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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.
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.
РезюмеРинит является самым распространенным заболеванием, он длится на три основных фенотипа: инфекционный (ИР), аллергический (АР) и неинфекционный неаллергический (НАР). Существуют и комбинированные формы. ИР является вирусным заболеванием. Описана его клиническая картина, отмечена частая необращаемость пациентов к врачу при этом заболевании, что способствует развитию осложнений и его хронизации. Авторы изложили характерные особенности клиники АР с «синдромом оральной аллергии». Отмечено, что НАР является гетерогенным заболеванием, которое подразделяют не менее чем на шесть субфенотипов: медикаментозный, вкусовой, гормональный, атрофический, идиопатический и ринит пожилых людей. Авторы разбирают причины их возникновения. Выделяют также профессиональную форму ринита. Все указанные фенотипы объединяет симптом затрудненного носового дыхания, который также имеет место при хроническом риносинусите и синдроме «пустого носа». Упомянуты и другие причины нарушения носового дыхания. При лечении пациентов практически с любым из фенотипов ринита основными являются ирригационно-элиминационная терапия и назначение топических деконгестантов (ТД). Немаловажную роль играет избегание причин, активизирующих течение ринита, и научение населения правильной организации индивидуального процесса лечения. Среди топических средств, устраняющих затруднение носового дыхания, лидируют топические сосудосуживающие препараты. Они в нашей стране продаются в обычном доступе и при неправильном применении могут вызвать развитие медикаментозного ринита и множество серьезных последствий. В статье раскрыты методы правильного введения препарата в виде капель и спрея, а также его возрастные дозировки.
The data about the prevalence of ENT organ diseases in children and the necessity of prescription of nasal forms of vasoconstrictors (decongestants) are presented. A review of the data about the mechanism of action of decongestants, safety and evidence base of their effectiveness in treatment of otorhinolaryngological diseases is presented. It is concluded that decongestants with a higher safety level are chosen a modern combined preparation containing antihistamine (dimethinden) and vasoconstrictor (phenylephrine) components.
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