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{{About|decongestant medications|their nasal delivery system|inhaler}} {{About|decongestant medications|their nasal delivery system|inhaler}}


A '''decongestant''', or '''nasal decongestant''', is a type of ] that is used to relieve ] in the ]. The active ingredient in most decongestants is either ] or ] (the latter of which has ]). Intranasal ]s can also be used as decongestants and ]s can be used to alleviate ]. A '''decongestant''', or '''nasal decongestant''', is a type of ] that is used to relieve ] in the ]. The active ingredient in most decongestants is either ] or ] (the latter of which has ]). Intranasal ]s can also be used as decongestants and ]s can be used to alleviate ], ], and ].<ref name="Ficalora2013">{{cite book|author=Robert D. Ficalora|title=Mayo Clinic Internal Medicine Board Review|url=https://books.google.com/books?id=UH5pAgAAQBAJ&pg=PA579|date=28 May 2013|publisher=Oxford University Press|isbn=978-0-19-998589-0|pages=579–}}</ref>


]s on ] as dilute solution (0.05–0.1%) produce local ]. ]s on ] as dilute solution (0.05–0.1%) produce local ].
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* ] * ]
* ] * ]

===Corticosteroids===
* ] (Beconase, QNASL)
* ] (Rhinocort)
* ] (Omnaris, Zetonna)
* ]
* ] (Nasarel)
* ]
* ] (Veramyst)
* ] (Flonase)
** ] (Dymista) – also an ] via ]
* ] (Nasonex)
* ]
* ] (Pivalone)
* ] (Nasacort)
* ] (Nasacort, Allernaze)


===Miscellaneous=== ===Miscellaneous===

Revision as of 01:06, 6 December 2017

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This article is about decongestant medications. For their nasal delivery system, see inhaler.

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.

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 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.

Pharmacology

The vast majority of decongestants act via enhancing norepinephrine (noradrenaline) and epinephrine (adrenaline) or adrenergic activity by stimulating the α-adrenergic receptors. 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

Adrenaline releasing agents

Main article: Norepinephrine releasing agent

Common or widely marketed

Uncommon or discontinued

α-Adrenergic receptor agonists

Main article: α-Adrenergic receptor agonist

Common or widely marketed

Uncommon or discontinued

Corticosteroids

Miscellaneous

Common or widely marketed

Uncommon or discontinued

See also

References

  1. Robert D. Ficalora (28 May 2013). Mayo Clinic Internal Medicine Board Review. Oxford University Press. pp. 579–. ISBN 978-0-19-998589-0.
Major chemical drug groups – based upon the Anatomical Therapeutic Chemical Classification System
gastrointestinal tract
/ metabolism (A)
blood and blood
forming organs (B)
cardiovascular
system (C)
skin (D)
genitourinary
system (G)
endocrine
system (H)
infections and
infestations (J, P, QI)
malignant disease
(L01–L02)
immune disease
(L03–L04)
muscles, bones,
and joints (M)
brain and
nervous system (N)
respiratory
system (R)
sensory organs (S)
other ATC (V)
Decongestants and other nasal preparations (R01)
Topical
Sympathomimetics, plain
Antiallergic agents,
excluding corticosteroids
Corticosteroids
Other nasal preparations
Combination products
Systemic use:
Sympathomimetics
Category:
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