Topical nasal decongestants: Comparative characteristics and a review of side effects

Varvyanskaya, A. V.; Лопатин, А С

doi:10.17116/rosrino201523450-56

Cited by 6 publications

(2 citation statements)

References 29 publications

(26 reference statements)

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“…Drug overdose of just a few extra drops can lead to severe intoxication (Tulupov et al 2018). Clinical manifestations of the adrenomimetic effect (neurological status impairment, changes in the cardiovascular system, hypothermia, excessive constriction of the pupils) may occur even as a result of a therapeutic use of the drug (Claudet and Fries 1997;Varvyanskaya and Lopatin 2015). Currently, there is no clear explanation for this situation; however it is possible that a larger size of the nasal mucosa surface in children compared to adults significantly increases the resorption area of alpha2-adrenergic agonists.…”

Section: Main Causes Of Acute Poisoning In Young Childrenmentioning

confidence: 99%

Pathogenetic features of acute naphazoline poisoning in children

Karpushkina¹,

Zhdanova²,

Батищева³

et al. 2021

RRP

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Introduction: Acute poisoning by nasal decongestants is an important issue in pediatrics due to physiological and anatomical characteristics of the child’s body and pharmacokinetics of drugs in early childhood. Epidemiology: The number of poisonings by this group of drugs ranged from 4% to 39% during the period from 2000 to 2018. All the studies reported that the most severe degree of intoxication was observed in children aged 1–3 years. Mechanism of action of nasal decongestants: The peculiarity of selective alpha2-adrenergic agonists is that when taken orally, misused or overdosed, they lose their selectivity for the target receptor. As a result, the drug causes acute poisoning and most often this effect occurs in children and adolescents. Clinical features and diagnostic criteria: Clinical signs of acute poisoning can appear both as a result of an overdose of the nasal decongestants and due to a therapeutic use of the drug according to the instruction. The symptoms are manifested by hypothermia, skin pallor, bradycardia, arterial hypotension, profuse sweating, and acrocyanosis. Imidazoline receptors and new opportunities: It is assumed that toxic effect of topical decongestants occurs not only by activation of alpha2-adrenergic receptors, but also through their influence on the selective imidazoline receptors. Based on the structure of these drugs, it is assumed that imidazoline receptors are the primary binding site for these drugs. Conclusion: Understanding the described mechanisms of alpha2-adrenergic agonist action and peculiarities of the child’s symptoms in acute poisoning is necessary for the timely diagnosis and selection of the correct treatment strategy.

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Section: Main Causes Of Acute Poisoning In Young Childrenmentioning

confidence: 99%

Pathogenetic features of acute naphazoline poisoning in children

Karpushkina¹,

Zhdanova²,

Батищева³

et al. 2021

RRP

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“…НД применяются в клинической практике множество лет. Основным показанием к применению местных НД является устранение отека слизистой оболочки полости носа и носоглотки при острых риносинуситах (ОР), а также при проведении прочих лечебно-диагностических мероприятий [1,7].…”

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The relevance of the situational use of nasal decongestants in modern clinical practice

Морозова¹,

Keda²

2021

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Nasal decongestants (ND) are representatives of the pharmacological group of α-adrenomimetics and are widely used in clinical practice. These drugs are successfully used as symptomatic therapy of acute rhinosinusitis (AR), as well as as part of the complex therapy of acute otitis during unloading therapy for the auditory tube. The use of ND is necessary before conducting an endoscopic examination of the nasal cavity, for a better assessment of the state of the ostiomeatal complex, the olfactory cleft, as well as differential diagnosis of various forms of rhinitis and dysosmia. ND are indispensable in the prevention of complications of AR, such as acute eustachiitis, exudative otitis media and acute otitis media. Also, these drugs are used in the prevention of the development of aerotitis and ear barotrauma. The most commonly used nasal medications of medium and long duration of action, such as xylometazoline and oxymetazoline. This article presents clinical studies demonstrating the high efficacy and safety of these drugs as part of the treatment of AR. It is shown that oxymetazoline and xylometazoline are well tolerated by patients with a minimum number of adverse events. Modern representatives of ND are such drugs as Otrivin express 0.05% with the aroma of menthol, the main active ingredient of which is oxymetazoline, Otrivin 0.1% Moisturizing formula and Otrivin 0.1% with menthol and eucalyptus, which includes xylometazoline as the main active ingredient. These drugs have confirmed their effectiveness and safety in a large number of clinical studies and can be recommended as local vasoconstrictors.

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