Decongestant nasal sprays

Low sedating antihistamine nasal spray with first-dose activity note onset of action not as fast as decongestant nasal sprays, but appropriate for prn use... 

Overuse or misuse of OTC products may induce significant medical problems. A prime example is rebound congestion from the regular use of decongestant nasal sprays for more than 3 days. The improper and long-term use of some... 

Graf P, HaUen H, Into JE. Benzalkonium chloride in a decongestant nasal spray aggravates rhinitis medicamentosa in healthy volunteers. Chn Exp Allergy 1995 25(5) 395-400. 

If using a decongestant nasal spray, use for one week only, as longer use can result in rebound effect. This increases inflammation of the nose, causing more congestion. 

If a steroid spray is to be used for inflammation and the nasal passages are blocked, the use of a decongestant nasal spray prior to the first uses of the steroid spray can clear the nostrils, ensuring that the steroid spray is delivered to the nasal lining. 

Allergic rhinitis Two percent aqueous nasal spray (EINTAL nasal spray) is used for nasal decongestion although it is not a nasal decongestant. 

Ephedrine is a component of the traditional Chinese remedy Ma Huang, extracted from Ephedra species, it is also used in nasal sprays as a decongestant. Pseudoephedrine is the active component of the decongestant Sudafed (so should that be Pseudephed ). 

Lunell E, Molander L, Andersson M. Relative bioavaUabil-ity of nicotine from a nasal spray in infectious rhinitis and after use of a topical decongestant. Eur J Clin Pharmacol 1995 48(l) 71-5. 

Ephedrine (C10H15ON) is a base that is used in nasal sprays as a decongestant. 

Menthol is a white, waxy crystalline compound having a strong odor of peppermint. Its main source is oil of peppermint from the plant, Mentha arvensis. It is an ingredient of decongestant ointments and nasal sprays and is also used to flavour toothpaste and cigarettes. 

TABLE 2.2 Over-the-Counter Medications with a High Potentiai for Addiction Nasal sprays Topical decongestants can be habit-forming. 

Ephedrine and neosynephrine are used as decongestants in cough syrups and nasal sprays. They cause shrinking of the membranes that line the nasal passages. These compounds are related to two chemicals that are important to the functioning of the central nervous system, L-dopa and dopamine, which are described in Section 16.5. 

Decongestants are available in nasal spray, drops, tablets, capsules, or in liquid form. Although decongestants address the congestion, frequent use of decon-... 

The development and use of adrenaline in the treatment of asthma was a major advance. In 1900, Solis-Cohen (19) injected crude adrenal extract into patients with asthma and hay fever. Shortly afterwards, Bullowa and Kaplan (20) reported the successful use of adrenaline injection. This became established as a standard therapy for relief of severe attacks of asthma. By 1911 a nasal spray containing adrenaline was in use for asthma and as a decongestant for hay fever and rhinitis. 

As the mucosa is highly sensitive to irritation, nasal toxicity of active substances and excipients is an important issue in formulating nasal preparations, especially when they are intended for treatment of chronic diseases [11]. Nearly all substances used in nasal preparations have a negative influence on the ciliary beat, and are therefore ciliotoxic. The influence may vary from a temporary (reversible) effect up to an irreversible inhibition of the ciliary beat [30]. In many nasal drops and nasal sprays preservatives cause the toxic effect on cilia [31], but the active substance itself may also have a negative influence on the ciliary epithelium. Nasal drops with decongestants have been shown to exhibit relatively low cUiotoxicity (e.g. Xylometazoline nasal drops 0.025 %, 0.05 % and 0.1 % (see Table 8.4) as well as a number of licensed preparations) [32]. 

Nasal decongestant sprays such as phenylephrine and oxymetazoline that reduce inflammation by vasoconstriction are often used in sinusitis. Use should be limited to the recommended duration of the product to prevent rebound congestion. Oral decongestants may also aid in nasal or sinus patency. To reduce mucociliary function, irrigation of the nasal cavity with saline and steam inhalation may be used to increase mucosal moisture, and mucolytics (e.g., guaifenesin) maybe used to decrease the viscosity of nasal secretions. Antihistamines should not be used for acute bacterial sinusitis in view of their anticholinergic effects that can dry mucosa and disturb clearance of mucosal secretions. 

Topical decongestants are applied directly to swollen nasal mucosa via drops or sprays (Table 79-3). They result in little or no systemic absorption. 

Blocked nasal passages should be cleared with a decongestant or saline irrigation before administration to ensure adequate penetration of the spray. 

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