Otolaryngology Book

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Topical Decongestant

Aka: Topical Decongestant, Spray Decongestant, Oxymetazoline, Afrin, Intranasal Phenylephrine, Intranasal Neo-Synephrine, Intranasal Propylhexedrine, Benedrex
  1. See Also
    1. Systemic Decongestant
    2. Nasal Saline
  2. Indications
    1. Acute Sinusitis
    2. Epistaxis
  3. Precautions
    1. Avoid using longer than 3 days
    2. Overuse results in Rhinitis Medicamentosa
    3. Avoid afrin (Oxymetazoline) in children (due to central alpha-2 agonist, Clonidine-like CNS depression)
      1. See One Pill Can Kill
      2. If a nasal Decongestant is used in children, Neo-Synephrine (Phenylephrine) is preferred
    4. Propylhexedrine (Benedrex) abuse
      1. Has been abused via ingestion, injection or large inhalation for Amphetamine-like effect
      2. Risk of Arrhythmia, Chest Pain, Agitation, Psychosis, death
      3. (2021) Presc Lett 28(5): 30 [PubMed]
  4. Preparations
    1. Oxymetazoline (Afrin)
      1. Two sprays per nostril twice daily for 2-3 days
    2. Phenylephrine (Neo-Synephrine)
      1. Adults: 2 sprays per nostril four times daily for 2-3 days
      2. Child: Neo-Synephrine 1/8% every 4-6 hours for 2-3 days
    3. Propylhexedrine (Benedrex)
      1. Adults and Children over age 6 years: two sprays each nostril up to every 2 hours for 2-3 days

Oxymetazoline (C0030071)

Definition (NCI) An imidazole derivative with direct acting sympathomimetic activity. Oxymetazoline binds to and activates alpha-2 adrenergic receptors. Upon nasal or ocular administration, oxymetazoline constricts the arterioles in the nose and eye, resulting in decreased nasal and conjunctival congestion, respectively.
Definition (MSH) A direct acting sympathomimetic used as a vasoconstrictor to relieve nasal congestion. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1251)
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D010109
SnomedCT 29129004, 387158001
English Oxymetazoline, Phenol, 3-((4,5-dihydro-1H-imidazol-2-yl)methyl)-6-(1,1-dimethylethyl)-2,4-dimethyl-, Oxymetazoline [Chemical/Ingredient], OXYMETAZOLINE, oxymetazoline, Oxymetazoline (product), Oxymetazoline (substance)
Swedish Oximetazolin
Czech oxymetazolin
Finnish Oksimetatsoliini
Russian OKSIMETAZOLIN, ОКСИМЕТАЗОЛИН
Polish Oksymetazolina
Spanish oximetazolina (producto), oximetazolina (sustancia), oximetazolina, Oximetazolina
French Oxymétazoline
German Oxymetazolin
Italian Ossimetazolina
Portuguese Oximetazolina
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Phenylephrine (C0031469)

Definition (MSH) An alpha-1 adrenergic agonist used as a mydriatic, nasal decongestant, and cardiotonic agent.
Definition (NCI) A direct-acting sympathomimetic amine chemically related to adrenaline and ephedrine with potent vasoconstrictor property. Phenylephrine is a post-synaptic alpha-adrenergic receptor agonist that causes vasoconstriction, increases systolic/diastolic pressures, reflex bradycardia, and stroke output.
Definition (CSP) direct acting sympathomimetic amine that stimulates alpha-adrenergic receptors and is a powerful vasoconstrictor.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D010656
SnomedCT 372771005, 54765002
LNC LP16252-6, MTHU007549
English Phenylephrine, (R)-3-Hydroxy-alpha-((methylamino)methyl)benzenemethanol, Benzenemethanol, 3-hydroxy-alpha-((methylamino)methyl)-, (R)-, decongestants phenylephrine, phenylephrine (medication), Phenylephrine [Chemical/Ingredient], PHENYLEPHRINE, phenylephrine, Phenylephrine (product), Phenylephrine (substance)
Swedish Fenylefrin
Czech fenylefrin
Finnish Fenyyliefriini
Russian FENILEFRIN, MEZATON, METASIMPATOL, METASINEFRIN, NEOSINEFRIN, METOKSIDRIN, МЕЗАТОН, МЕТАСИМПАТОЛ, МЕТАСИНЕФРИН, МЕТОКСИДРИН, НЕОСИНЕФРИН, ФЕНИЛЭФРИН
Japanese フェニルエフリン, ネオシネフリン, フェニレフリン
Polish Metasympatol, Fenylefryna, Neosynefryna
Spanish fenilefrina (producto), fenilefrina (sustancia), fenilefrina, Fenilefrina
French Phényléphrine
German Phenylephrin
Italian Fenilefrina
Portuguese Fenilefrina
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Afrin (C0718291)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
English Afrin, afrin
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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