ADVERSE EFFECTS OF NASAL DECONGESTANTS (REVIEW OF LITERATURE)

Abstract

Nasal decongestants are ones of the most popular and widespread medicines due to high frequency of respiratory infections. But on the other hand they are characterized by significant abuse potential for users seeking such effects as euphoria, psychostimulation, less of appetite and lose the weight. The affections of the cardio-circulation and nervous systems are the most frequent complications after overdosing of the nasal decongestants. The development of the strikes in the young age was associated with the nasal decongestants abuse in every tenth patient. The cases of the malignant arterial hypertension, cerebral hemorrhages, ischemic strokes, heart decompensation after the nasal decongestants abuse is known as nasal decongestants poisoning. And although the side effects more often develop when nasal decongestants are used orally, intranasal way could not be considered as absolutely safe, especially in cases of overdosing. The development of the psychotic disorders is one of the most frequent nasal decongestants adverse effects. The elderly people with organic brain damage, drug addiction, mental illness are in the risk group for the development of psychotic complications. Misuse of the nasal decongestants in children is especially dangerous because of the high risk of the development of the life-threatening toxic poisoning. Fatal cases of poisoning were associated with small age of a child, using several medicines with the same ingredient, using decongestants in a daycare setting, mistakes in measuring and identification the medicine, the absence of the doctor’s prescription, use of the product for adult age. Using nasal decongestants in supine position of the patient may lead to the significantly dose increase inside the nasal cavity and may cause toxic poisoning. Adolescents are quite sensitive to the development of nasal decongestants side effects with such risk factors as age, gender, family income, physical and mental health, use of other medicines and alcohol. The special type of the adverse effects of the long-term using of the nasal decongestants is the rhinitis medicamentosa taking place in adult persons with predisposition to the nasal hyperreactivity. The diagnosis of the rhinitis medicamentosa is based on the nasal hyperactivity and swelling of the nasal mucous membrane in combination with poor response on treatment caused or exaggerated by long-term use of topical nasal decongestants. The development of the rhinitis medicamentosa depends on a number of factors such as the type of nasal decongestants, the type of preservative, the presence of risk factors that determine the patient's predisposition to the development of nasal hyperreactivity. Here we review the existing literature concerning the adverse effects of the nasal decongestants including the development of the rhinitis medicamentosa.

Keywords

• Nasal Decongestants; Adverse Effect; Poisoning; Rhinitis Medicamentosa.