanol and benzyl alcohol has been demonstrated to be effective in some patients. This has been reported to be well tolerated with little or no adverse effects.41,44
Development of palliative medicine in the United Kingdom and Ireland
Published in Eduardo Bruera, Irene Higginson, Charles F von Gunten, Tatsuya Morita, Textbook of Palliative Medicine and Supportive Care, 2015
Numerous medications prolong the rate-corrected QT (QTc) interval and induce arrhythmias by blocking ionic current through cardiac potassium channels composed of subunits expressed by the human ether-a-go-go-related gene (HERG). Recent reports suggest that high doses of methadone cause torsades de pointes [98]. Kornick et al. [99] found that methadone in combination with chlorobutanol (the preservative present in the formulation of parenteral methadone) is associated with QTc interval prolongation.
Drug-induced bronchospasm
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
K Suresh Babu, Jaymin Morjaria
Edentate disodium (EDTA), a stabilizing agent, and benzoalkonium chloride (BAC), an antibacterial agent, are often present as preservative or stabilizing agents in inhalers and nebulizer solutions used in the treatment of asthma and COPD.133,134 Furthermore, sulphites and chlorobutanol have also been used as additives to non-sterile products to prevent bacterial growth in nebulizer solutions; however the former has also been reported to induce bronchospasm.132 Steroid-dependent asthmatics seem to be at a higher risk. Also of note, it has been reported that in asthmatic patients the use of inhaled corticosteroids (ICS) containing ethanol (an excipient) can trigger bronchoconstriction, probably due to the direct contact of ethanol and the bronchial mucosa.135 Thus, the use of ethanol-free formulations of ICS prevents this side-effect.
Microbial contamination of multiple‐use bottles of fluorescein ophthalmic solution
Published in Clinical and Experimental Optometry, 2019
Samuel Kyei, David France, Kofi Asiedu
The fluorescein‐anaesthetic combinations were compounded extemporaneously at the various facilities by mixing one part of two per cent w/v fluorescein with two parts 0.5 per cent w/v anaesthetic. The fluorescein solutions were obtained from a local pharmaceutical company (Archdiocesan Health Pharmacy Ltd, Kumasi, Ghana) and others imported from Aurolab, India. Benzalkonium chloride was the named preservative in all fluorescein solutions. The anaesthetics included Proparacaine HCl (Alcon, Fort Worth, Texas, USA and Ashford Laboratories, Macau, China) and Tetracaine HCl (Adcock Ingram Limited, Johannesburg, South Africa). The preservative was benzalkonium chloride for the Proparacaine HCl and chlorobutanol for the Tetracaine HCl.
N-hydroxymethylglycinate with EDTA is an efficient eye drop preservative with very low toxicity: an in vitro comparative study
Published in Cutaneous and Ocular Toxicology, 2018
Martina Cristaldi, Melania Olivieri, Gabriella Lupo, Carmelina D. Anfuso, Salvatore Pezzino, Dario Rusciano
Other preservatives used in eye drops such as chlorobutanol (Cbl), methyl paraben (MP), and stabilized thimerosal (Thi) also showed moderate to high toxicity24. Currently, SP, an oxidant preservative, has caused minimal toxicity to the eye25. It has been used in dental hygiene solutions since 1950 for its biocidal activity against bacteria, fungi, and viruses26. However, by forming hydrogen peroxide (a powerful antimicrobial agent), SP can disrupt cellular functions such as protein synthesis and generate free radicals that oxidize unsaturated lipids and glutathione, finally causing also some eukaryotic cell toxicity25.