This article is about decongestant medications. For their nasal delivery system, see inhaler. Show
A decongestant, or nasal decongestant, is a type of pharmaceutical drug that is used to relieve nasal congestion in the upper respiratory tract. The active ingredient in most decongestants is either pseudoephedrine or phenylephrine (the latter of which has disputed effectiveness). Intranasal corticosteroids can also be used as decongestants and antihistamines can be used to alleviate runny nose, nasal itch, and sneezing.[1] Topical decongestants on topical application as dilute solution (0.05–0.1%) produce local vasoconstriction. Regular use of decongestants for long periods should be avoided because mucosal ciliary function is impaired: atrophic rhinitis and anosmia (loss of the sense of smell) can occur due to persistent vasoconstriction. Decongestants can be absorbed from the nose via an inhaler and produce systemic effects, mainly central nervous system stimulation and rise in blood pressure. These drugs should be used cautiously in hypertensives and in those receiving monoamine oxidase inhibitors (MAOIs), as they can cause hypertensive crisis. Expectorants such as guaifenesin are a related type of drug which help to clear mucus. Medical uses[edit]Decongestants are used to treat nasal congestion, for instance in allergies, infections like the common cold, influenza, and sinus infection, and nasal polyps. A 2016 Cochrane review found insufficient evidence to support the use of intranasal corticosteroids in the relief of common cold symptoms;[2] however, the review was based on three trials and the quality of the evidence was regarded as very low.[2] Pharmacology[edit]The vast majority of decongestants act via enhancing norepinephrine (noradrenaline) and epinephrine (adrenaline) or adrenergic activity by stimulating the α1-adrenergic receptor since they mediate vasoconstriction and constricting nasal vasculature causes decongestion of nasal mucosa. This induces vasoconstriction of the blood vessels in the nose, throat, and paranasal sinuses, which results in reduced inflammation (swelling) and mucus formation in these areas. Decongestant nasal sprays and eye drops often contain oxymetazoline and are used for topical decongestion. Pseudoephedrine acts indirectly on the adrenergic receptor system, whereas phenylephrine and oxymetazoline are direct agonists. The effects are not limited to the nose, and these medicines may cause hypertension (high blood pressure) through vasoconstriction; it is for this reason that people with hypertension are advised to avoid them. Most decongestants, however, are not pronounced stimulants, due to lack of response from the other adrenoreceptors. Besides hypertension, common side-effects include sleeplessness, anxiety, dizziness, excitability, and nervousness. Topical nasal or ophthalmic decongestants quickly develop tachyphylaxis (a rapid decrease in the response to a drug after repeated doses over a short period of time). Long-term use is not recommended since these agents lose effectiveness after a few days. List of agents[edit]Adrenaline releasing agents[edit]Common or widely marketed[edit]
Uncommon or discontinued[edit]
α-Adrenergic receptor agonists[edit]Common or widely marketed[edit]
Uncommon or discontinued[edit]
Corticosteroids[edit]
Miscellaneous[edit]Common or widely marketed[edit]
Uncommon or discontinued[edit]
See also[edit]
References[edit]
Which would contraindicate the use of a topical nasal decongestant?Both oral and topical nasal decongestants are contraindicated for patients with heart disease (they increase the workload of the heart), hypertension (they raise blood pressure), thyroid disease (they increase the risk of adverse reactions), diabetes, or, in men, difficulty in urination caused by an enlarged prostate.
When the use of antihistamines result in dryness of the mouth the nurse should recommend which to relieve the dryness?Antihistamines may cause dryness of the mouth, nose, and throat. For temporary relief of mouth dryness, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if your mouth continues to feel dry for more than 2 weeks, check with your dentist.
Which agent acts directly on the medullary cough center?Therapeutic actions of antitussives
Acts directly on the medullary cough center of the brain to depress the cough reflex.
Which condition would contraindicate the use of or Oxymetazoline?high blood pressure. coronary artery disease. hardening of the arteries due to plaque buildup. enlarged prostate.
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