Both many doctors and patients are sure that the vasoconstrictor sprays and drops are added to addiction too long. We decided to check if this idea has a medical justification.

Specialized drugs write about such a side effect of drugs Media, sites otolaryngological clinic and themselves Patients. The latter They complainthat long -term intake of vasoconstrictor drugs causes such a dependence that for normal nasal breathing they need ten, or even more times the recommended daily dose. Many also Report About psychological Dependencies from drugs, forcing them to go behind a spray or drops into a pharmacy even in the middle of the night.

All vasoconstrictor drugs Contain One of the following substances or their combination: Nafazolin, oxymetazolin, xylometazoline, phenylefrin. In this material, we will not use the trading names of sprays and drops, but limit ourselves to only their active substance. To correlate a specific nose spray with one of them, just contact the “active substance” section in paper instructions or study information about the drug, for example, on site "Reference to drugs Vidal." Vasocusing drugs in a broad sense are called decongestants. By statistics, up to 30% of adults and up to 40% of children experience regular problems with nasal breathing and resort to the use of decongestants.

Nasal shells Drive A large number of capillaries and venous vascular bags. Such a volume of circulating blood is necessary for warming and moisturizing inhaled air. Accordingly, if the edema occurs due to the disease or allergies, nasal breathing is much difficult. The introduction of local vasoconstrictors, as the name understands, narrows the lumen of the vessels, reduces the volume of the mucosa and makes the nasal moves more free for inspiration and exhalation. In Russia, the drugs of the vasoconstrictor group Relate to over -the -counter drugs, which makes them first choice in the treatment of various colds and removing the symptoms of allergic diseases.

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At the same time, decongestants Inherent Tachyphylaxia is a rapid decrease in effectiveness with the re -administration of the drug and the need to constant an increase in its dose. It is about tachyphylaxis, and not about addiction, dependence or “planting”, which is most correct to speak in the case of vasoconstrictors. Tachyphilaxia, not developing drug addiction, for example, Explained The need for a constant increase in the dose of morphine at the terminal stages of cancer. It is worth noting that manufacturers of vasoconstrictor drugs usually indicate tachyfilaxia V list Side actions.

In the case of long -term and significant excess of the dose of vasoconstrictive sprays and drops in the patient develops Medication rhinitis. The term is accepted as in Russian -speaking, and in English -speaking field, while absent in MKB-10 And it is not planned to enter into MKB-11. Since drug rhinitis is accompanied by atrophy, that is, mucosa murders, it is most often encoded as “atrophic rhinitis”. Atrophy in itself - the thinning of the mucosa - leads to an even greater nasal congestion, therefore, the patient needs to constantly increase the dose to achieve a more short period of normalization of nasal breathing. In addition to the occurrence of drug rhinitis, the excess of dosages of vasoconstrictor drugs Maybe To lead to complications such as thrombosis of the branches of the retinal artery, ventricular arrhythmia, brisk states and even strokes.

Although the diagnosis of drug rhinitis is absent in the ICD, there are enough studies proving its existence and direct connection with the abuse of decongestants. Back in 1996, scientists Sicked A group of healthy volunteers: one of them received a spray with oxymetazolin for a month, the other with benzalco chloride (an antimicrobial drug without a vasoconstrictor effect), and the third - a placebo. After 28 days of using sprays, the first group showed a significant deterioration in the state of the mucosa, and also appreciated the subjective congestion of the nose and problems with nasal breathing.

Another group of researchers Collected Samples of tissues of nasal shells in 22 patients using xylometazoline on a regular basis, and compared with ten samples of tissues of people who did not use vasoconstrictor drugs with this active substance. In all 22 samples, plane cell metaplasia was revealed - a structural change characterized by the replacement of ciliary epithelium with multilayer flat epithelium. That is, one type of cell literally died and was replaced by another, not intended to ensure breathing functions.

The problem of drug rhinitis is quite common: according to statistics, from 1% to 9% of all appeals to otolaryngological clinics Related With medication rhinitis. At the same time, Mark Specialists, numbers are precisely lower than the real amount of drops dependent, since many patients do not consider this dependence a problem requiring an appeal to a specialist.

At the same time, there is good news - we completely cure the drug rhinitis and turn. To get rid of dependence, it is used as a conservative treatment corticosteroid and antihistamine drugs, and surgical - for example, Vasotomy, dissecting blood vessels, and conchotomy, excision of part of the affected mucous membrane mechanically or by laser or cryodestruction. Surgical treatment Conducted At the choice of the patient under local or general anesthesia, in many cases - outpatiently, that is, hospitalization is not required. Surgical intervention Provides Long -term normalization of nasal breathing, provided that it is abandoned by the abuse of vasoconstrictor drugs.

Thus, the exceeding the daily doses of vasoconstrictor drugs or taking the recommended one in terms of duration, really leads to the formation of the drug determined by both subjectively by the patient and objectively by the doctor when examining the structure of tissues of nasal sinks. Such pathological changes are called drug rhinitis. However, they are reversible, there are effective therapeutic methods of treatment, and in difficult cases, surgical intervention is justified, which greatly facilitates the life of the patient.