Decongestants, such as pseudoephedrine, act by con-stricting blood vessels in the nasal membranes and thereby reduce nasal swelling. These drugs have been shown to effectively reduce the sensation of nasal congestion but have minimal effects upon other nasal symptoms, such as sneezing, itching of the eyes or nose, or discharge.
When given orally, these drugs begin to work within 1 to 2 hours and, depending upon the preparation, may last between 4 and 24 hours. Oral decongestants may have significant side effects, including effects on the brain (insomnia, anx-iety, irritability), effects on the cardiovascular system (rapid heartbeat, palpitations, increased blood pressure), and urinary retention, particularly in men with prostatic enlargement.
Oral pseudoephedrine has historically been available over the counter (OTC). Recently, however, OTC use of this medication has become severely restricted— not because of any newly discovered safety issues but because this compound can be chemically converted into methamphetamine.
Nasal decongestant sprays, such as oxymetazoline, act much more quickly than the oral formulations, often within 5 minutes. Because the spray form of these drugs is given in extremely small quantities, there are usually no systemic effects, although very young and much older patients may occasionally have some of the systemic effects previously listed. In addition, when given for longer than 3 to 5 days, patients may experience rebound nasal swelling after stopping the drug, a condition referred to as “rhinitis medicamentosa”.
Decongestant
An agent that decreases nasal congestion by constricting blood vessels in the nose.