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Long-acting nasal decongestants. Nasal decongestants: limitations of use

Vasoconstrictors are popular for a runny nose and nasal congestion. It has been proven that in the acute period they reduce clinical manifestations by almost 2 times. About the action of drugs, side effects, contraindications and possible complications.

Vasoconstrictor medications that relieve nasal congestion are called decongestants. The term translated from English means “against stagnation, blockage.”

These medicinal substances can be used:

  • Orally (systemic).
  • Locally (in the nose).

Decongestants are presented in three groups:

  1. With the main component pseudoephedrine. Systemic agents for oral administration: TheraFlu, Grippex and complex preparations with the antihistamine component Akrivastin, Actipred, Brompheniramine.
  2. With the main component phenylephrine. These are systemic combined (Maxicold, Coldrex, Rinza) and local drugs (Adrianol) with a duration of action of 4 to 6 hours. This group also includes Vibrocil (drops, spray) - an allergic combination drug.
  3. With the main component phenylpropanolamide - a combined agent with antihistamine action Contact 400.

Combined drugs, in addition to vasoconstriction, provide antibacterial, anti-inflammatory and mucolytic effects. They are prescribed for colds, sinusitis, acute and chronic rhinitis, and upper respiratory tract allergies.

The use of decognestants is justified in most cases: nasal congestion worsens the quality of life and negatively affects sleep, work and study. The drugs act quickly and effectively. They are easy to use and most can be purchased at pharmacies without a prescription.

But, despite the objective advantages of the drugs, self-medication and uncontrolled use can lead to serious consequences.

Flaws

Systemic (oral) decongestant medications have an extensive list of side effects. This is because they are quickly absorbed and act as stimulants on the nervous system. From the category of over-the-counter decongestants, they are gradually being transferred to prescription drugs.

For special indications, they are prescribed to patients with hypertension and men with prostate pathology. Decongestants cause nervous excitement and insomnia, so they are not recommended for use in the evening.

Local nasal agents after use can provoke both unwanted local symptoms and a general toxic effect.

Local manifestations:

  • Burning, dry mucous membranes in the nose and nasopharynx
  • Signs of rebound syndrome: deterioration of condition after discontinuation or reduction of dosage.
  • Autonomic changes, nasal hyperactivity.
  • Inhibition of secretory ability.
  • Impaired microcirculation of the mucous membrane.
  • Development of medicinal or atrophic rhinitis.

Local remedies of this group have another side effect: they stop the work of ciliated epithelial cells, and this makes it difficult for the self-cleaning of the mucosa. This leads to the uncontrolled development of bacterial flora in the paranasal sinuses.

Security Issues

The most serious problem associated with the use of decongestants is drug dependence and secondary nasal vasodilation (persistent enlargement of the lumens of blood vessels). Long-term use of drugs leads to drug-induced rhinitis, when hyperemia, swelling and congestion persist despite the therapy.


Vagotonics are susceptible to drug dependence on decognestants - people in whom the parasympathetic part of the nervous system predominates: hypotension with wet, cold palms and sensitivity to temperature changes.

In such patients, nasal decongestants normalize blood pressure, increase vitality and physical activity. For them, the drops replace several cups of coffee, and they use them more often. A vicious circle is formed: active, uncontrolled use worsens nasal breathing, the general toxic effect increases, and patients are unable to stop using these drops on their own.

Most of them exhibit symptoms of “withdrawal”, which differs little from alcohol or drug addiction.

Features of use in pediatric practice

It has been proven that young patients under 10 years of age are not susceptible to drug-induced rhinitis and “rebound syndrome”. This is due to the fact that at this age they are sympathotonic - with increased physical activity, increased heart rate, and early morning rises. But with uncontrolled treatment and overdoses, it is possible to obtain a general toxic and stimulating effect.

Ignorance among adults about side effects, availability of drugs, and lack of control by pediatricians lead to severe poisoning with decongestants. Clinical manifestations of intoxication in children occur in two phases:

  1. General nausea and vomiting, headaches, anxiety.
  2. Pale or bluish skin, muscle weakness, decreased body temperature.

In medical protocols for the treatment of bacterial and viral infections, children under 6 months with nasal congestion are advised to moisten the mucous membranes only with saline solution. Topical decongestants are allowed for children older than six months. Using them for more than three days is strictly prohibited!

Security Issues

Experts believe that decongestants are best used in the form of nasal sprays. Thanks to this dosage form, uniform irrigation of the mucous membrane and accurate dosage are ensured.

Rules for using decognestants:

  1. Before the procedure, thoroughly clear the nasal passages of mucus.
  2. While in a sitting or lying position, tilt your head back. When irrigating your left nostril, turn your head slightly to the left, and your right nostril to the right.
  3. Keep in mind that with deviated nasal septums and polyps, the effectiveness of local decongents is noticeably reduced.
  4. Use the medicine for no more than three days. In special cases, as prescribed by a specialist, the treatment period can be extended to one week.

Small patients (6–12 years old) with nasal congestion are prescribed half doses of drugs, and up to 6 years old - quarter doses. For children under 2 years of age, decongestant therapy should be carried out only according to indications and under the supervision of a pediatrician.

In the nose. Sometimes they are simply vital: the desire to inhale the air deeply forces you to resort to their use again and again. Time passes, sinusitis subsides, but the runny nose often remains, and along with it - nasal drops. Attempts to get rid of the annoying medication do not bring results, and the patient ends up in a vicious circle of drug-induced rhinitis. How to avoid such a turn of events?

Decongestants and sinusitis: a necessary necessity

Vasoconstrictor drugs - decongestants - are needed for sinusitis, almost like air. They not only restore breathing and allow the patient to feel like a human being. They facilitate the outflow of pus from the paranasal sinuses, reducing the size of the nasal cavity. It is the hyperemic, enlarged mucosa that “blocks” the opening between the sinus and the nasal passage. In addition, decongestants also reduce inflammation. Therefore, it is almost impossible to do without them for sinusitis.

Let us recall that nasal decongestants include two main classes of drugs:

  • sympathomimetics, which activate sympathetic nerves by releasing the neurotransmitter norepinephrine.
    Norepinephrine subsequently binds to alpha-adrenergic receptors, which it is rich in and causes constriction of blood vessels. Sympathomimetics include ephedrine preparations (pseudoephedrine, phenylephrine, ephedrine). Let us add that these products are available both in the form of nasal drops and in the form of tablets and children's syrups, which, as a rule, have a complex composition. Among the most famous drops with sympathomimetics, which are used for sinusitis and rhinosinusitis, is Vibrocil, containing phenylepherine and the antiallergic component dimethindene (diphenhydramine).
  • alpha-adrenergic agonists acting directly on receptors in the nasal cavity.
    Due to the fact that adrenergic agonists work “directly”, their effectiveness is more pronounced.

Vasoconstrictor nasal drops are an indispensable ingredient in home first aid kits. Not a single flu or acute respiratory viral infection can do without naphazoline, xylometazoline, oxymetazoline and other imidazoline drugs. What can we say about sinusitis or sinusitis?

What is the danger?

Decongestants work great. Regardless of the severity of rhinitis or sinusitis, they constrict blood vessels and give us the opportunity to breathe fully. But if you get carried away with such treatment, if the duration of use of decongestants is more than 4-6 days, you will have a lot of opportunities to get another problem in addition to sinusitis. Drug-induced rhinitis, also known as rebound rhinitis or withdrawal rhinitis, is characterized by no runny nose or sneezing. And the reason for this condition lies in adherence to decongestants.

The mechanism of development of drug-induced rhinitis is still not precisely known. However, experts have clearly identified risk factors that increase the likelihood of rebound rhinitis many times over. Among them:

  • allergic reaction;
  • rhinoplasty in the past;
  • chronic rhinosinusitis or sinusitis, including sinusitis;
  • upper respiratory tract infections.


For quotation: Zaplatnikov, Ovsyannikova E.M. Rational use of nasal decongestants for acute respiratory viral infections in children // RMZh. 2004. No. 1. P. 36

ABOUT Severe respiratory viral infections (ARVI) are the most common infectious diseases in children. The significant incidence of ARVI is due to the high susceptibility of children, especially young children, to the causative agents of these infections, a wide variety of etiological agents, as well as airborne transmission.

The entry gate for ARVI pathogens is the mucous membranes of the upper respiratory tract (nose, pharynx, larynx). Respiratory viruses, penetrating the epithelial cells of the upper respiratory tract, begin to actively replicate. The reproduction of viruses is accompanied by a cytopathic effect, the severity of which is determined by the characteristics of the pathogen. In this case, inflammation develops in the mucous membranes of the respiratory tract, accompanied by vasodilation with increased permeability of the vascular wall and increased exudation. Clinical manifestations of these processes are catarrhal symptoms (runny nose, cough, hyperemia of the mucous membranes of the tonsils, pharynx, etc.).

Treatment of children with ARVI is based on the individual characteristics of the child and the clinical picture of the disease. Thus, in children with an unfavorable premorbid background, regardless of condition, as well as in patients with severe variants of infection, the use of not only symptomatic, but also antiviral drugs (interferons, inducers of endogenous interferon, etc.) is indicated. In mild forms of ARVI, treatment of children is usually limited to the prescription of symptomatic drugs. It should be noted that in recent years, algorithms for the selection and features of the use of various symptomatic drugs (antipyretic, antitussive, expectorant, mucolytic) in children have been actively discussed. At the same time, the issues of rational use of nasal vasoconstrictor drugs in pediatric practice are not sufficiently covered, which was the reason for this publication.

A runny nose is the most common symptom of ARVI, reflecting inflammation of the nasal mucosa . In this case, hypersecretion and swelling of the mucous membrane develop. As a result, the clearance of the nasal passages decreases, which causes a feeling of “stuffiness” and makes nasal breathing difficult. Swelling of the nasal mucosa also leads to impaired drainage of the paranasal sinuses, which contributes to an increase in pressure in them. Conditions are created for the activation of opportunistic flora. As a result, there is a risk of developing complications such as bacterial sinusitis. Severe swelling of the nasopharyngeal mucosa leads to obstruction of the auditory tube with the possible subsequent occurrence of eustachitis, as well as otitis media. It should be noted that a runny nose, especially in young children, can cause sleep and appetite disturbances. At the same time, in newborns and infants, difficult nasal breathing can lead to refusal of breastfeeding.

Considering the above, it is clear that the use of medications that relieve a runny nose during ARVI not only improves the child’s well-being, but also prevents the development of possible complications. For this purpose they are used drugs that cause vasoconstriction of the vessels of the nasal mucosa . These vasoconstrictor drugs are called nasal decongestants (literal translation - “eliminating hyperemia and congestion in the nose,” from English. congestion- blockage, stagnation, hyperemia). Depending on the method of application, systemic and local decongestants are distinguished.

In pediatric practice they are mainly used topical decongestants . Moreover, in recent years, drugs containing adrenaline and ephedrine are practically not used for ARVI, and preference is given to imidazolines. Imidazolines include drugs such as oxymetazoline (Nazivin) , xylometazoline, tetrizoline, indanazoline and naphazoline (Table 1). Imidazolines are α-adrenomimetic drugs. When used, a-adrenergic receptors in the vessels of the nasal mucosa are activated, which leads to nasal vasoconstriction. Thanks to this, hyperemia and swelling of the mucous membrane are reduced, the level of nasal secretion is reduced, and the outflow of mucus from the paranasal sinuses is restored, which leads to normalization of pressure in them. At the same time, a runny nose is relieved, nasal breathing improves and the feeling of “stuffiness” disappears. In addition, reducing swelling of the mucous membrane in the area of ​​the pharyngeal mouth of the auditory tube contributes to adequate aeration of the middle ear. However, despite the similar mechanism of action, the analyzed drugs have significant differences, which determine their clinical effectiveness. Depending on the duration of the anticongestive effect, short-, medium- and long-acting drugs are distinguished (Table 1).

Derivatives of naphazoline, tetrizoline, and indanazoline are characterized by a short-term persistence of the vasoconstrictor effect (no more than 4-6 hours), which requires their more frequent use - up to 4 times a day. It has been established that among all nasal decongestants, these drugs have the greatest toxic effect on the cells of the ciliated epithelium of the nasal mucosa. It should be noted that in a number of countries, naphazoline derivatives are not recommended for use in pediatric practice. In Russia, the use of naphazoline is permitted in children over 2 years of age. It is emphasized that for children aged 2 to 6 years it is necessary to use a 0.025% solution of naphazoline. However, in practice, implementation of these recommendations is problematic, because official solutions of naphazoline and its analogues correspond to 0.05% and 0.1% concentrations. Attempts to independently, especially on the part of parents, bring the drug to the required concentration pose a potential threat of overdose. Considering this, the use of naphazoline and its derivatives in young children and preschoolers is inappropriate. In general, in recent years, short-acting vasoconstrictor drugs have been used less and less in children.

Nasal decongestants with an average duration of action (up to 8-10 hours) include xylometazoline derivatives . These drugs are not recommended for use in newborns, infants and children under the first 2 years of life. In children aged 2 to 12 years, a 0.05% xylometazoline solution can be used, and in children over 12 years old, a 0.1% solution can be used. Considering the duration of action of the drugs, the frequency of their use should not exceed 3 times a day.

Oxymetazoline derivatives (Nasivin) refer to topical vasoconstrictor drugs, the duration of action of which lasts for 10-12 hours. Thanks to this, the clinical effect is achieved with less frequent administration - it is usually sufficient to use them no more than 2-3 times a day. It should be noted that oxymetazoline preparations (Nasivin) when used in recommended doses do not cause disturbances in mucociliary clearance.

It has been established that the therapeutic effectiveness of oxymetazoline is achieved in lower concentrations than other vasoconstrictors. Thanks to this, dosage forms of oxymetazoline were created in a low concentration of 0.01%, which are effective in newborns and infants. The results of open multicenter studies studying the clinical effectiveness and safety of oxymetazoline (Nazivin 0.01%), conducted in 638 infants, showed that in 97% of cases of use of the drug, long-term restoration of nasal breathing was observed. Moreover, in more than 70% of cases, normalization of night sleep was noted.

High efficiency and good tolerability of low concentrations of oxymetazoline (Nazivin 0.01%) made it possible to recommend its use even in the treatment of newborns . It should be noted that Nazivin 0.01% is currently the only topical decongestant approved by the Ministry of Health of the Russian Federation for use in newborns and infants. In this case, newborns Nazivin 0.01% are prescribed 1 drop in each nasal passage 2-3 times a day, and from the fifth month - 1-2 drops in each nasal passage 2-3 times a day. It is recommended to use in children over 1 year of age and in preschoolers (up to 6 years of age). Nazivin 0.025% , while the concentration of the drug is 2 times lower than that of other local decongestants recommended for use from 2 to 6 years. Used in school-age children Nazivin 0.05% .

For practical use, topical decongestants produced in the form of nasal sprays are convenient. The use of nasal sprays is more effective due to the uniform distribution of the drug on the nasopharyngeal mucosa. However, until recently, their use in pediatric practice was limited due to the lack of dosage forms approved for use in children. Only in recent years, nasal sprays of xylometazoline and oxymetazoline (Nazivin 0.05%) have been registered in Russia. However, most of them have age restrictions, because... recommended for use in children over 6 years of age or even 12 years of age.

With strict adherence to the recommended dosage regimen, methods of application (intranasal administration in the form of drops or spray) and duration of use (no more than 3-5 days), side and undesirable effects when using topical vasoconstrictor drugs are rare. Among them are described: individual intolerance, medicinal rhinitis, as well as general manifestations (headache, nausea, increased excitability, palpitations, etc.), which more often develop in patients with hypersensitivity to adrenergic agonists. If the dosage regimen of local vasoconstrictor drugs is violated, drug-induced rhinitis may develop. At the same time, the occurrence of refractoriness of the vessels of the nasal mucosa to adrenergic agonists is discussed as the main cause of this condition, which leads to the development of secondary nasal vasodilation. Clinically, drug-induced rhinitis is characterized by the reappearance of hyperemia and swelling of the nasal mucosa with impaired nasal breathing and “stuffiness”, despite the therapy. The development of this complication occurs more often when using short-acting drugs. With prolonged and uncontrolled use of local decongestants, atrophy of the nasal mucosa may develop. Therefore, treatment with these drugs should not exceed 3-5 days.

It should be noted that in children, especially young children, despite the local method of application, the use of decongestants may be accompanied by the development of systemic undesirable effects. This is due to the fact that in children the resorptive surface of the nasal mucosa is increased due to the larger size of their relative area (relative to body weight). An increased entry of local decongestants into the systemic circulation is also facilitated by trauma to the mucous membrane, which often occurs due to defects in the toileting of the nasal passages (damage during rinsing and/or instillation with the tip of a pipette or bulb).

Violations of the recommended dosage regimen (increasing single doses or frequency of use) can lead to overdose with the development of serious pathological conditions including central nervous system depression, hypothermia and coma. Similar clinical manifestations are observed with accidental oral ingestion of these drugs. Therefore, topical decongestants, like all other drugs, must be kept out of the reach of children, and their use must be strictly regulated. At the same time, when prescribing these drugs to a child, the doctor must warn parents not to exceed the recommended doses.

It should also be remembered that it is inadmissible to use local vasoconstrictors simultaneously with taking tricyclic antidepressants (amitriptyline, clomipromine, etc.) or MAO inhibitors (metrolindole, etc.) due to the high risk of adverse events.

Concluding the description of local vasoconstrictor drugs, it should be noted that in general the optimal topical decongestant for the treatment of children with ARVI is oxymetazoline (Nazivin) .

In recent years, combination drugs for the symptomatic treatment of acute upper respiratory tract infections have become widely available on the domestic pharmaceutical market. As a rule, these drugs include an antipyretic and a systemic decongestant; less often, the combination is supplemented with antihistamines, ascorbic acid and expectorants. In this case, phenylephrine is used as a systemic decongestant. Previously included in combined over-the-counter drugs, phenylpropanolamine and pseudoephedrine are now classified as potent drugs, and therefore excluded from the list of over-the-counter drugs.

The therapeutic effect of systemic decongestants is due to their stimulation of α-adrenergic receptors in the vessels of the nasopharyngeal mucosa. As a result, nasal vasoconstriction occurs, hyperemia and tissue exudation decrease. This is accompanied by a decrease in nasal congestion, relief of a runny nose and improved nasal breathing in general. Restoring drainage of the paranasal sinuses and Eustachian tube helps reduce pressure in the paranasal cavities and middle ear. However, the lack of selectivity of action of systemic decongestants and the potential risk of developing various side effects require serious consideration of their use in children. In this regard, we consider it appropriate to briefly dwell on the most important issues of the practical use of systemic decongestants in pediatric practice.

Phenylephrine - adrenomimetic, stimulating predominantly a-adrenergic receptors. Phenylephrine is included in a number of combination medications used for influenza and other acute respiratory viral infections. Although in usual therapeutic doses the drug does not have a pronounced stimulating effect on the central nervous system, its use may develop side effects, manifested by agitation, anxiety, irritability, and tremor. The use of phenylephrine may also be accompanied by hypertension, cardiac pain and arrhythmia, dizziness and headache. Concomitant use with phenothiazine derivatives, furosemide and other diuretics reduces the therapeutic effect.

It should be especially emphasized that in pediatric practice, systemic decongestants (phenylephrine, etc.) due to the risk of developing the listed side effects have limited use and are allowed only in children over 12 years of age.

When prescribing combination drugs containing systemic decongestants, the doctor must draw the attention of the patient and his parents to the fact that these drugs may contain antipyretics (paracetamol or ibuprofen), histamine H1 receptor blockers (chlorphenamine, pheniramine, etc.) , antitussives (dextramethorphan), ascorbic acid, caffeine, etc. Therefore, additional use of antipyretic, antihistamine, antitussive or expectorant drugs can lead to their overdose and the development of undesirable effects.

Thus, when using nasal decongestants in the treatment of children with ARVI, the following principles should be adhered to. The choice of drug depends on the age of the child and his individual characteristics (Table 2). In this case, in newborns and infants, the drug of choice is Nazivin 0.01%. In children aged 1 to 2 years, Nazivin 0.025% should be used as initial anticongestive therapy.

In children aged 2 to 6 years, when using drugs in the form of intranasal drops, preference should be given to Nazivin 0.025%, as a drug that contains the active substance in a lower concentration and at the same time has a long-lasting clinical effect. In cases where it is decided to use a decongestant in the form of a nasal spray in children aged 2 to 6 years, only Xymelin 0.05% (xylometazoline) is prescribed.

Both oxymetazoline and xylometazoline can be used in children aged 6 to 12 years. In this case, oxymetazoline is used in the form of Nazivin 0.05% nasal drops or Nazivin 0.05% spray. Xylometazoline is also prescribed as nasal drops or a spray.

In children over the age of 12 years and in adolescents, “adult” dosages of xylometazoline in the form of 0.1% preparations can be used. At the same time, it is preferable to use oxymetazoline, which, even in children of this age, is effective in a lower concentration (Nazivin 0.05%). It should be noted that systemic decongestants can be considered an alternative to topical vasoconstrictor drugs in patients of this age group. The prescription of systemic nasal decongestants may be justified if a child with ARVI simultaneously has symptoms of intoxication (fever, headache, etc.) and there are no contraindications for their use.

Thus, currently in the arsenal of pediatricians there are effective anti-congestive drugs, the rational use of which can quickly stop the clinical manifestations of inflammation of the nasopharyngeal mucosa during ARVI, which not only improves well-being, but also prevents the development of possible complications.

Literature:

1. State register of medicines. - M.: Ministry of Health of the Russian Federation, 2000.

2. Acute respiratory viral infections./ Nisevich N.I., Uchaikin V.F. Infectious diseases in children. - M.: Medicine, 1985. - P. 55-73.

3. Acute respiratory diseases in children: treatment and prevention / Scientific and practical program of the Union of Pediatricians of Russia. - M.: International Foundation for Mother and Child Health, 2002. - 69 p.

4. Nurmukhametov R.A. Vasoconstrictors (decongestants). - Consilium provisorum. - 2001. - No. 1(1). pp. 21-23.

5. The state of health of the population of the Russian Federation in 2001 (Statistical report of the Ministry of Health of the Russian Federation). - Healthcare of the Russian Federation. - 2003. - No. 1. - P. 49.

6. Tatochenko V.K. Therapeutic tactics for acute diseases of the nasopharynx. GRM. - 1999. - T.7. - No. 11. - pp. 520-522.

7. Uchaikin V.F. Guide to infectious diseases in children. - M.: Geotar Medicine, 1998. - 700 p.

8. Akerlund A., Klint T., Olen L., Rundcrantz H. Nasal decongestant effect of oxymetazoline in the common cold: An objective dose response study. J Laringol Otol 1989; 103: 743-6

9. Cannon N.L., Dalgleisch J., Frank H. et al. Evaluation of oxymetazoline pediatric in the treatment of nasal congestion. J. Matern. Child. Health 1976; 1:32-3

10. Deitmer T., Scheffler R. The effect of different preparations of nasal decongestants in ciliary beat frequency in vitro. Rhinology 1993; 31: 151-3

11. Franke G., Muhle V., Tschiakin M. Final report on Post-Marketing Survelliance (PMS) study: Use of Nasivin TM sanft 0.01% metered dropper for infants. Merck Produckte Vertiebsgesellschaft& Co, Darmstadt, 2000

12. Jones N.S. Current concepts in management of pediatric rhinosinusitis. J Laringol Otol 1999; 113:1-9

13. Red Book: 2000. Report of the Committee on Infectious Diseases. 25rd: American Academy of Pediatrics, 2000, 855 p.

14. Ruggeberg F. Clinical trials of oxymetazoline hydrochloride nasal drops for babies (Nasivin TM 0.01%). Z Allg Med 1974; 11: 535-7

15. The Merck Manual. - 17th Ed., 1999.

16. Decree of the Government of the Russian Federation No. 681 of June 30, 1998 On approval of the list of narcotic drugs and their precursors subject to control in the Russian Federation.

Topical, or local, decongestants are a group of vasoconstrictor drugs that are actively used in the treatment of the common cold and its complications. The literal translation of this term: de is a prefix meaning “decrease”, congestion (English) is “swelling, stagnation”. Under the influence of decongestants, the lumen of the blood vessels narrows, blood supply decreases and the secretion (secretion) of nasal mucus decreases, which helps reduce swelling, nasal congestion and facilitate nasal breathing. Most decongestants are classified as over-the-counter products, which has made them extremely popular among consumers.

Mechanism of action of traditional decongestants

Under the influence of the active component of the vasoconstrictor (decongestant), the lumen of the blood vessels narrows and the swelling of the mucous membrane decreases, which facilitates nasal breathing. At the same time, a decongestant can have an undesirable side effect on the mucous membrane: cause it to become dry and lead to a weakening of the movement of special “cilia” that cleanse the mucous membrane of bacteria, viruses and other foreign particles.

Indications for the use of vasoconstrictors

  • Acute rhinitis of bacterial or viral nature
  • Acute sinusitis and exacerbation of chronic sinusitis
  • Acute otitis media
  • Seasonal and year-round allergic rhinitis

Decongestants are used as aids in preparation for diagnostic procedures and in the first days after surgical interventions on the nasal cavity. Decongestants should be used taking into account age-related characteristics.

Rinomaris ® - a new generation decongestant

Rinomaris ® is a new generation decongestant, which, in addition to xylometazoline (one of the most effective and safe vasoconstrictors), includes natural sea water. Under the influence of xylometazoline, due to the rapid narrowing of blood vessels, swelling decreases and breathing becomes easier, and sea water prevents mucus stagnation and the spread of harmful microorganisms into the cavities adjacent to the nose - the auditory tube and paranasal sinuses, thus reducing the risk of complications of the common cold (otitis and sinusitis).

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1. Abdulmajid A.K., Arlt A.V., Molchanov A.I. The effect of dibicor and taurine on cerebral blood flow in the post-ischemic period // Pharmacy.–2009. –No. 1.– P. 45 – 47.

2. Arlt A.V. The effect of preductal and trimetazidine on cerebral blood flow / A.V. Arlt, A.M. Salman, M.N. Ivashev // Pharmacy. – 2007. – No. 2. – P. 32–34.

3. Visualization of nonspecific inflammation in experiment / A.V. Sergienko et al. // Allergology and immunology. – 2006. – T.7. – No. 3. – P. 440.

4. The influence of glucose on the systemic and central hemodynamics of awake animals / S.A. Rozhnova and others // Deposited manuscript No. 741-B2003 04/17/2003.

5. The effect of fatty oil of Nigella Damascus on the lipid spectrum of blood plasma in rats with simulated chronic heart failure / A.V. Sergienko and others // Modern high technology. – 2012. – No. 8. – P. 42–43.

6. Ivashev M.N. Iodinol and Ebola fever / M.N. Ivashev, V.S. Afanasov, A.V. Sergienko, E.G. Chechulin // Advances in modern natural science. – 2014. – No. 11-3. – pp. 125–126.

7. Study of the irritant activity of the oil extract of sabal palm fruits in situ on the chorion-allantoic membrane of chicken embryos / A.V. Sergienko and others // Modern high technology. – 2012. – No. 12. – P. 28–29.

8. Study of the reparative activity of rosehip fatty oil extract in simulated burns in rats / E.E. Zatsepin and others // Advances in modern natural science. – 2013. – No. 3. – P. 122–123.

9. Clinical pharmacology of acetylcysteine ​​/ M.N. Ivashev [et al.] Advances in modern natural science. – 2013. – No. 5. – P. 116–117.

10. Clinical pharmacology of carbapenems / A.V. Sergienko et al. //International Journal of Applied and Fundamental Research. – 2013. – No. 8–3. – P. 138.

11. Clinical pharmacology of low molecular weight heparins / A.V. Sergienko [and others] // Modern science-intensive technologies. – 2013. – No. 3. – P. 92.

12. Clinical pharmacology of drugs used for undiagnosed cerebral stroke / A.V. Arlt et al. // Modern high technology. – 2013. – No. 3. – P. 101.

13. Clinical pharmacology of antiepileptic drugs in the educational process of students / T.A. Lysenko et al. // International Journal of Experimental Education. – 2012. – No. 12–1. – pp. 19–22.

15. Sodium selenite in Semakur oil – a means of stimulating metabolic processes / A.V. Sergienko et al. // Deposited manuscript No. 711-B2003 04/15/2003.

The use of medicines must be accompanied by compliance with the principles of effectiveness and appropriate safety.

Purpose of the study. Determine the classifications of decongestants.

Material and research methods. Analysis of literature data.

Research results and discussion. Decongestants are vasoconstrictors, which are divided into agents used for a systemic effect (adrenaline, norepinephrine, etc.) and for a local (topical) effect on the nasal mucosa and reducing nasal congestion. According to the mechanism of action, decongestants are sympathomimetics and are divided into stimulants (mimetics) of alpha-1-(phenylephrine), alpha-2-(indanazolamine, xylometazoline, naphazoline, oxymetazoline, tetrizoline) or alpha-beta-adrenergic receptors (adrenaline hydrochloride). The indirect-acting sympathomimetic ephedrine is also isolated.

Classification of nasal decongestants of the alpha-2-adrenergic agonist group:

1. Short-acting (within 4-6 hours) - ephedrine, adrenaline (epinephrine), naphazoline, phenylephrine, tetrazoline;

2. Medium action (within 8-10 hours) - xylometazoline;

3. Long-term action (more than 12 hours) - oxymetazoline (this formula has a clinically proven antiviral effect).

Combined nasal decongestants (vibrocil, etc.), in addition to the vasoconstrictor, include components that have antiallergic, mucolytic, anti-inflammatory or antibacterial effects.

Depending on the form of release, decongestants are divided into drops and sprays. Preference should be given to nasal decongestants in the form of a spray since this dosage form is more convenient to use; ensures uniform irrigation of the nasal mucosa; ensures precise dosing of the drug, which accordingly reduces the risk of overdose and side effects, is allowed in children over 2 years of age.

Conclusions. Classifications are needed for the rational use of decongestants.

Bibliographic link

Sampieva K.T., Ivashev M.N. CLASSIFICATION OF DECONGESTANTS // International Journal of Experimental Education. – 2016. – No. 6-1. – P. 84-84;
URL: http://expeducation.ru/ru/article/view?id=10136 (date of access: 01/31/2020). We bring to your attention magazines published by the publishing house "Academy of Natural Sciences"