|
 |
|
|
|
As easy as breathing
Breathing is easy to take for granted. So when you get congested and it's hard to breathe, it's doubly difficult. You have to think about how hard it is to breathe, and you have to figure out what to do about it.
Over-the-counter nasal sprays, drops, and inhalers offer something wonderful -- speedy relief. They contain decongestants that can work within minutes to relieve a stuffy nose. Sprays, drops, and inhalers help clear the nasal passages, promote nasal and sinus drainage, and shrink swollen membranes. But don't get too crazy with decongestants. Overuse can cause a "rebound" effect in which the stuffiness returns.
|
|
|
|
|
Stuff to Clear a Stuffy Nose
If you wake up with a stuffy nose, one of the easiest ways to restore normal breathing is with a few drops of warm water. You can also use a mild saline solution. Put a few drops in the entrance of the nose and tip your head back, inhaling gently. The fluids loosen the mucous material blocking the nasal passages, and you can then blow your nose to clear out the phlegm. Using a humidifier at night or taking a steamy bath or shower can also help relieve nasal discomfort. Make sure you also drink plenty of fluids to thin nasal secretions and loosen phlegm.
If you decide to use a nasal decongestant to clear those blocked passages, keep these things in mind:
- Use topical decongestants (sprays, drops, and inhalers) for no more than three to five days. Overuse of topical decongestants can lead to "rebound congestion," a condition in which the mucous lining becomes resistant to treatment. Symptoms will reappear and are generally more severe than before the start of treatment.
- Higher-than-recommended dosages of decongestants can cause nervousness, insomnia, or dizziness.
- Women should avoid decongestants during pregnancy or when breastfeeding.
Comparing Sprays, Drops, and Inhalers
Sprays
- Sprays give rapid relief.
- The mist covers a large surface area, offering greater relief.
- Spray bottles are small and convenient.
- Sprayers need to be cleaned frequently to prevent the tips from clogging.
- The dose delivered through the spray is inconsistent and depends on how hard you squeeze. Metered pumps that require priming can help make spray dosages more consistent.
- Sprays can also suck mucus back into the bottle, causing contamination.
Inhalers
- Inhalers provide rapid relief.
- They are small and convenient.
- After they have been opened, their shelf-life is short -- approximately two to three months.
- Compared to sprays, the medication in inhalers has a harder time reaching congested tissues.
Drops
- Drops are recommended for small children. They do not require simultaneous inhalation -- as sprays do -- and can be administered by an adult.
- Drops do not cover as great a surface area as inhalers or sprays, so the symptomatic relief is not as great.
- There is a chance the drops will travel from the nasal passages into the throat.
- If not cleaned properly, the dropper can foster bacterial growth inside the tube and contaminate the medication.
|
|
|
|
|
Decongestants
Nasal decongestants unstuff clogged nasal passages and improve breathing for allergy sufferers. They work by significantly constricting, or narrowing, blood vessels to decrease blood flow to the nose. This shrinks the swollen tissues and reduces secretions, allowing you to breathe more easily. Decongestants in sprays and drops work quickly because they are applied directly on swollen nasal tissues. Their benefits are more short-lived than those of oral decongestants, and they may produce rebound congestion (a return of symptoms). However, spray and drop decongestants have few and minimal systemic side effects, unlike oral decongestants.
| Decongestants | Ingredient | Description |
|---|
| Ephedrine | ? | Quick, safe, and effective when applied topically in low concentrations (0.25% to 1%). Rebound congestion may be avoided if used less than three days. No longer sold because it can be used to produce illicit drugs. | | Naphazoline | ? | Acts within 10 minutes and lasts for up to five or six hours. Rebound effect sometimes occurs after only one treatment and is likely to occur if used repeatedly. Can be habit forming. Should not be used by children under age 12. | | Oxymetazoline | ? | Long acting: effects last five or six hours. Rebound decongestion is less likely to occur with this drug. | | Phenylephrine | ? | Fast acting and effective. When taken orally provides significant decongestant effect, but can also raise blood pressure and increase heart rate in high doses. Preparations of 1% strength are especially likely to cause rebound congestion and other side effects. | | Phenylpropanolamine (Conditionally Approved) | ? | Studies show the effectiveness of phenylpropanolamines as nasal decongestants. However, there are concerns over side effects that are potentially dangerous, including increased blood pressure. | | Propylhexedrine | ? | Can be used up to three days -- even by people who can't use ephedrine or ephedrine-like decongestants -- without little to no side effects. | | Xylometazoline | ? | Fast acting and effective. Single dose lasts more than five hours. Rebound effects not as much of a problem as with other decongestants. |
|
|
|
|
|
FDA-Approved Uses
Decongestants
- Temporarily relieve nasal congestion due to common colds, hay fever, allergies, and sinusitis.
- Reduce swelling of nasal passages; shrink swollen membranes
- Temporarily restore freer breathing through the nose
Avoiding Rebound Congestion- Rebound congestion is when your stuffy nose returns with a vengeance. The overuse of nasal spray is the culprit here.
- During rebound congestion, the blood vessels in your nose stop responding to the decongestants you use. They then swell up more than when you first started using medication, causing bad congestion.
- Don't use decongestants more frequently or for a longer period of time than recommended. Whatever the case, DO NOT USE TOPICAL DECONGESTANTS FOR MORE THAN THREE TO FIVE DAYS if you want to avoid rebound congestion.
General Advice on Use- Find the expiration date on the product and throw the bottle away if it is expired.
- If you think the product has not been stored properly or may have degraded, throw it away.
- To avoid spreading infection, use only your own product. Do not share with others or use another person's product.
- Clear your nasal passages before use by blowing your nose so that the medication can reach affected tissues.
- After you use the product, do not blow your nose for several minutes to allow time for the medication to contact your nasal passages and go to work.
- Use only as needed to relieve your symptoms. If you do not have symptoms, do not use these products.
Using Sprays- Do not shake the product.
- Open the product and check the tip for clogs. If it is clogged, wipe it with a clean paper towel or hold the tip sideways under hot running water. Do not let water enter the product.
- Gently insert the tip into one nostril. If you wish you may press your other nostril closed with your free hand.
- Keeping your head upright, squeeze the bottle and inhale simultaneously.
- If the other nostril is congested then repeat this procedure.
- Clean the product by running hot water over the tip. Again, make sure no water enters it. Wipe the tip dry with a clean paper towel and recap.
Using Drops- Draw the medication into the dropper by squeezing the rubber bulb once.
- Remove the filled dropper from the container.
- Tilt your head backwards and place the appropriate number of drops in the affected nostril(s). This can be accomplished sitting, standing, or lying down.
- Carefully tilt your head from side to side to help disperse the medication.
- Clean the dropper by running it under hot water, let it air dry, and recap the container.
Administering drops to an infant- Make sure your hands are clean.
- Clean any mucus from your child's nostrils.
- Draw the medication into the dropper by squeezing the rubber bulb once. But do not remove the dropper. You want your hands free to steady your child.
- Lie your child down on a bed with a pillow under his or her shoulders so that the head is tilted and nostrils are angled up.
- Alternatively, you can sit down on a chair. Lay your child on your lab and cradle his or her shoulders on your forearm so that the head is tilted and nostrils are angled up.
- Place the appropriate amount of drops into your child's nostril. You might have to insert the dropper into your child's nose, but do not insert it more than one-third of an inch.
- Repeat this procedure in the other nostril if necessary.
- Do not reinsert the dropper into the bottle until after you have washed it under hot water and air-dried it.
Using Metered Pumps- Do not shake the product.
- Open the product and check the tip for clogs. If it is clogged, wipe with a clean paper towel or hold the tip sideways under hot running water. Do not let water enter the product.
- Point the tip away from you or others and prime the product by depressing it several times before using it.
- Gently insert the tip into one nostril. If you wish you may press your other nostril closed with your free hand.
- Keeping your head upright, squeeze the bottle and inhale simultaneously.
- Repeat this procedure in the other nostril if it is congested.
- Clean the product by running hot water over the tip. Again, make sure no water enters the product. Wipe the tip dry with a clean paper towel and recap.
Using Inhalers- Uncap the inhaler.
- With one hand close one nostril
- Inhale the medication in the open nostril.
- Repeat the process for the other nostril if necessary.
- Clean the inhaler with a paper towel and recap.
- Remember that the medication in inhalers is pressurized. After you open one, it is only good for two to three months.
Recommended Dosage
| Recommended Dosage for Decongestants | | Drug | Adults & Children Over Age 12 | Max. Daily | Children Ages 6 to 12 | Max. Daily | Children Under Age 6 | Max. Daily |
|---|
| Ephedrine 0.5% | 2 to 3 drops or sprays every 4 hrs | Up to 6 doses | 1 to 2 drops or sprays every 4 hrs | Up to 6 doses | Consult a physician | | Naphazoline 0.05% | 1 to 2 drops or sprays every 6 hrs | Up to 4 doses | Consult a physician | Consult a physician | | Naphazoline 0.025% | 1 to 2 drops or sprays every 6 hrs | Up to 4 doses | 1 to 2 drops or sprays every 6 hrs | Up to 4 doses | Consult a physician | | Oxymetazoline 0.05% | 2 to 3 drops or sprays, once morning and once night | Up to 2 doses | 2 to 3 drops or sprays, once morning and once night | Up to 2 doses | Consult a physician | | Oxymetazoline 0.025% | 2 to 3 drops or sprays, once morning and once night | Up to 2 doses | 2 to 3 drops or sprays, once morning and once night | Up to 2 doses | Refer to package or consult a physician | | Phenylephrine 0.5% | 2 to 3 drops or sprays every 4 hrs | Up to 6 doses | Consult a physician | Consult a physician | | Phenylephrine 0.25% | 2 to 3 drops or sprays every 4 hrs | Up to 6 doses | 2 to 3 drops or sprays every 4 hrs | Up to 6 doses | Consult a physician | | Phenylephrine 0.125% | 2 to 3 drops or sprays every 4 hrs | Up to 6 doses | 2 to 3 drops or sprays every 4 hrs | Up to 6 doses | Refer to package or consult a physician | | Propylhexedrine | 2 inhalations every 4 hrs | Up to 6 doses | 2 inhalations every 4 hrs | Up to 6 doses | Consult a physician | | Tetrahydrozoline 0.1% | 2 to 4 drops or sprays every 3 hrs | 2 to 4 drops not more than every 3 hrs | 2 to 4 drops or sprays every 4 hrs | 2 to 4 drops not more often than every 3 hrs | Consult a physician | | Tetrahydrozoline 0.05% | 2 to 4 drops or sprays every 3 hrs | Up to 8 doses | 2 to 4 drops or sprays every 3 hrs | Up to 8 doses | Refer to package or consult a physician | | Xylometazoline 0.1% | 2 to 3 drops or sprays every 8 to 10 hrs | Up to 3 doses | Consult a physician | Consult a physician | | Xylometazoline 0.05% | 2 to 3 sprays every 8 to 10 hrs | Up to 3 doses | 2 to 3 sprays every 8 to 10 hrs | Up to 3 doses | Consult a physician |
|
|
|
|
|
Warnings
Decongestants
Consult a physician before using or do not use if you have:
- Allergy to decongestants
- High blood pressure
- Diabetes
- Glaucoma
- Heart disease
- Thyroid disease
Or if you:
- Are pregnant or a nursing mother
- Are a senior; you may require a lower dosage
- Are administering to a child under age 6
- Plan to use for prolonged periods; this increases the likelihood of experiencing rebound congestion
Or if you are taking:
- Antihypertensives, such as:
- Enalapril (Vasotec): may decrease enalapril's antihypertensive effects
- Nifedipine (Adalat): may decrease nifedipine's antihypertensive effects
- Guanethidine (Ismelin): may increase decongestant effects
- Methyldopa (Aldomet): may increase decongestant side effects
- Monoamine oxidase inhibitors (MOAs, a class of antidepressants), such as:
- Phenelzine (Nardil): may increase decongestant side effects
- Tranylcypromine (Parnate): may increase decongestant side effects
- Tricyclic antidepressants, such as:
- Amitriptyline (Elavil): may increase decongestant side effects
- Nortriptyline (Pamelor): may increase decongestant side effects
- Reserpine: may increase decongestant side effects
- Phenothiazines, such as:
- Perphenazine (Trilafon): may reduce decongestant effects
- Trifluoperazine (Stelazine): may reduce decongestant effects
Common Side Effects
Decongestants
- Burning sensation
- Rebound congestion
- Sneezing
Infrequent to Rare Side Effects
- Dryness
- Stinging sensation
Effects of an Overdose
What to Do In Case of Overdose
- It is unlikely that an overdose of this medication will cause life-threatening symptoms. If you are still concerned, please seek the advice of your health professional.
|
|
|
|
|
Websites, Organizations & Manufacturers
Sources & Further Reading
Government Sources
- 1. Food & Drug Administration.Federal Register 8/23/94.
- 2. Food & Drug Administration.Federal Register 3/8/96.
Books
- 1. Covington, TR et al. Handbook of Nonprescription Drugs, Eleventh Ed. American Pharmaceutical Assoc. Washington, DC 1996.
- 2. Kastrup EK et al. Drug Facts and Comparisons. Facts and Comparisons.
- 3. Inlander, CB and Slamans, S.The Over-the-Counter Doctor. Cader Books. New York, NY 1997.
- 4. Zimmerman, DR.Zimmerman's Complete Guide to Nonprescription Drugs, Second Ed. Gale Research, Inc. 1983.
Find more books on health and wellness at  barnesandnoble.com.
| |
|
