Nasal decongestants Sympathomimetics

Tetrahydro2oline [84-22-0] 2-(l,2,3,4-tetrahydro-l-naphthyl)2-imida2olin, (Tysine, Visine) (40), a sympathomimetic and nasal decongestant, is made by the condensation of 1,2,3,4-tetrahydro-l-naphthoic acid or its methyl ester with 1,2-ethylenediamine. 

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. 

Phenylephrine is a nasal decongestant that mimics the sympathetic system, thereby increasing the heart rate and blood pressure. It may aggravate conditions such as diabetes, hypertension and glaucoma. Patients with hypertension, ischaemic heart disease, hyperthyroidism, diabetes and glaucoma are therefore given topical nasal sympathomimetics rather than systemic sympathomimetics. Both topical and systemic sympathomimetics are contraindicated in patients taking monoamine oxidase inhibitors, because concurrent administration of the two products may lead to a hypertensive crisis. 

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. 

Most interactions listed apply to sympathomimetics when used as vasopressors however, consider the interaction when using the nasal decongestants. 

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

SYMPATHOMIMETICS CYTOTOXICS -PROCARBAZINE Co-administration of ephedrine, metaraminol, methylphenidate, phenylephrine or pseudoephedrine (including nasal and ophthalmic solutions) with procarbazine may cause a prolongation and t intensity of the cardiac stimulant effects and effects on BP, which may lead to headache, arrhythmias, hypertensive or hyperpyretic crisis The metabolism of sympathomimetics is impaired due to an inhibition of MAO It is recommended that sympathomimetics not be administered during and within 14 days of stopping procarbazine. Do not use any OTC nasal decongestants (sprays or oral preparations) or asthma relief agents without consulting the pharmacist/doctor... 

Sander KL, Brady WJ Jr, Hennes H. Visual hallucinations in a toddler accidental ingestion of a sympathomimetic over-the-counter nasal decongestant. Am J Emerg Med 1997 15(5) 521-6. 

Clonazoline [inn] is an imidazole sympathomimetic, an a-ADRENOCEPTOR AGONIST which Can be used as a VASOCONSTRICTOR and nasal decongestant. 

Inapsine droperidol. indanazoline [inn] is an imidazoline related to naphazoline. It is a sympathomimetic with vasoconstrictor properties, formerly used as a topical nasal decongestant. indapamide [ban.inn.jan, usan) (LozoI Natrilix etc.) is a (thiazide-related) DIURETIC, which can be used in antihypertensive therapy. 

ANTI ARRHYTHMIC, ANTIMIGRAINE, ANXIOLYTIC and ANTITHYROID treatment. The racemate is usually used in medicine but the (I )-form is also available - dexpropranolol [ban, inn) dexpropranolol hydrochloride [usan]. propranolol hydrochloride propranolol, propylhexedrine [ban, inn] (hexahydrodesoxyephedrine) is an (indirect-acting) sympathomimetic, a volatile liquid with properties similar to dexedrine. It is a CNS STIMULANT (with abuse potential) and has been used as a VASOCONSTRICTOR nasal DECONGESTANT. 

Phenylephrine hydrochloride LD50 in mice, 1000 mg/kg. Medical use Sympathomimetic. Topically as a vascoconstrictor, mydriatic, and nasal decongestant. 

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