1. Nasal Decongestant Done by:
2. Nasal Decongestant: Nasal decongestants are vasoconstrictive drugs extremely useful as nonprescription medication. Both oral and topical dosage forms are often chosen as therapy in the common cold.
3. Mechanism of action: Nasal decongestants belong to the pharmacological class of sympathomimetic amines. Decongestant stimulates alpha-adrenergic agonist, by constriction of blood vessels, reducing its supply to the nose, decrease the amount of blood in sinusoid vessels and decrease mucosal edema.
4. Types of nasal decongestant: Internally or systemic decongestant: (e.g. pseudoephedrine, phenylpropanolamine (PPA) and phenylephrine).
Topical decongestant: drops or sprays (e.g. xylometazoline, phenylephrine, oxymetazoline, naphazoline).
Inhaler: (1-desoxyephedrine and propylhexedrine).
5. Systemic nasal decongestant: Mechanism of action:
Potent direct acting alpha-adrenergic stimulator with weak beta-Adrenergic activity, causes vasoconstriction of the arterioles of the nasal mucosa and conjunctive, activates the dilator muscle of the pupil to causes contraction, and produce systemic arterial vasoconstriction.
6. Side effect of systemic decongestant: CNS effect: Nervousness, restlessness, headach and insomnia.
CV effect: increase blood pressure and increase heart rate.
Urinary sphincter constriction
7. Examples of systemic decongestant: Pseudoephedrine
11. Topical Nasal Decongestant: Include:
12. 1- sprays: Its advantages:
Have fast onset of action.
Cover large surface area.
Simple to use.
Tendency for tip the bottle to become clogged.
13. 2- drops: It preferred for small children.
High risk of contamination.
Limited coverage into nasal mucosa.
Easy passage into larynx.
14. 3- inhaler: Easy to be handle and carry.
16. Side effect of topical decongestant: Local irritation.
the patient must follow the instruction in label duration & frequency of use, if not they follow it can cause rebound congestion well be developed.
Cause of rebound congestion:
ischemic as result of local vasoconstriction of the drug or local irritation of the drug.
How to over come rebound congestion?
Stop topical & switch to the oral nasal decongestant or intranasal isotonic normal saline (50%), or intranasal steroids.
18. Example of topical decongestant: Ephedrine HCL, Xylometazoline HCL, Oxymetazoline HCL, Ipratropium bromide (antimuscarinic).