Nasal decongestants for

Menthol, also known as peppermint oil, is used widely in toothpastes, mouthwashes, gum, sore-throat lozenges, lip balms, and nasal decongestants. For topical analgesic use, it is available in creams, lotions, ointment, and patches. The patches can be trimmed to fit the affected area. 

Taverner D, Latte J, Draper M. Nasal decongestants for the common cold. Cochrane Database SystRev. 

Nasal Decongestants for Systemic Use Sympathomimetics (pseudoephedrine, phenylpropanolamine, phenylephrine) and structural analogues (epinephrine, ephedrine)... 

Systemic decongestants or nasal decongestants for the reduction of the congestion that accompanies sinusitis... 

Sudafed 24 Hour (pseudoephedrine) over-the-counter nasal decongestant for 24 h relief of colds, sinusitis, hay fever, and other respiratory allergies. 

Additive sympathomimetic effects may develop when decongestants are administered with other sympathomimetic drug s (see Chap. 22). Use of the nasal decongestants with the MAOIs may cause hypertensive crisis. Use of a decongestant with beta-adrenergic blocking dragp may cause hypertension or bradycardia. When ephedrine is administered with theophylline, the patient is at increased risk for theophylline toxicity. 

Discuss important teaching points that should be included in developing a teaching plan for a patient taking a nasal decongestant. Determine what teaching points would be the most important. Provide a rationale for your answer. 

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. 

Methamphetamine is a potent stimulant that was first synthesized by a Japanese scientist in the early 1900s as an analogue of amphetamine for use as a nasal decongestant, antiasthma drug, and weight loss aid. However, it was not used commercially until the 1940s when it was manufactured and marketed as Methedrine by the pharmaceutical company Burroughs Wellcome. 

Ibuprofen, pseudoephedrine and chlorpheniramine are the drag substances have an effect as antihistaminic, nasal decongestant and antiinflammatory, respectively. The combination of these drags, is effective in cold, sinus and flu symptoms and used for upper respiratory infections. Nipagen (methylparaben) is widely used as... 

Rhinocort Aqua and Nasonex are preparations containing topical nasal corticosteroids (budesonide and mometasone furoate respectively). Otrivine contains a nasal decongestant (xylometazoline) and Sudafed is a systemic preparation containing a nasal decongestant (phenylephrine). Molcer is a preparation for ear-wax removal and which contains docusate sodium. Emadine contains an antihistamine (emedastine) and is presented as eye drops. 

Sodium chloride 0.9% is safe and effective in relieving rhinorrhoea. It is safer to use in children than topical nasal decongestants (xylometazoline), which are to be avoided in children under 6 years as the latter are more likely are cause side-effects (such as effects on sleep or hallucinations). Budesonide spray is used for allergic conditions and is not normally used in paediatric patients. Benzydamine spray is a throat spray intended to relieve pain in the throat. Mupirocin is indicated for staphylococcal infections. 

Paracetamol is indicated as an anti-pyretic and may be safely administered in a patient on warfarin. A topical nasal decongestant is effective for rhinorrhoea (runny nose) and would not interfere with warfarin. Altering the dose of warfarin is only recommended on the basis of results of international normalised ratio (INR) levels. 

Xylometazoline is a nasal decongestant. The maximum adult dose recommended is two drops into each nostril three times daily. The drops are not recommended for children under 2 years of age. 

Vasoconstriction. Local application of a-sympathomimetics can be employed in infiltration anesthesia (p. 204) or for nasal decongestion (naphazoline, tetra-hydrozoline, xylometazoline pp. 90, 324). Systemically administered epinephrine is important in the treatment of anaphylactic shock for combating hypotension. 

Recommended Dosage Guidelines for Oral and Topical Nasal Decongestants (Dosage Maximum per 24 h)-... 

Ephedrine is the main alkaloid produced in the roots of Ephedra sinica, preparations of which have found medical application in China for at least 5000 years. It was first purified from its natural source in 1887, and its chemical synthesis was achieved in 1927. It was initially used in cardiovascular medicine, but subsequently found wider application in the treatment of mild hayfever and asthma. It is also used as a nasal decongestant and cough suppressant. 

Do not take nasal decongestants or OTC cold preparations, especially those containing stimulants, without consulting the physician for approval... 

Yohimbine (4.43) is an antagonist. Yohimbine, an indole alkaloid closely related to reserpine—an a antagonist—has been evaluated as a potential treatment for male erectile dysfunction. Naphazoline (4.46) and other a-agonist imidazoline compounds are nasal decongestants, used by inhalation to decrease swelling of the nasal mucosa. Overdependence on and overuse of these drugs can lead to rebound swelling. 

A positive screening test result for amphetamines may be due to use of amphetamine or methamphetamine-containing prescription or over-the-counter drugs. For example, the drug Selegiline, which is used to treat Parkinson s disease, is metabolized to amphetamine and methamphetamine. The nasal decongestant pseudoephedrine can cross-react in the test and result in a false positive. In the latter case, the confirmatory test is for amphetamine. 

Ephedrine is useful for the treatment of chronic and moderate type of bronchial asthma, used as nasal decongestant and as a mydriatic without cycloplegia. It is also useful in preventing ventricular asystole in Stokes Adams syndrome. It is also used in narcolepsy, however amphetamines are the drug of choice. 

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

A very lipophUic, highly substituted benzene ring provides the side chain for the nasal decongestant a-blocker xylometazoline (82-5). The synthesis of this compound starts with the chloromethylation of the mesitylene derivative (82-1) followed by the displacement of chlorine by cyanide there is thus obtained the arylacetonittile (82-3). This is then converted to the corresponding imidazoline via iminoether (82-4) [86] by the sequence outlined above. 

The antihypertensive action of clonidine, a 2-imidazoline derivative, was discovered in the course of testing the drug for use as a nasal decongestant. 

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... 

Rynatan pediatric suspension is an antihistamine/nasal decongestant combination available for oral administration as a suspension. Each 5 mL (one teaspoonful) of the slate-purple-colored, natural strawberry-artificial currant-flavored suspension contains phenylephrine tannate 5 mg, chlorpheniramine tannate 4.5 mg, benzoic... 

Phenylephrine is a specific a-agonist with very little effect on p-receptors The other name for this drug, a brand name, is Neosynephrine and it can be found in nasal decongestant sprays and as a dilator in opthamology. It can also be used with the antihypertensive drug phenoxybenzamine and the smooth muscle relaxant papaverine in order to treat impotence in males. 

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