China
Africa
Explore chapters and articles related to this topic
Antihistamines, Decongestants, and Expectorants during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Naphazoline, oxymetazoline, and xylometazoline are sympathomimetic agents with decongestant in long-acting nasal sprays (Afrin, Allerest, Dristan, 4-Way). Birth defects were not increased in frequency among more than 250 infants born to women who used oxymetazoline during the first trimester (Aselton et al., 1985; Jick et al., 1981). The Swedish registry reported no increased frequency of birth defects (3.3 percent) among 3521 infants whose were exposed to oxymetazoline during organogenesis (Kallen, 2019). Likewise, the frequency of birth defects was not increased in 432 infants exposed to xylometazoline during embryogenesis (Aselton et al., 1985; Jick et al., 1981). The Swedish registry reported the frequency of birth defects was not increased among 1168 infants born to women who used xylometazoline during the first trimester (Kallen, 2019). An incidental observation is that xylometazoline was significantly protective against congenital anomalies in the analysis. No studies have been published regarding naphazoline monotherapy use during pregnancy. However, the combination antazoline—naphazoline ophthalmologic preparation was used during the first trimester among 3061 infants, and the rate of birth defects was not increased above background (3.0 percent) or compared to controls (3.5 percent) (Thomseth et al., 2019).
The Pharmacotherapy of Rhinitis and Asthma
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
Amanda Grippen Goddard, Harold S. Nelson, Rohit Katial, Flavia Hoyte
Topical decongestants such as oxymetazoline can be very effective in reducing nasal congestion but do not reduce itching, sneezing or nasal secretions (Wallace and Dykewicz 2008). Due to the development of tolerance and rebound vasodilation with chronic use, termed rhinitis medicamentosa, they are not recommended for long-term treatment (Bousquet et al. 2008, Wallace and Dykewicz 2008).
Biogenic amines
Published in William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop, Atlas of Inherited Metabolic Diseases, 2020
William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop
Nasal congestion is a frequent problem for AADC patients probably because of their deficit in catecholamines. Topical application of oxymetazoline or xylometazoline is necessary in most cases. The package insert, as well as major textbooks, warns that the use of the combination of MAO inhibitors and topical alpha-adrenoreceptor agonists nose drops may cause severe hypertensive crises. In AADC patients, however, catecholamines are reduced and in practice we are not aware of any such complication using this combination in our patients.
Congenital Nasolacrimal Duct Obstruction Update Study (CUP Study): Report III. Analysis of Earlier Failed Probing without Endoscopy Guidance
Published in Seminars in Ophthalmology, 2022
Nandini Bothra, Oshin Bansal, Abhimanyu Sharma, Mohammad Javed Ali
Irrigation and probing were performed under short general anaesthesia with a laryngeal mask airway. Nasal mucosa was decongested with 0.025% oxymetazoline. The upper punctum was dilated using the short taper Nettleship’s punctum dilator. Irrigation was performed using a one ml syringe and 27 G straight cannula to confirm the nasolacrimal duct obstruction. A standard probing was then performed using age-appropriate Bowman probe sizes. The advancing probe was brought to a halt the moment any obstruction was felt. A 2.7 mm, 0-degree endoscope was used to visualize the nasal cavity. The inferior turbinate was then medialized using the blunt edge of the periosteal elevator, and a direct view of the inferior meatus and the NLD was achieved. The probe was then advanced under direct visualization into the inferior meatus, the type of obstruction or its variations were noted, and appropriate recanalization measures were initiated. Following NLD recanalization, lacrimal irrigation was performed to confirm the egress of fluorescein-stained fluid into the inferior meatus. When indicated, stent intubation or balloon dacryoplasty was performed. Endoscopic dacryocystorhinostomy was performed for CNLDO refractory to all the minimally invasive measures listed.
Adjuncts to pulsed dye laser for treatment of port wine stains: a literature review
Published in Journal of Cosmetic and Laser Therapy, 2021
Bing Wang, Xianglin Mei, Yanlong Wang, Xin Hu, Fuqiu Li
Oxymetazoline is a mild vasoconstrictor that exhibits high selectivity for the α1A-adrenoreceptor and partial selectivity for the α2A-adrenoreceptor. Based on α1A-adrenoceptor agonist activity in target vessels with smooth muscle cells, it has been approved by FDA for treatment of erythematotelangiectatic rosacea (51). Although capillaries do not contain smooth muscle, its effect on the smooth muscle of superficial and deep vessels reduces overall erythema in rosacea, especially persistent facial erythema. A randomized, baseline-controlled prospective trial in rosacea patients by Sodha et al. demonstrated the safety and efficacy of combination treatment with topical oxymetazoline and PDL compared with topical oxymetazoline alone (52). The authors reported minimal treatment-associated adverse events and side effects. Topical adrenergic agonists display an intricate interaction with their receptors. Oxymetazoline has shown considerable off-target activities, such as 5-hydroxytryptamine receptor activity that may affect the overall clinical effect. Kelly et al. performed a number of experiments to demonstrate the microvascular effects of oxymetazoline and PDL. They observed persistent vascular shutdown achieved with combination therapy with oxymetazoline and PDL (51). These findings demonstrated that this combination therapy may offer improved results in the treatment of cutaneous vascular diseases, including rosacea and vascular malformations such as PWS. However, there is a paucity of clinical trials of oxymetazoline combined with PDL in patients with PWS.
Difference in vasoconstrictors: oxymetazoline vs. brimonidine
Published in Journal of Dermatological Treatment, 2021
Nwanneka Okwundu, Abigail Cline, Steven R. Feldman
A long-term, open-label, phase III trial evaluate the safety and efficacy of oxymetazoline in 440 subjects over 52 weeks. The study had a similar design to the 29-day phase III clinical trials, but also included the Clinician Telangiectasia Assessment (CTA score). At week 52, 36.7% and 43.4% of patients receiving oxymetazoline achieved a 2-grade improvement in both CEA and SSA scores, respectively, at hours 3 and 6 compared with pre-dose. Among 440 patients, 8.2% reported TEAEs. The incidence of TAE's was highest during the first 90 days of treatment (5.9%) and lower the subsequent 90 day periods (1.5%, 0.7%, and 0.3% respectively). Less than 1% of patients experienced a rebound effect following treatment cessation (Table 1, #3).