Otolaryngology Book

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Intranasal SteroidAka: Corticosteroid Intranasal, Nasacort, Rhinocort, Nasarel, Beconase, Vancenase, Flonase

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  1. Efficacy of Intranasal Steroids
    1. Significantly reduced symptoms
      1. Reduced nasal obstruction
      2. Reduced Rhinorrhea, sneezing, and nasal itching
      3. By comparison, Seldane was same as Placebo
    2. Reference
      1. Bronsky (1996) J Allergy Clin Immunol 97:915
  2. Safety
    1. Appears safe in children as young as age 2 years
      1. No hypothalamic-pituitary-adrenal axis suppression
      2. Galant (2003) Pediatrics 112:96
  3. Adverse Effects
    1. Epistaxis
      1. Reduced by spraying away from septum
      2. Use left hand when spraying right nostril
      3. Use right hand when spraying left nostril
      4. (2004) Prescribers Letter 11(1):2
  4. General
    1. Aqueous Preparations: Better for dry nose, winter
      1. Moisturizing: Nasarel (Flunisolide)
      2. Moisture neutral: Nasocort AQ and Rhinocort AQ
      3. Drying agents (Alcohol): most AQ agents
    2. Non-Aqueous: Better for "wet", watery nose
  5. Preparations: Low potency agents (especially in children)
    1. Triamcinolone acetonide (Nasacort)
      1. Dose (age 6 and older): 1-2 sprays per nostril daily
      2. Relative potency: 1
    2. Mometasone (Nasonex)
      1. Dose (2 years and older): 1 spray each nostril daily (adults should use 2 sprays each nostril)
      2. Relative potency: 1
  6. Preparations: Medium potency agents
    1. Flunisolide (Nasalide)
      1. Dose: 2 sprays per nostril twice daily
      2. Relative potency: 3
    2. Beclomethasone (Beclovent)
      1. Dose (age 6 and older): 1-2 sprays per nostril twice daily
      2. Relative potency: 5
  7. Preparations: Higher potency agents
    1. Budesonide (Rhinocort)
      1. Dose (age 6 to older): 1-2 sprays each nostril daily
      2. Adults may bolus start with 4 sprays/nostril daily for 1 week then use standard dose (1-2 sprays)
      3. Relative potency: 10
    2. Fluticasone propionate (Flonase)
      1. Dose (age 4 years and older): 1-2 sprays per nostril daily
      2. Relative potency: 10
    3. Qvar 80 mg (use oral inhaler with nasal adapter)
      1. Dose: 1-2 sprays each nostril daily
  8. References
    1. Wallace (2008) J Allergy Clin Immunol 122(2 suppl):S21

Flonase (C0286677)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHC065382
EnglishFlonase
SourcesMSH, NCI, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)


Beconase (C0591154)

ConceptsSteroid (T110) , Pharmacologic Substance (T121)
MSHC107432, D001507
EnglishA & H Brand of Beclomethasone Dipropionate, Allen & Hanburys Brand of Beclomethasone Dipropionate, Becloforte, becodisk, Becodisks, Beconase, Becotide, Glaxo Wellcome Brand of Beclomethasone Dipropionate, GlaxoSmithKline Brand 1 of Beclomethasone Dipropionate, Propaderm, Sanasthmyl, Shire Brand of Beclomethasone Dipropionate
SourcesMSH, NCI, PDQ, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)


Nasacort (C0594040)

ConceptsSteroid (T110) , Pharmacologic Substance (T121)
EnglishNasacort
SourcesNCI, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)


Rhinocort (C0678163)

ConceptsSteroid (T110) , Pharmacologic Substance (T121)
MSHD019819
EnglishRhinocort
SourcesMSH, NCI, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)


Vancenase (C0699072)

ConceptsSteroid (T110) , Pharmacologic Substance (T121)
MSHD001507
EnglishSchering Brand 1 of Beclomethasone Dipropionate, Vancenase
SourcesMSH, NCI, PDQ, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)


Nasarel (C0721979)

ConceptsSteroid (T110) , Pharmacologic Substance (T121)
MSHC007734
EnglishElan Brand 2 of Flunisolide, Nasarel
SourcesMSH, MTH, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)



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