Download Nasal Decongestant

Nasal Decongestant
Done by:
Hibah AL-Abri
Eyman AL-Harbi
Jawaher AL-Amoudi
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.
Mechanism of action:
Nasal decongestants belong to the
pharmacological class of sympathomimetic
amines. Decongestant stimulates alphaadrenergic agonist, by constriction of blood
vessels, reducing its supply to the nose,
decrease the amount of blood in sinusoid
vessels and decrease mucosal edema.
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).
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.
Side effect of systemic
decongestant:
• CNS effect: Nervousness, restlessness,
headach and insomnia.
• CV effect: increase blood pressure and
increase heart rate.
• Urinary sphincter constriction
Examples of systemic
decongestant:
– Pseudoephedrine
– Phenylpropanolamine (PPA)
– phenylephrine
Brand Name
Indication
Side effect
Pseudoephedrine
Phenylephrine HCL
Decofed®
Neo-Synephrine®
Its symptomatically relief of
nasal congestion due to
common cold, upper
respiratory allergies and it
promotes nasal or sinus
drainage.
For Symptomatically
relief of nasal and
nasopharyngeal mucosal
congestion and relief of
redness of the eye due
CNS: nervousness,
irritability, restlessness,
headache and insomnia.
CV: ↑blood pressure and
heart rate is irregular and
palpitation.
GIT: nausea, vomiting.
Neuromuscular and skeletal:
weakness, tremor.
CNS: nervousness,
irritability, restlessness,
headache.
CV: ↑blood pressure and
heart rate is irregular and
palpitation.
GIT: nausea, vomiting.
Neuromuscular and
skeletal: weakness,
tremor.
to irritation.
Dosage form
Drug interaction
Solution oral drops, as
HCL: Dimetapp®
decongestant infant
drops:
7.5mg/0.8ml(15ml)
Syrup, as HCL:
30mg/5ml (120ml,
480ml).
Tablet, HCL:30mg,
60mg
MAOI may increase
blood pressure.
Sympathomimetic may
increase toxicity it can
decrease effect of
methyldopa, reserpine.
Nasal decongestant
(therapy should not
exceed 3continuous day):
•2-6 years: install 3
drops every 2-4 hours of
0.125% solution as
needed.
•Children > 12yrs and
adult: install 1-2 sprays
or 1-2 drops every 4 hrs
of 0.25% to 0.5%
___
_____
In elderly.
hyperthyroidism.
bradycardia.
partial heart
blocker.
____
Hypersensitivity
Hypertension
Ventricular
tachycardia
Caution
Contraindication
Topical Nasal Decongestant:
Include:
sprays,
drops,
inhalers
1- sprays:
Its advantages:
• Have fast onset of action.
• Cover large surface area.
• Simple to use.
• Inexpensive.
Its disadvantage:
• Imprecise dosage
• Tendency for tip the bottle to become
clogged.
2- drops:
It preferred for small children.
Its disadvantage:
– High risk of contamination.
– Limited coverage into nasal mucosa.
– Easy passage into larynx.
3- inhaler:
Easy to be handle and carry.
Disadvantage:
Unobstructed airway and sufficient air
flow needed to
distribute drug to nasal mucosa.
Side effect of topical
decongestant:
• Local irritation.
• Rebound congestion
Note:
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.
Example of topical decongestant:
Ephedrine HCL, Xylometazoline HCL,
Oxymetazoline HCL, Ipratropium
bromide (antimuscarinic).
Ephederdrine
HCL
Brand Name
ephedrine®
Nasal
Decongestant
Rhinorrhoea
associated with
allergic and non
allergic rhinitis.
Instill 1-2 drops
into each nostril
up to 3 or 4 times
daily.
Apply 42
microgram as 2
spray into each
nostril 2-3 times
daily.
Indication
Dose
Ipratropium
Bromide
(Antimuscarinic)
Atrovent®
Avoid excessive or
prolonged used.
Side effect
caution
Nasal dryness.
Irritation.
Nausea.
Headache.
Antimuscarinic
affect:
-GIT disturbance.
-Palpitation.
Urinary retention
In infant under three Avoid spraying near
months.
eyes.
Used with:
-Myasthenia
Gravis.
-Narrow angle
glaucoma.
Benign prostatic
hyperplasia.
Contraindications
Drug
interaction
Hypersensitivity to
ephedrine.
Cardiac arrhythmias.
Angle-closure
glaucoma.
Patient with
hypersensitivity to
Ipratropium
Soya lecithin or
related food
products.
Atropine
Increase effect with:
- Sympathomimetic
agent.
- Theophylline.
- Cardiac glycoside.
- Anesthetic.
Decrease effect with:
-Alpha and Beta
adrenergic blockers.
Increase toxicity
with anticholinergic
or drug with
anticholinergic
properties
•Nasal drops:
ephedrine HCL
0.5%.
Dosage
form
• Solution for
nubulization 0.02%.
• Solution for oral
inhalation
18mcg/actuation.
• Solution for
intranasal spray
0.03% or 0.06%.
Thank you..