Nasal disorders rhinitis

Nasal disorders Use of the nasal spray is not recommended in patients with known chronic nasal disorders (eg, allergy, rhinitis, nasal polyps, sinusitis) because such use has not been adequately studied. 

Nasal corticosteroids are effective in vasomotor rhinitis, but because of the duration of the disorder, certain caution is advised to avoid systemic effects and local adverse reactions after long-term use. Ipratropium bromide spray works well if the dominating problem is runny nose. 

Beclomethasone dipropionate is also used as a nasal spray in the prophylaxis and treatment of allergic and nonallergic rhinitis, and is used topically in the treatment of various skin disorders. It is generally applied as a cream or ointment. Beclomethasone salicylate has also been used topically. 

Infrequent adverse effects of desmopressin spray include nasal irritation, epistaxis, rhinitis, and nasal congestion, whereas desmopressin tablets or spray may cause transient headache, chills, dizziness, nausea, and abdominal pain. Rarely, water intoxication, hyponatremia, and subsequent tonic-clonic seizures have been reported, " particularly in children with concurrent physical disorders, intentional overdoses, or excessive fluid intake. When desmopressin is administered, evening fluids should be limited to 8 ounces to prevent hyponatremia or water intoxication. ... 

Ephedrine (25 to 50 mg p.o. t.i.d.) is indicated in the treatment of allergic disorders such as bronchial asthma nasal congestion in acute coryza vasomotor rhinitis, acute sinusitis, and hay fever. Ephedrine (25 to 30 mg slowly SC, IM, or IV) has been used to relieve acute bronchospasm, but epinephrine is more effective. Ephedrine is also used in shock. It is a naturally occurring sympathomimetic agent that stimulates alpha and beta receptors and CNS. It is less potent than epinephrine but has a longer duration of action (see also Figure 37). 

The mast cell stabilizers are used in combination widi other drugs in the treatment of asdima and odier allergic disorders, including allergic rhinitis (nasal solution), and in the prevention of exercise-induced bron-chospasm. When die mast cell stabilizers are used in conjunction widi odier antiasdima dni, a reduction in dosage of die dni may be possible after using die mast cell stabilizer for 3 or 4 weeks. These dni may be given by nebulization, aerosol spray, or as an oral concentrate... 

Olfactory disorders are often caused by affections of the nose and sinuses, such as rhinitis, sinusitis, nasal polyps, nasal septal deviation, and less frequently diabetes, hepatic diseases, or renal insufficiency. In this case, even though pyrazinamide was the probable cause, a role of diabetes cannot be totally excluded. Altered sense of smell has been associated with pyrazinamide plus levofloxacin [76 ] and altered taste or smell has been reported with pyrazinamide plus isoniazid plus rifampicin and with gatifloxacin [77 ]. 

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