Otolaryngology Book

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DecongestantAka: Systemic Decongestant, Pseudoephedrine, Sudafed

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  1. Indications
    1. Sinusitis
    2. Upper Respiratory Infection
  2. Contraindications
    1. Hypertension
    2. Coronary Artery Disease
    3. Benign Prostatic Hyperplasia
  3. Adverse Effects
    1. Headache
    2. Nausea, Vomiting
    3. Loss of appetite
    4. Cardiac effects
      1. Hypertension
      2. Dysrhythmias (tachycardia)
    5. CNS stimulation
      1. Seizures
      2. Insomnia
      3. Psychosis
      4. Agitation
    6. Other effects
      1. Cerebral hemorrhage
      2. Cerebrovascular Accident
  4. Preparations: Systemic decongestants
    1. Pseudophedrine
      1. Available as prescription and over-the-counter in U.S.
      2. U.S. pharmacies keep this behind counter due to Methamphetamine production-related use
    2. Phenylephrine
      1. Available in U.S. OTC products at 10 mg
      2. No more effective as Placebo for congestion at this dose
      3. Hatton (2007) Ann Pharmacother 41(3):381
  5. Preparation: Alternative agents (Topical)
    1. Nasal Saline
    2. Limited use of Topical Decongestant (3 days only)
  6. Dosing: Pseudoephedrine (Sudafed)
    1. Adults: 60 mg PO q6h
    2. Child (30 mg/5ml elixir)
      1. Ages 6-12 years: 30 mg (5 ml) per dose
      2. Ages 2-5 years: 15 mg (2.5 ml) per dose

Pseudoephedrine (C0033798)

Definition (NCI)A phenethylamine and a diastereomer of ephedrine with sympathomimetic property. Pseudoephedrine displaces norepinephrine from storage vesicles in presynaptic neurones, thereby releasing norepinephrine into the neuronal synapses where it stimulates primarily alpha-adrenergic receptors. It also has weak direct agonist activity at alpha- and beta- adrenergic receptors. Receptor stimulation results in vasoconstriction and decreases nasal and sinus congestion.
Definition (MSH)A phenethylamine that is an isomer of EPHEDRINE which has less central nervous system effects and usage is mainly for respiratory tract decongestion.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD054199
EnglishPseudoephedrine, PSEUDOEPHEDRINE PREPARATION
Spanishpseudoefedrina, seudoefedrina
Parent ConceptsPhenethylamines (C0031399), Propanolamines (C0033442), Adrenergic alpha-Agonists (C0001640), Ephedrine (C0014479), [RE200] DECONGESTANTS, SYSTEMIC (C0973622), Decongestants (C0282374), Respiratory sympathomimetic agent (C1272573)
SourcesLNC, MSH, NCI, NDFRT, RXNORM, SCTSPA, SNOMEDCT, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Decongestants (C0282374)

ConceptsPharmacologic Substance (T121)
MSHD014663
EnglishDecongestant, Decongestant preparation, Decongestants
Spanishdescongestivo, preparado descongestivo
Parent ConceptsVasoconstrictor Agents (C0042397), Respiratory sympathomimetic agent (C1272573), Cough AND/OR decongestant agent (C1276307)
SourcesMSH, MTH, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Sudafed (C0700727)

Definition (MSH)Pseudoephedrine hydrochloride.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD054199
EnglishSudafed
SourcesMSH, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)



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