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Nasal congestion :-
 Nasal congestion can be caused by anything
that irritates or inflames the nasal tissues .
 Infections such as cold , flu or sinusitis and
allergies are frequent causes of nasal
congestion and runny nose .
 Sometimes a congested and runny nose can be
caused by irritants such as tobacco , smoke etc…
Nasal decongestants :-
 Nasal decongestants are pharmaceutical drugs
that are used to relieve nasal congestion in the
upper respiratory tract .
Mechanism of action :-
The mechanism of nasal decongestants are
activation of postjunctional alpha-adrenergic
receptors found on precapillary and
postcapillary blood vessels of the nasal mucosa.
CLASSIFICATION :-
The active ingredients in most decongestants is
either pseudoephedrine or phenylepherine .
a) Adrenalin release agents :-
Ex:- Ephedrine , Levo methamphitamine , phenyl
propional amine , pseudoephedrine .
b) Alpha-adrenergic receptor agonist:-
Ex:-Naphazoline , oxymetazoline , phenylephrine.
c) Corticosteroids :-
Ex:- Beclomethasone dipropionate , pregnisolone.
• Mechanism of action :-
Ephedrine , the principle mechanism of action relies
on its indirect stimulation of the adrenergic
receptor system by increasing the activity of
norepinephrine at the postsynaptic alpha and beta
receptors .
• Ephedrine stimulates alpha-adrenergic receptors in
blood veseels of nasal mucosa , producing
vasoconstriction and nasal decongestion .
Pharmacological actions :-
 Heart :-
On heart ephedrine action on beta-adrenergic
receptors in the heart produces a positive
ionotropic effect .
 Brain :-
Ephedrine activates pathways in human brain
that are responsible for weight loss mediated
through ß2 receptors .
 Smooth muscle :-
Ephedrine relaxes the smooth muscles of
gastro-intestinal tract by stimulating the α1 and
ß1 receptors .
 Blood pressure :-
Ephedrine shows biphasic response . If
ephedrine at low doses taken by iv and sc
routes causes decreasing in BP mediated
through ß2 receptors . When ephedrine at high
doses increases BP .
PHARMACOKINETICS :-
 Ephedrine is absorbed through orally , iv , im and sc.
 Bioavailability :- 85%
 Metabolism :- In liver by oxidative deamination .
 Onset of action :- IV[seconds] , IM[10min to 20min] ,
orally [15min to 60min] .
 Duration of action :- IV/IM[60min] , orally[2 to 4hrs].
 Elimination half-life :- 3h to 6 hrs .
 Excretion :- 22% to 99% through urine .
Adverse reactions :-
CNS :- Insomnia , euphoria , dizziness,headache,
confusion, nervosness and excitation with nasal
solution .
CV:- palpitations, hypertension, tachycardia with
nasal solution .
EENT:- Drynose and throat , rebound nasal
congestion with excessive use , mucosal irritation
with nasal solution .
GI:- Nausea, vomiting, anorexia .
Contraindications :-
 Ephedrine is containdicated to the patients
with severe hypertension , cardiac arrhythmias ,
organic heart disease , coronary artery disease ,
angina or other cardiac disease .
 Ephedrine is contraindicated in patients with
closed-angle glaucoma .
Levomethamphetamine :-
• It is a sympathomimetic vasoconstrictor which
is the active ingredient in some over-the-
counter nasal decongestants inhalers in the
united states .
MOA :-
It temporarily relieves nasal congestion by
constricting bloodvessels in the nasal mucosa .
ALPHA-ADRENERGIC RECEPTOR AGONIST:-
• Phenylephrine :-
• Phenylephrine was approved in 1976 for nasal
congestion .
• It is a medication primarily used as a
decongestant , to dilate the pupil , to increase
blood pressure .
 MOA :-
Phenylephrine is an agonist of α1-
adrenoceptors.Nasal decongestant action is
mediated by activation of α1-adrenoceptors in
the arterioles of the nasal mucosa . This causes
vasoconstriction, which leads to decreased
edema and increased drainage of the sinus
cavities .
Pharmacokinetics :-
 Metabolism through liver by oxidative
deamination.
 Onset of action very rapid through iv, within
20min by mouth .
 Duration of action :- upto 20min[iv], 4hrs [by
mouth] .
 Elimination half-life :-2.1 – 3.4hrs .
 Protein binding :- 95%
 Bioavailability :- 38% through GI tract .
OXYMETAZOLINE :-
 MOA :-
Oxymetazoline binds to activates α2 adrenergic
receptors .upon nasal administration ,
oxymetazoline constricts the arterioles in the
nose decreasing nasal congestion .
USES :- Oxymetazoline is available over the
counter as a nasal decongestant in the form of
oxymetazoline hydrochloride in nasal sprays
such as a otrivin , afrin , vicks sinex ……..
THANK YOU ………

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Nasal decongestants

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  • 3. Nasal congestion :-  Nasal congestion can be caused by anything that irritates or inflames the nasal tissues .  Infections such as cold , flu or sinusitis and allergies are frequent causes of nasal congestion and runny nose .  Sometimes a congested and runny nose can be caused by irritants such as tobacco , smoke etc…
  • 4. Nasal decongestants :-  Nasal decongestants are pharmaceutical drugs that are used to relieve nasal congestion in the upper respiratory tract .
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  • 6. Mechanism of action :- The mechanism of nasal decongestants are activation of postjunctional alpha-adrenergic receptors found on precapillary and postcapillary blood vessels of the nasal mucosa.
  • 7. CLASSIFICATION :- The active ingredients in most decongestants is either pseudoephedrine or phenylepherine . a) Adrenalin release agents :- Ex:- Ephedrine , Levo methamphitamine , phenyl propional amine , pseudoephedrine . b) Alpha-adrenergic receptor agonist:- Ex:-Naphazoline , oxymetazoline , phenylephrine. c) Corticosteroids :- Ex:- Beclomethasone dipropionate , pregnisolone.
  • 8. • Mechanism of action :- Ephedrine , the principle mechanism of action relies on its indirect stimulation of the adrenergic receptor system by increasing the activity of norepinephrine at the postsynaptic alpha and beta receptors . • Ephedrine stimulates alpha-adrenergic receptors in blood veseels of nasal mucosa , producing vasoconstriction and nasal decongestion .
  • 9. Pharmacological actions :-  Heart :- On heart ephedrine action on beta-adrenergic receptors in the heart produces a positive ionotropic effect .  Brain :- Ephedrine activates pathways in human brain that are responsible for weight loss mediated through ß2 receptors .
  • 10.  Smooth muscle :- Ephedrine relaxes the smooth muscles of gastro-intestinal tract by stimulating the α1 and ß1 receptors .  Blood pressure :- Ephedrine shows biphasic response . If ephedrine at low doses taken by iv and sc routes causes decreasing in BP mediated through ß2 receptors . When ephedrine at high doses increases BP .
  • 11. PHARMACOKINETICS :-  Ephedrine is absorbed through orally , iv , im and sc.  Bioavailability :- 85%  Metabolism :- In liver by oxidative deamination .  Onset of action :- IV[seconds] , IM[10min to 20min] , orally [15min to 60min] .  Duration of action :- IV/IM[60min] , orally[2 to 4hrs].  Elimination half-life :- 3h to 6 hrs .  Excretion :- 22% to 99% through urine .
  • 12. Adverse reactions :- CNS :- Insomnia , euphoria , dizziness,headache, confusion, nervosness and excitation with nasal solution . CV:- palpitations, hypertension, tachycardia with nasal solution . EENT:- Drynose and throat , rebound nasal congestion with excessive use , mucosal irritation with nasal solution . GI:- Nausea, vomiting, anorexia .
  • 13. Contraindications :-  Ephedrine is containdicated to the patients with severe hypertension , cardiac arrhythmias , organic heart disease , coronary artery disease , angina or other cardiac disease .  Ephedrine is contraindicated in patients with closed-angle glaucoma .
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  • 15. Levomethamphetamine :- • It is a sympathomimetic vasoconstrictor which is the active ingredient in some over-the- counter nasal decongestants inhalers in the united states . MOA :- It temporarily relieves nasal congestion by constricting bloodvessels in the nasal mucosa .
  • 16. ALPHA-ADRENERGIC RECEPTOR AGONIST:- • Phenylephrine :- • Phenylephrine was approved in 1976 for nasal congestion . • It is a medication primarily used as a decongestant , to dilate the pupil , to increase blood pressure .
  • 17.  MOA :- Phenylephrine is an agonist of α1- adrenoceptors.Nasal decongestant action is mediated by activation of α1-adrenoceptors in the arterioles of the nasal mucosa . This causes vasoconstriction, which leads to decreased edema and increased drainage of the sinus cavities .
  • 18. Pharmacokinetics :-  Metabolism through liver by oxidative deamination.  Onset of action very rapid through iv, within 20min by mouth .  Duration of action :- upto 20min[iv], 4hrs [by mouth] .  Elimination half-life :-2.1 – 3.4hrs .  Protein binding :- 95%  Bioavailability :- 38% through GI tract .
  • 19. OXYMETAZOLINE :-  MOA :- Oxymetazoline binds to activates α2 adrenergic receptors .upon nasal administration , oxymetazoline constricts the arterioles in the nose decreasing nasal congestion . USES :- Oxymetazoline is available over the counter as a nasal decongestant in the form of oxymetazoline hydrochloride in nasal sprays such as a otrivin , afrin , vicks sinex ……..
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