Abstract
Nasal decongestants (ND) are representatives of the pharmacological group of α-adrenomimetics and are widely used in clinical practice. These drugs are successfully used as symptomatic therapy of acute rhinosinusitis (AR), as well as as part of the complex therapy of acute otitis during unloading therapy for the auditory tube. The use of ND is necessary before conducting an endoscopic examination of the nasal cavity, for a better assessment of the state of the ostiomeatal complex, the olfactory cleft, as well as differential diagnosis of various forms of rhinitis and dysosmia. ND are indispensable in the prevention of complications of AR, such as acute eustachiitis, exudative otitis media and acute otitis media. Also, these drugs are used in the prevention of the development of aerotitis and ear barotrauma. The most commonly used nasal medications of medium and long duration of action, such as xylometazoline and oxymetazoline. This article presents clinical studies demonstrating the high efficacy and safety of these drugs as part of the treatment of AR. It is shown that oxymetazoline and xylometazoline are well tolerated by patients with a minimum number of adverse events. Modern representatives of ND are such drugs as Otrivin express 0.05% with the aroma of menthol, the main active ingredient of which is oxymetazoline, Otrivin 0.1% Moisturizing formula and Otrivin 0.1% with menthol and eucalyptus, which includes xylometazoline as the main active ingredient. These drugs have confirmed their effectiveness and safety in a large number of clinical studies and can be recommended as local vasoconstrictors.
Highlights
Nasal decongestants (ND) are representatives of the pharmacological group of α-adrenomimetics and are widely used in clinical practice. These drugs are successfully used as symptomatic therapy of acute rhinosinusitis (AR), as well as as part of the complex therapy of acute otitis during unloading therapy for the auditory tube
The use of ND is necessary before conducting an endoscopic examination of the nasal cavity, for a better assessment of the state of the ostiomeatal complex, the olfactory cleft, as well as differential diagnosis of various forms of rhinitis and dysosmia
ND are indispensable in the prevention of complications of AR, such as acute eustachiitis, exudative otitis media and acute otitis media
Summary
Одним из наиболее частых заболеваний, с которым сталкивается врач-оториноларинголог амбулаторного звена, является ОР, представляющий собой воспаление слизистой оболочки полости носа и околоносовых пазух. Диагноз поствирусного риносинусита может устанавливаться при сохранении симптомов ОР более 10 дней или усилении выраженности симптомов на 5-й день заболевания («вторая волна»). При передней риноскопии оценивают состояние слизистой оболочки полости носа, ее цвет и степень отечности, наличие и характер отделяемого в носовых ходах. Гипертонические растворы помимо очищения полости носа используются также и для уменьшения отека слизистой оболочки. Двойное слепое плацебо-контролируемое исследование с участием 247 пациентов с ОР продемонстрировало, что в группе больных, получавших в качестве лечения оксиметазолин, уменьшалась продолжительность заболевания в среднем на 2 дня по сравнению с группой, получавшей плацебо – физиологический раствор (4 дня против 6 дней). В публикации, включившей в себя описание 2 слепых плацебо-контролируемых исследований с участием 61 и 67 человек, показано, что оксиметазолин 0,05% эффективнее устраняет отек слизистой оболочки полости носа с 1 по 12-й час наблюдений по сравнению с плацебо [16]. Исследование демонстрирует эффективность данного препарата и хорошую переносимость [18]
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