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Topical decongestants in otorhinolaryngologist practice

https://doi.org/10.21518/2079-701X-2020-21-84-89

Abstract

The problem of long-term and uncontrolled use of decongestants remains one of the most relevant problems of modern otorhinolaryngology. To date vasoconstrictors are the most actively used drugs for the treatment of acute and chronic rhinitis, as well as other diseases accompanied by nasal congestion. Most of the topical decongestants are selective α2-adrenergic agonists that act on postsynaptic α2-adrenergic receptors, which perform the main function in the implementation of sympathetic stimuli in the nasal cavity. Sympathomimetic drugs in addition to the main vasoconstrictor effect also have their own anti-inflammatory and antioxidant effects. Topical decongestants are included in the treatment guidelines for acute and chronic rhinitis, rhinosinusitis, allergic rhinitis, acute and chronic otitis media, eustachitis. The recommended duration of decongestants is usually limited to 5–7 days. Longer use of this drug class can lead to paresis of the nasal mucosa vessels or an allergic reaction, to the development of rhinitis medicamentosa. Side effects that occur with the use of topical decongestants are divided into 2 groups: local symptoms and general toxic reactions. However, with strict adherence to the recommended dosing regimen of topical decongestants, to the method of use and to the duration of use, undesirable side effects are rare. The group of vasoconstrictor drugs received a new development as a result of the combination of decongestants with other drugs, which lead to the reducing local side effects and the elimination of not only nasal congestion, but also other symptoms of the common cold.

About the Authors

A. A. Krivopalov
Saint Petersburg Research Institute of Ear, Throat, Nose and Speech
Russian Federation

Dr. of Sci. (Med.), Senior Researcher, 

9, Bronnitskaya St., St Petersburg, 190013



P. A. Shamkina
Saint Petersburg Research Institute of Ear, Throat, Nose and Speech
Russian Federation

Graduate Student, 

9, Bronnitskaya St., St Petersburg, 190013



References

1. Klöcker N., Rudolph P., Verse T. Evaluation of protective and therapeutic effects of dexpanthenol on nasal decongestants and preservatives: results of cytotoxic studies in vitro. Am J Rhinol. 2004;18(5):315–320. Available at: https://pubmed.ncbi.nlm.nih.gov/15586804.

2. Lopatin A.S. Nasal Decongestants: Old Drugs and New Formulations. Doktor.Ru = Doctor.Ru. 2011;(6):173–23. (In Russ.) Available at: https://myvrachi.ru/sites/default/files/publications/9429/pdf/nazalnye_dekongestanty_starye_preparaty_i_novye_formy.pdf.

3. Karalskaya Zh., Zryachkin N., Makarova O., Zaitseva G. Topical decongestants in the pediatrician’s practice. Vrach = Doctor. 2010:(8):18–20. (In Russ.) Available at: http://epidem.rusvrach.ru/ru/vrach-2010-08-06.

4. Deckx L., De Sutter A.I., Guo L., Mir N.A., van Driel M.L. Nasal decongestants in monotherapy for the common cold. Cochrane Database Syst Rev. 2016;10(10):CD009612. doi: 10.1002/14651858.CD009612.pub2.

5. Mortuaire G., de Gabory L., François M., Massé G., Bloch F., Brion N. et al. Rebound congestion and rhinitis medicamentosa: nasal decongestants in clinical practice. Critical review of the literature by a medical panel. Eur Ann Otorhinolaryngol Head Neck Dis. 2013;130(3):137–144. doi: 10.1016/j.anorl.2012.09.005.

6. Lacroix J.S. Adrenergic and non-adrenergic mechanisms in sympathetic vascular control of the nasal mucosa. Acta Physiologica Scandinavica. 1989;581:1–63. Available at: https://www.semanticscholar.org/paper/Adrenergic-and-non-adrenergicmechanisms-in-control-Lacroix/7f20d9c17decf908dea2f45d34c68b13a8649b01.

7. Pshenichaya E.V., Dudchak A.P., Usenko N.A. Decongestants and their side effects for treatment of acute rhinitis in children (clinical example). Mat’ i ditya v Kuzbasse = Mother and Baby in Kuzbass. 2018;(3):50–53. (In Russ.) Available at: https://mednauki.ru/index.php/MD/article/view/223/473.

8. Tulupov D.A. Acute rhinitis in children. Voprosy sovremennoy pediatrii = Current Pediatrics. 2012;5(11):124–129. (In Russ.) doi: 10.15690/vsp.v11i5.440.

9. Chiba Y., Matsuo K., Sakai H., Abe K., Misawa M. Regional differences in vascular responsiveness of nasal mucosae isolated from naive guinea pigs. Auris Nasus Larynx. 2007;34(2):197–201. doi: 10.1016/j.anl.2006.09.014.

10. Svistushkin V.M., Nikiforova G.N., Shevchik E.A., Dedova M.G. Use of intranasal drugs in the treatment of patients with acute infectious rhinitis. RMZh. Otolaringologiya = RMJ. Otolaryngology. 2014;(26):1903–1907. (In Russ.) Available at: https://www.rmj.ru/articles/otorinolaringologiya/Ispolyzovanie_intranazalynyh_preparatov_v_lechenii_bolynyh_ostrym_infekcionnym_rinitom.

11. Krivopalov A.A., Ryazansev S.V., Shamkina P.A. Complex homeopathic therapy of acute infectious rhinitis. Meditsinskiy sovet = Medical Council. 2019;(8):38–42. (In Russ.) doi: 10.21518/2079-701X-2019-8-38-42.

12. Karpishchenko S.A., Vereshchagina O.E., Teplova E.О. Clinical approach to the selection of topical decongestants in paediatric otolaryngology practice. Meditsinskiy sovet = Medical Council. 2019;(2):168–172. (In Russ.) doi: 10.21518/2079-701X-2019-2-168-172.

13. Fokkens W.J., Lund V.J., Hopkins C., Hellings P.W., Kern R., Reitsma S. et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020;58(S26):1–464. doi: 10.4193/Rhin20.600.

14. Polyakov D.P. Harms and benefits of nasal decongestants: ways to decrease the risks. Consilium Medicum. 2015;17(11):94–98. (In Russ.) doi: 10.26442/2075-1753_2015.11.94-98.

15. Kryukov A.I., Kunelskaya N.L., Izotova G.N., Gurov A.V., Yushkina M.A., Sokolov S.A. Approaches to acute rhinitis therapy. Meditsinskiy sovet = Medical Council. 2016;(9):45–47. (In Russ.) doi: 10.21518/2079-701X-2016-9-45-47.

16. Varvyanskaya A.V., Lopatin A.S. Topical nasal decongestants: Comparative characteristics and a review of side effects. Rossiyskaya rinologiya = Russian Rhinology. 2015;23(4):50–56. (In Russ.) doi: 10.17116/rosrino201523450-56.

17. Svistushkin V.M., Morozova E.S. The use of nasal decongestants in ENT practice. Farmateka = Pharmateca. 2020;(5):102–105. (In Russ.) doi: 10.18565/pharmateca.2020.5.102-104.

18. Miroshnichenko N.A., Ovchinnikov A.Yu. Topical decongestants: myth and reality. Meditsinskiy sovet = Medical Council. 2018;(12):40–43. (In Russ.) doi: 10.21518/2079-701X-2018-12-40-43.

19. Eccles R., Eriksson M., Garreffa S., Chen S.C. The nasal decongestant effect of xylometazoline in the common cold. Am J Rhinol. 2008;22(5):491–496. doi: 10.2500/ajr.2008.22.3202.

20. Graf P., Eccles R., Chen S. Efficacy and safety of intranasal xylometazoline and ipratropium in patients with common cold. Expert Opin Pharmacother. 2009;10(5): 889–908. doi: 10.1517/14656560902783051.

21. Taverner D., Latte J., Draper M. Nasal decongestants for the common cold. Cochrane Database Syst Rev. 2007;(1):CD001953. doi: 10.1002/14651858.CD001953.pub3.

22. Caenen M., Hamels K., Deron P., Clement P. Comparison of decongestive capacity of xylometazoline and pseudoephedrine with rhinomanometry and MRI. Rhinology. 2005;43(3):205–209. Available at: https://pubmed.ncbi.nlm.nih.gov/16218514.

23. Eccles R., Martensson K., Chen S.C. Effects of intranasal xylometazoline, alone or in combination with ipratropium, in patients with common cold. Curr Med Res Opin. 2010;26(4):889–899. doi: 10.1185/03007991003648015.

24. Beck-Speier I., Dayal N., Karg E., Maier K.L., Schumann G., Semmler M., Koelsch S.M. Oxymetazoline Inhibits Proinflammatory Reactions: Effect on Arachidonic Acid-Derived Metabolites. J Pharmacol Exp Ther. 2006;316(2):843– 851. doi: 10.1124/jpet.105.093278.

25. Joganathan V., Beigi B. Safety of the use of xylometazoline nasal spray in young children undergoing lacrimal surgery: an observational study. Eur J Ophthalmol. 2018;28(3):279–281. doi: 10.5301/ejo.5001054.

26. Hayden F.G., Diamond L., Wood P.B., Korts D.C., Wecker M.T. Effectiveness and Safety of Intranasal Ipratropium Bromide in Common Colds: A Randomized, Double-Blind, Placebo-Controlled Trial. Ann Intern Med. 1996;125(2):89–97. doi: 10.7326/0003-4819-125-2-199607150-00002.

27. Eccles R., Pedersen A., Regberg D., Tulento H., Borum P., Stjärne P. Efficacy and safety of topical combinations of ipratropium and xylometazoline for the treatment of symptoms of runny nose and nasal congestion associated with acute upper respiratory tract infection. Am J Rhinol. 2007;21(1):40–45. doi: 10.2500/ajr.2007.21.2902.

28. Karpischenko S.A., Lavrenova G.V., Kulikova O.A. Peculiarities of the acute sinusitis course in patients with chronic vasopathy. Meditsinskiy sovet = Medical Council. 2016;(17):68–72. (In Russ.) doi: 10.21518/2079-701X2016-17-68-72.


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For citations:


Krivopalov AA, Shamkina PA. Topical decongestants in otorhinolaryngologist practice. Meditsinskiy sovet = Medical Council. 2020;(21):84-89. (In Russ.) https://doi.org/10.21518/2079-701X-2020-21-84-89

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