Medicinal rhinitis treatment. Medicinal rhinitis

In most cases, it is not difficult to treat rhinitis with medication, and noticeable results are achieved after 7-10 days of therapy - the patient has the most pronounced symptoms and nasal breathing is partially restored. As a rule, the treatment of drug-induced rhinitis is limited to conservative therapy, and only in the most severe neglected situations, the disease can be cured only with the use of surgical methods. At the same time, it is not always possible to completely restore the functions of the nasal mucosa if rhinitis has led to the degeneration of its epithelium.

In all cases, the basis for the treatment of medication rhinitis is the rejection of vasoconstrictor drops. It is imperative not only to cancel the drug that caused the disease, and not to start using similar vasoconstrictor drugs. For example, if the disease is caused by prolonged use of Naphthyzine, it makes no sense to simply replace Naphthyzine with, say, Galazolin - the atrophy of the mucous membrane in this case will continue.

The cause of rhinitis medication is the intake of vasoconstrictor drops. For effective treatment, this cause must be eliminated.

Cancellation of vasoconstrictor drops in rhinitis medication can be difficult for the patient. In the first days of refusal, his nose is completely blocked, possibly drying out of the mucous membrane with unpleasant sensations. To alleviate these symptoms, you can use anti-inflammatory nasal drugs that do not contain α-adrenergic agonists:

• Hormonal drops for the common cold (Nasonex, Nasobek, Avamis, Fliksonase);
• Antihistamines (in the form of nasal drops - Allergodil, Histimet, Reactin, in the form of oral agents - Erius, Suprastin).

These drugs allow you to relieve swelling and inflammation in the nose, but when they are taken, the mechanisms that caused rhinitis medication are not implemented. Consequently, nasal congestion when using them disappears for a certain period (usually longer than when taking vasoconstrictor drops), although they do not completely cure the disease, the causes of drug rhinitis have already disappeared and the restoration of the nasal mucosa begins.

Treatment of rhinitis medication in children should be those that are allowed at a particular age, since antihistamines can have systemic side effects, which are especially pronounced at a young age.

There is no specific cure for rhinitis medication. There is no such remedy on the market that would be enough to spend on drink in a special course and guaranteed to get rid of the disease.

It is important to remember that it is impossible to get rid of rhinitis medication quickly. In the best case, the patient's condition is slightly normalized in 3-4 days, and completely nasal breathing is restored in 2-3 weeks. In more severe situations, the disease needs to be treated for several weeks, or even months.

Adjunctive therapy for rhinitis medicamentosa

To eliminate discomfort in the nose, as well as to accelerate the regeneration of the mucous membrane, it is necessary to rinse the nose with saline or its analogues. It is fashionable to buy the saline solution at the pharmacy, but you can prepare it at home if you dissolve a teaspoon of table salt in a liter of water.

More expensive, more prestigious, but similar in efficiency taxes of such a solution are:

• AquaMaris;
• Dolphin;
• Marimer;
• Aqualor;
• Quicks ...

…other. All of them moisturize the nasal passages, cleanse it, help remove snot from the nose and, in general, normalize the state of the mucous membrane. Its recovery and regeneration in such conditions is faster.

Rinsing the nose can be done often - up to 8-10 times a day. It is advisable not to do them immediately before going outside at low temperatures.

It is useful to rinse the nose even when there is no rhinitis and the nose is breathing normally.

It is also very useful during treatment (as well as at the end of it) to maintain microclimate parameters that are comfortable for the mucous membrane in the room: air temperature 18-20 ° C and humidity 55-75%. Breathing with such air is as gentle as possible for the nasal mucosa.

After giving up vasoconstrictor agents, you can do acupressure of the nose. It will not give a quick result, but it will provide some activation of the mucous membrane and help to speed up its recovery.

These funds and methods are conservative and are used for 2-3 weeks under the supervision of a physician. If during this time there is a noticeable progress in the restoration of the nasal mucosa and nasal breathing itself, the treatment continues. If this treatment does not work, surgery may be required.

Methods of surgical treatment of medication rhinitis

The effectiveness of the surgical intervention is due to the fact that a part of the enlarged mucous membrane is removed from the patient, sometimes with areas of the turbinates, as a result of which the lumen of the nasal passages and their throughput increase, and the patient can fully breathe air through his nose and breathe normally. Usually, one of the following procedures is used for this:

• Conchotomy;
• Cold plasma vasotomy of the inferior turbinates;
• Submucosal vasotomy;
• Laser moxibustion.

In cases when a patient has rhinitis medicamentous combined with a severe curvature of the nasal septum, a pronounced effect can be provided by septoplasty or turbinoplasty, in which the normal lumen of the nasal passages is restored only by aligning the nasal septum.

Ineffective means and methods of therapy

Rhinitis medication is extremely difficult to treat with folk remedies. So, with him, they often recommend:

• Rinse your nose with a decoction of chamomile (a spoonful of chamomile flowers in a glass of boiling water);
• Instill in the nose aloe juice diluted with water or olive oil;
• Lubricate the nasal mucosa with a mixture of natural essential oils of peach, eucalyptus and rose hips;
• Breathe in the bath over the steam from the infusion of chamomile, celandine, motherwort, St. John's wort and eucalyptus splashed on hot stones.

However, in practice, the use of such drugs has practically no effect on the outcome of treatment. Folk remedies can only enhance the effect of other drugs to some extent. In particular, chamomile reduces inflammation, essential oils protect dry mucous membranes from cracking. All this makes it possible to improve the patient's condition during treatment at home, but practically does not affect the restoration of the mucous membrane. At the same time, most of these drugs can cause side effects that are more pronounced than their beneficial effect. For example, oil drops disrupt the work of the ciliated epithelium and inhibit the removal of mucus from the nose, and aloe juice can cause allergies.

Typical mild allergic rash in response to rinsing the nose with a decoction of herbs

Similarly, it is ineffective to treat rhinitis medicament by inhalation (the same effect as from steam inhalations can be achieved by simple but safer instillation of the solution into the nose, and inhalation with a compressor inhaler or nebulizer does not allow treating the nasal mucosa) and use homeopathic remedies (for example, Korizaliyu, Sinupret, Euphorbium Compositum - the effectiveness of these drugs is very low and does not exceed the effectiveness of placebo).

Also, the use of immunomodulators based on interferon and inductors of interferon itself will not give an effect.

Prevention of medication rhinitis

The main and only way to avoid the development of drug-induced rhinitis is to strictly adhere to the rules for taking vasoconstrictor nasal drops. With ARVI and runny nose, they can be taken for no more than 5 days for children and no more than 7 days for adults. Even during this period, they should not be buried in the nose constantly, but only before bedtime, in order to provide the patient with normal rest. Decongestants cannot be used longer than this period.

If, with an illness, a runny nose and swelling of the nasal mucosa persists for more than a week, vasoconstrictor drops should be replaced with hormonal or antihistamines.

Practice shows that with the correct organization of the treatment of ARVI or another disease that causes a runny nose, the use of vasoconstrictor drops can always be avoided. In any case, they should be treated as an emergency aid, used 1-2 times in the most severe cases. Constantly burying your nose with them is harmful and dangerous.

In more than 90% of cases, medical rhinitis can be treated using conservative methods, in which the patient, under the guidance of a doctor:

1. Completely stops taking vasoconstrictor drops;
2. In the first days, it eliminates edema and inflammation with the help of hormonal and antihistamines;
3. Rinses and moisturizes the nose regularly and often;
4. Normalizes the parameters of the air in the room in which he sleeps and spends the most time.

Only if these measures do not give a result, the option of surgical intervention is considered.

Interesting video: Dr. Komarovsky tells how vasoconstrictor drops cause rhinitis medicament

Sources:

• Palchun V.T., Magomedov M.M., Luchikhin L.A. Otorhinolaryngology: a textbook for universities. - 2nd ed., Rev. and add. - 2008 - 656 p.
• On the safety of the use of nasal vasoconstrictor drugs in pediatric practice. - P. Karpova, D.A. Tulupov

About the bottom of the varieties of the common cold, with which patients often come to see an ENT doctor, this is rhinitis medicament. Pathology develops due to the abuse of vasoconstrictor drops, since many people, at the first symptoms of nasal congestion, immediately go to the pharmacy for a life-saving remedy, while using it uncontrollably and much longer than the prescribed 3-5 days.

Of course, the action of such drugs is fast and persistent, but not everyone knows about the side effects that cause vasoconstrictor drops and sprays. How to prevent disastrous consequences after using the remedies for the common cold and what to do if the addiction has already developed - will be described further.

To understand why rhinitis medication develops, it is necessary to know the principle of action of vasoconstrictor drugs, and why their prolonged, uncontrolled use can lead to negative consequences.

The nasal passages of a person are covered with a layer of cavernous tissue, which, with abundant blood filling, can increase several times and decrease on its own with the same speed.

The main function of the cavernous epithelium is the regulation of the temperature of the air that enters the lungs, that is, its timely cooling or warming.

When entering the cold air, the cavernous bodies increase, for the most comfortable contact of cold air with the nasal mucosa, and the inhaled stream has time to warm up before it penetrates the lung cavity.

When entering a warm room, the vessels return to their usual state, since additional heating of the epithelium is no longer required.

Vasoconstrictor drops act on the capillaries of the nasal passages forcibly - they force them to contract, in no way connecting this need with environmental conditions. As a result, the nervous system cannot recognize this command, and forces the vessels to dilate again. The mucous membrane becomes swollen, the patient again suffers from nasal congestion, and he is forced to seek help from drops from the common cold - a vicious circle is formed.

The more often a person uses vasoconstrictors, the more the mucous epithelium swells, for many the pathology becomes chronic, when a whole bottle of drops is spent per day in order to somehow breathe freely through the nose.

Rare causes

Much more rare provocateurs of drug-induced rhinitis in adults are drugs from the groups of alpha-blockers (Prazonin, Doxazosin), sympatholytics (Adelfan), and central adrenomimetics (Clofelin, Methyldopa).

All these drugs are prescribed for the treatment of hypertension, with tumors of the adrenal cortex and Raynaud's disease, but they are taken orally, and not used intranasally, although the side effect is similar to vasoconstrictor drugs. When the active substances reach the nasal cavity, moving along the general bloodstream, an unexpected swelling of the cavernous epithelium develops.

This effect is manifested after 2-3 months of constant use of the listed medicines.

More often, drug-induced vasomotor rhinitis develops in patients with vegetative-vascular dystonia, since these patients are prone to disorders of the hormonal and nervous systems. And in children under 10 years of age, this pathology is practically not diagnosed.

Typical symptoms

The clinical symptoms of medication rhinitis are as follows:

• persistent nasal congestion;
• complete or partial violation of the lack of olfactory function;
• profuse discharge of mucus from the nasal passages;
• burning and itching in the nostrils and sinuses;
• sleep disturbances, night snoring.

Having noticed one or several of the listed symptoms at once, the patient should immediately consult an ENT doctor for a thorough diagnosis.

In some cases, when the pathology is at the initial stage of development, only and can be observed, and these signs are stopped only for a short time, but after a couple of hours they return again.

It is at this moment that you need to seek medical help, since getting rid of medication rhinitis, which has not yet become chronic, will be much easier.

Diagnostics and differential examinations

As a rule, rhinitis medication is started after the diagnosis is confirmed. Examination of the nasal mucosa, which is carried out using a rhinoscope or endoscope, reveals the following changes in the state of the epithelium:

• loss of ciliated cilia from the surface of epithelial tissue;
• metaplasia of the upper epithelial layer into a flat one, the cover becomes non-keratinized;
• an increase in glands in volume, against the background of increased production of mucous secretions;
• increased capillary permeability and excessive swelling resulting from this symptom.

In addition to external diagnostics, it is necessary to conduct a differential examination, because rhinitis medication can occur in various forms - against the background of tissue atrophy, allergic reactions, disorders in the functioning of the hormonal and nervous systems.

To identify allergies, skin tests are carried out, with the definition of the irritant. If you suspect a bacterial or viral form of the common cold, a swab from the nasal cavity is taken (bacteriological culture).

If, during the instrumental examination, polypous growths were found, due to which the patient had nasal congestion and persistent runny nose, he was shown to undergo an MRI (magnetic resonance imaging) scan.

How to stop using vasoconstrictor drops

In order to cure medication rhinitis on your own, it will take a lot of willpower and perseverance, since most patients experience the process of weaning from vasoconstrictor drugs is very painful.

It should be clarified that home treatment will only help those patients whose pathology has not yet become chronic. There are several ways to get rid of addiction.

Abrupt rejection of drops and sprays with a vasoconstrictor effect

The method is radical and rather complicated; not many patients agree to use it to treat addiction. To get rid of medication rhinitis, it will take at least 4 days absolutely without the use of drops, during which time the capillaries will partially return the lost functions of self-control.

The complete restoration of regulation will take place only after 2 weeks.

Gradual withdrawal

This method is considered more gentle, since the patient is allowed to use vasoconstrictors, but only with an increase in the time between instillations.

Replacing the drug

If the patient is experiencing dependence, for example, on naphazoline-based drops, it is recommended that he start using a product containing xylometazoline, while increasing the intervals between instillations.

In parallel with the listed methods of getting rid of addiction, doctors recommend inhalation Sodium chloride (saline) or ordinary table mineral water, for example Borjomi.

This will help get rid of excess swelling of the epithelium of the nasal passages, moisturize it and remove mucus. In addition, the patient after inhalation will be able to do without drops for some time.

Pharmacological treatment

If independent attempts to get rid of drug dependence have not been successful, the ENT doctor will prescribe a pharmacological treatment regimen, which will be based on the use of intranasal drugs of another group - corticosteroids.

Ancillary treatment procedures will be selected depending on how far the addiction to drops has gone, and what changes are noted on the part of the nasal mucous epithelium.

Local glucocorticosteroids for the treatment of medicamentous rhinitis are represented by the following drugs:

• Nasonex is a spray based on mometasone. It is used 1-2 times a day, 1-2 injections into each nasal passage;
• Flixonase is a medicine that contains fluticasone. Also used as Nasonex, or in accordance with the recommendations of a doctor;
• Avamis - a spray also containing fluticasone, the method of administration is the same;
• Tafen Nasal is a remedy, the active component of which is budesonide. Used twice a day, 1-2 sprays in each nostril;
• Dexamethasone - contains the hormone of the same name. It is injected into the nasal passages 2 times a day, the course of treatment is 1 week.

Experts agree that drugs for intranasal use containing mometasone are more effective than drugs based on fluticasone, they have practically no side effects and do not enter the general bloodstream (however, they are much more expensive).

In parallel with the use of the listed funds, it is recommended to take antihistamines - Loratadin, Zyrtec, Erius, Zestra, Claritin and others.

They are prescribed to exclude the allergic nature of rhinitis, as well as to relieve increased swelling of the epithelium.

Surgery

Surgical intervention is indicated for patients who received conservative (pharmacological) therapy for a month, but the results were not achieved. Today, there are several surgical methods for treating rhinitis medicamentosa:

The light beam acts on the surface of the mucous epithelium of the nose for a certain time (it is selected taking into account the state of the cavernous tissue), while the vessels are compressed, and the edema subsides. The effect of the operation can last from several years to the end of life. It is carried out under local anesthesia, and the recovery period is 10-20 days, at which time the patient is shown nasal rinsing procedures.

• Ultrasonic disintegration.

The vascular surgeon destroys capillaries that have lost their independent ability to contract using ultrasound. In their place, new ones gradually grow, possessing the ability to function correctly. Exposure to an ultrasound probe is carried out for 10-15 seconds inside each nostril, the procedure is carried out under local anesthesia.

The next day, the cavernous epithelium is treated with steroid drugs to relieve inflammation and speedy tissue regeneration. Spontaneous breathing through the nose returns to the patient as early as 4-5 days after the operation.

A gentle and effective way to treat rhinitis medication, which gives positive results in 90% of cases. Before the intervention, the patient is recommended to undergo computed tomography of the paranasal sinuses in order to make a decision about the expediency of the operation.

Cryotherapy and conchotomy are considered less popular and outdated methods of treatment, since the results of these procedures are controversial, moreover, after their implementation, there is an increased frequency of pathology relapses. If at the same time with medication rhinitis the patient has signs of curvature of the nasal septum, septoplasty is recommended.

Physiotherapy

Both during the treatment of drug-induced rhinitis and in the recovery period after surgery, the patient is shown physiotherapy:

• acupuncture;
• phonophoresis using Hydrocortisone ointment;
• intranasal electrophoresis using diphenhydramine and calcium.

These procedures help to improve the blood supply to tissues, to establish the contractile function of the capillaries and to increase local immunity. The duration of the course of therapy is determined by the attending physician.

In addition to the listed physiotherapy methods, doctors recommend rinsing the nose with the "Cuckoo" method or independent regular irrigation of the nasal passages with drugs Dolphin, Aqualor, Humer, Sterimar.

To prevent the nasal mucosa from drying out, it can be lubricated Erythromycin and Hydrocortisone ointment, as well as the drug Lorizan.

Alternative medicine

The most popular and effective alternative medicine methods for the treatment of rhinitis medicamentosa:

• Aloe juice. Squeeze juice from several leaves of a plant (preferably 3-5 years old), dilute it in half with boiled warm water. Inject the resulting composition into each nostril 3-4 times a day.
• Honey drops. You need to take a small amount of fresh, liquid honey and dilute it with boiled water in a 1: 1 ratio. The resulting drops must be instilled into each nasal passage up to 6 times a day, 4-5 drops.
• Onion oil. One medium-sized onion must be chopped on a grater, and then add 200 ml of boiled (hot) corn oil to the gruel. Then they wrap it up in a warm cloth, scarf or jacket, and let it brew for 9-10 hours in a row. The resulting agent is lubricated with the mucous epithelium of the nose to relieve puffiness and get rid of a cold.
• Chamomile infusion... To prepare a decoction for rinsing the nose, you need to take 1 tbsp. dry raw materials, pour boiling water in an amount of 250-300 ml and leave for at least 40 minutes. After the solution, you need to strain and carry out the procedures at least 3 times a day.
• Beet . You can prepare drops - squeeze juice from one grated root vegetable and inject it into the nostrils 3-4 times a day (you can mix it with water). Or make the infusion like this - peel and chop one fruit, pour boiling water and insist in a warm place for 3-4 days, then strain through cheesecloth and use as nose drops.

Such complex therapy (alternation of medicines and folk remedies) will produce the greatest effect on patients who cannot immediately completely abandon vasoconstrictor drugs.

Possible complications

If you ignore the symptoms of medication rhinitis for a long time and do not make attempts to get rid of addiction, the negative consequences of the pathology can affect different systems of the body.

Complications may not be the most pleasant, among them:

• inability to breathe through your nose on your own;
• regular headaches;
• insufficient supply of oxygen to the brain, as a result of which hypoxia develops;
• impairment of memory, concentration and attention;
• severe sleep disturbances;
• decreased immunity.

In almost all cases of the disease, snoring occurs at night, and against its background, the patient notes a loss of olfactory function. A drug-induced rhinitis, which does not respond to adequate treatment for several years, becomes so neglected that the patient can be considered a pathologically unhealthy person.

Such patients are diagnosed arrhythmia, hypertension, disturbances in the work of the nervous and endocrine systems, tachycardia. To avoid such consequences, it is necessary to start treatment of drug dependence in a timely manner.

Recovery and prognosis

If the patient turned to the otolaryngologist on time and received comprehensive adequate treatment based on a combination of clinical symptoms and laboratory tests, then the prognosis of therapy will be good. Often, it takes 1-2 months to completely get rid of drug dependence, while the patient is advised to maintain respiratory function with the help of gymnastics, acupressure and sports.

The recovery period after surgery lasts on average 10-25 days, depending on what type of surgery was performed. Some types of surgery, such as conchotomy, are traumatic and fraught with relapses, so it is better to choose modern and safe techniques. So, after laser treatment, the percentage of complications and relapses is only 5-10%.

Like any disease, a medication rhinitis is easier to prevent than to cure for a long time and persistently. First of all, vasoconstrictor drugs should not be abused - their use should be limited to 2-3 instillations per day, with a course of no more than 5 days.

Before using drops and sprays, it is recommended to try to eliminate a runny nose with the help of inhalations, breathing exercises, rinsing the nose with saline and herbal decoctions. For the prevention of a runny nose, it is worth being in the fresh air more often, regularly wet cleaning and airing the room, and in the cold season, use Oxolinic ointment - it will reduce the likelihood of contracting ARVI and influenza.

Get rid of naphthyzine addiction

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Rhinitis medication is a very urgent problem in otolaryngology. Today, the symptomatology of the common cold is observed in a large number of people, since allergic rhinitis has become widespread.

Many patients complain of dependence on nasal drops and their ineffectiveness.

This is due to the lack of knowledge about how to properly prescribe treatment and prevent rhinitis medicamentosa.

What is a medication (medicinal) rhinitis?

Rhinitis medication is an inflammation of the nasal mucosa that develops as a result of prolonged use of nasal drops or sprays that have a vasoconstrictor effect.

Medicamentous rhinitis has a chronic course, since it develops against the background of developed tachyphylaxis to decongestants (vasoconstrictor drops). Tachyphylaxis is usually called the phenomenon of addiction to the frequent use of drugs.

An early symptom of addiction to nasal drops is a decrease in the effectiveness of their use. The disease gradually becomes chronic and the patient becomes dependent on the use of a nasal spray.

The best way to combat medication (medicinal) rhinitis is

Further, there is a complete lack of result from the use of the drug. This is due to the fact that the nasal spray stimulates the constant narrowing of the vessels of the nasal cavity, but since in the future the vessels become resistant to its effects, their constant expansion develops, which leads to the round-the-clock release of liquid contents from the nasal cavity.

By the type of exudation, drug rhinitis resembles vasomotor rhinitis, since the secretion of nasal secretions develops as a result of the chemical influence of the drug.

Medicamentous rhinitis due to drops

The main reason for the development of medication rhinitis is long-term use of nasal drops with a vasoconstrictor effect or their use in a dosage that exceeds the maximum daily dose for treatment.

Especially important!

Medicamentous rhinitis develops after daily use of nasal drops for more than 2 weeks for the treatment of catarrhal symptoms of the nose.

• Reducing the sensitivity of the nasal mucosa to norepinephrine.

Norepinephrine is a hormone of the adrenal medulla, the main function of which is to regulate vascular tone. Prolonged use of nasal drops leads to the fact that the receptors of the mucous membrane become less sensitive to its effects. Gradually, changes in the mucous membrane lead to the fact that the receptors stop responding to changes in the concentration of norepinephrine in the blood.

• The formation of polyps and crusts in the nasal cavity.

The constant intake of vasoconstrictor drugs leads to the development of polyposis changes in the nose. They fill the nasal passage to some extent, which in turn leads to an increase in nasal breathing.

Also, a large number of crusts form in the nose. The result of such changes is a narrowing of the common nasal passage. The flow of air through the narrowed nasal passage leads to increased breathing and irritation of the mucous membrane, which provokes the release of mucus from the nose. Such changes often require surgical treatment.

• Atrophic changes in the nasal mucosa.

The constant introduction of a pharmacological drug into the nasal cavity provokes a decrease in the mobility of the ciliated epithelium. "Paralysis" of the ciliated epithelium does not fulfill its functional purpose, which leads to the gradual development of the death of the mucous membrane.

• Dystonia of the vessels of the nose.

Changes in vascular tone are a direct effect of decongestants. Their introduction stimulates vasoconstriction, which is replaced by irreversible dilation and the development of a cold in the patient.

• Long-term use of drugs such as antihypertensive drugs, tranquilizers, hormones.

Antihypertensive drugs for the treatment of pathology of the cardiovascular system have a systemic effect and lead to vasodilation. The dilated vessels of the nasal cavity stimulate the abundant secretion of fluid.

Therefore, a slight runny nose is typical for people suffering from hypertension. Taking hormonal drugs with vasodilatory properties leads to persistent nasal discharge. The most modern tranquilizers, in addition to the main functions, affect the tone of the vascular wall, stimulating a decrease in its tone and an increase in exudation from the nose.

• Work at hazardous enterprises.

Working in chemical, pharmaceutical and toxic industries often leads to the constant influence of harmful chemicals of various origins on the mucous membrane and leads to the development of chronic secretion of mucous contents from the nasal cavity. This type of rhinitis is difficult to treat.

There are such symptoms of a medicinal rhinitis:

1. Microscopic symptoms;
2. Macroscopic symptoms;
3. Clinical symptoms.

Can rhinitis medication cause death?

These cases have not been established in medical practice. But with rhinitis medication, snoring appears during sleep, which is deadly.

The clinical symptoms of a medicinal rhinitis include

• Insomnia.
• Development of changes in blood pressure.

At the onset of the disease, nasal sprays have vasoconstrictor properties, which led to vasoconstriction. As a result, blood pressure rises. In the future, the vessels become resistant to the action of decongestants, then in patients with drug-induced rhinitis arterial hypotension develops.

• Tachycardia under the influence of decongestants is replaced by chronic bradycardia.
• The development of vascular dystonia.

Violation of vascular tone develops as a result of the use of decongestants. In such cases, it is recommended to prescribe the treatment of rhinitis, which contributes to the disappearance of the symptoms of VSD.

• Feeling of increased heartbeat and constriction in the region of the heart.

Variable fluctuations in blood pressure indicators, as well as vascular tone, lead to the development of such pathological sensations as a feeling of increased heartbeat and a feeling of tightness in the chest.

The microscopic symptoms of rhinitis medication include

• Atrophy of the cilia of the ciliated epithelium.
• An increase in the size of glands and goblet cells with the development of hypersecretion.
• Increased permeability of the vascular wall.
• The development of edema.
• Transformation of a single-layer multilayered ciliated epithelium into squamous non-keratinizing epithelium.

Microscopic symptoms make it possible to confirm the diagnosis of a drug-induced rhinitis, as well as to carry out differential diagnosis with other forms of the disease.

Macroscopic symptoms

• Decreased sense of smell.

Hyposmia is a consequence of such local changes in the nasal cavity as atrophy of the mucous membrane, dysfunction of the ciliated epithelium, as well as the formation of crusts and polyps.

• Discharge of mucus from the nose.
• Burning and itching.

The composition of nasal secretions includes salts that irritate receptors and cause the development of hyperemia in the damaged areas of the nasal cavity.

Medicamentous rhinitis why is it impossible to sleep?

Snoring with medication rhinitis develops as a result of narrowing of the lumen of the nasal passages. The air flow becomes turbulent, which also provokes the development of snoring. This provokes a person to constantly wake up from oxygen deficiency.

Treatment of medication rhinitis

Distinguish between conservative, surgical and physiotherapeutic treatment of medication rhinitis. The basis for the treatment of medication rhinitis is based on the refusal to use nasal drops.

How is rhinitis medication treated?

Especially important!

Refusal to use vasoconstrictor drops should be gradual. If you abruptly refuse to use drops, then the risk of developing symptoms of acute drug-induced rhinitis with characteristic discharge and swelling of the nasal mucosa increases.

In severe cases curing rhinitis medication is not always possible to get rid of the symptoms of the common cold in this way. The following medications are highly effective in the treatment of severe medication rhinitis:

• Corticosteroid drugs (Fluticazole, Avamis).

To surgical treatment medicated rhinitis is used in the following cases:

• The ineffectiveness of the conducted conservative therapy.
• Lack of response to treatment with Avamis in pregnant women.
• Extensive polyps of the nasal cavity.

Surgery The most advanced treatment for rhinitis medication today is to carry out:

• Conchotomy (partial or complete removal of the nasal mucosa in the lower or middle region).
• vessels of the nasal mucosa.
• Turbinoplasty and septoplasty.

After surgical treatment, the use of those nasal drops that provoked the development of a cold is strictly contraindicated.

1. At easy the degree of rhinitis for treatment, it is enough to abandon the use of drops. Thus, the treatment for rhinitis drug depends on the severity.
2. At average severity, the treatment of drug rhinitis is based on the additional use of additional drug therapy.
3. At heavy the severity of the indicated surgical treatment of drug rhinitis.

To get rid of medication rhinitis, it is recommended to prescribe such physiotherapy procedures:

• Ultraviolet irradiation;
• Inhalation of medicinal herbs;
• Electrophoresis;

Also, in order to improve the results of treatment, it is recommended to do daily wet cleaning, walk in the fresh air and during the treatment and prevention of respiratory diseases.

Vasomotor rhinitis medicamentosa is a disease caused by chemical damage to the nasal mucosa with prolonged use of vasoconstrictor drops (decongensants).

Treatment seems to be an extremely difficult task, one small mistake triggers the disease mechanism: the patient continues to use vasoconstrictor drops after the end of the course of treatment.

The cause of the disease is the long-term uncontrolled use of vasoconstrictors. For the appearance of signs of damage to the nasal mucosa, it is enough to use drops for more than 2 weeks.

During this time, the vessels of the shells lose their ability to narrow on their own. They expand, overflow with blood, the mucous membrane of the shells swells, which leads to an increase in the shells, overlapping of the nasal passages.

Only a new portion of vasoconstrictor drops can make the capillaries narrow.

A stuffy nose makes you wake up at night, disrupts sleep.

Changes are also observed in the mucous membrane of the nasal concha:

• squamous cell metaplasia is noted- replacement of the cylindrical ciliated epithelium of the mucous membrane with stratified squamous epithelium;
• the work of the mucous glands is disrupted, the amount of mucus produced increases;
• increased capillary permeability, which causes chronic swelling of the nasal mucosa.

Cause addiction and provoke rhinitis medicamentous drugs containing in the composition:

• naphazoline- Naphtizin, Sanorin;
• oxymetazoline- Nazivin, Nazol;
• phenylephrine- Metazone, Vibrocil, Nazol Kids, Nazol Baby;
• xylometazoline- Dlyanos, Otrivin, Xilin, Galazolin, Rinorm, Rinomaris.

The effect of the use of these drugs is achieved almost instantly, but the duration of action is insignificant, and after the cessation of the action of the drug, the patient's nose clogs up more than before using the drops.

Symptoms

In addition to nasal congestion, difficulty in nasal breathing, symptoms of naphthyzine dependence are:

• headache;
• violation of the sense of smell;
• sleep disturbance;
• irritability;
• increased blood pressure;
• increased heart rate;
• the appearance of a symptom complex of vegetative-vascular dystonia;
• discomfort in the region of the heart - tightness, burning, tachycardia.

Nasal discharge with medication rhinitis is often insignificant, in some cases they may even be absent.

The mucous membrane swells, completely blocking the nasal passages, making it impossible to breathe through the nose, the symptoms of drug-induced rhinitis are aggravated in the evening, when a person's activity decreases, blood flow decreases, vascular tone decreases.

These phenomena lead to stagnation of fluid, swelling of the mucous membrane of the nasal concha. Sitting on the couch in the evening, taking a lying position or half-sitting in an armchair, a person is forced to put a bottle with vasoconstrictor drops next to him.

Nasal drops containing decongestants are addictive with frequent use - the blood vessels of the nasal conchas lose their ability to narrow on their own. Most often observed - dependence on naphthyzine.

Naphthyzine dependence can last for years, there are cases of 20 years of systematic use of decongensants, the intervals between instillation are reduced over time. There are cases when a day such a patient is forced to use a full bottle of medicine in order to clear the nasal passages and be able to breathe through the nose.

Diagnostics

In addition to collecting anamnesis, a general examination, the patient is prescribed a blood test, additional studies are carried out:

• X-ray of the sinuses of the nose;
• endoscopy of the nasopharynx, nasal cavity;
• analysis of nasal secretions.

Treatment

The main task of the treatment of drug-induced rhinitis consists in the abolition of the vasoconstrictor drug, the restoration of the functions of the mucous membrane of the shells. The best treatment is to completely stop using vasoconstrictor drugs.

If this cannot be done, drug treatment is prescribed:

• corticosteroid drugs- Fluticasone, Nazonex, Fliksonase, Avamis. During pregnancy, lactation, these drugs are not prescribed;
• antihistamines- Zertek, Telfast, Claritin, Teridin;
• rinsing the nose with antiseptic agents- furacilin solution, saline;
• rinsing the nose drugs Dolphin, Sterimar, Aqualor.

Dexpanthenol and Derinat have proven efficacy in the treatment of drug-induced rhinitis.

The drug Ipratropium bromide relieves the signs of rhinitis, it reduces the production of secretion by the submucous glands, is almost not absorbed, does not affect the body as a whole.

When the drug is discontinued, the symptoms of rhinitis do not recur.

According to the reviews of patients with naphthyzine dependence, the transition to Sinupret, Tafen helps, the use of corticosteroid drops gives a good result. They do not act as quickly as vasoconstrictor drugs, but they allow you to quickly get rid of addiction and restore the functions of independent regulation of blood vessels.

A complete rejection of deconghexants is an important condition for cure. The ineffectiveness of drug therapy makes it necessary to resort to surgery.

Surgery

The operation removes the symptoms of the disease, but cannot cure the cause of the medication rhinitis. If, after the operation, you again resort to instillation with vasoconstrictor drops, the disease will return.

As an operative measure, use:

• submucosal vasotomy;
• radiofrequency disintegration of shells;
• laser destruction.

Physiotherapy

Physiotherapeutic procedures are effective adjuncts in the treatment of medication rhinitis:

• ultraviolet irradiation;
• electrophoresis;
• phonophoresis;
• washing the sinuses of the nose;
• inhalation.

How to stop using vasoconstrictor drops

According to people who have managed to cope with addiction to vasoconstrictor drops, it is enough to endure 2-3 days without using decongestants to get rid of this disease by 100%.

It is easier to get rid of medication rhinitis with a few tricks:

• massaging the outer shells, this makes it easier to breathe through the nose;
• make a hot foot bath with mustard powder, while the blood flows to the feet, the blood supply to the vessels of the nasal conchas decreases, and breathing improves;
• perform breathing exercises - a deep breath through the nose and a sharp exhalation through the mouth.

Folk ways to combat medication rhinitis

Traditional methods of treatment, like the methods of traditional medicine, are aimed at restoring the functions of nasal breathing, refusing to use vasoconstrictor drops.

To outwit the body, patients use a variety of methods:

• At night, drink a diuretic and put it in the nose with a mummy.
• The use of an aroma lamp with 5 drops of eucalyptus, sage or marjoram at night helps.
• Bury a decoction of oak bark in the nose.
• Rinse the nose with a solution of sea salt, water infusion of calendula, chamomile, sage.
• Turn on a humidifier at night.
• Rinse your nose daily with Aqualor.
• Bury Aquamaris.
• Rinse the nose with a warm aqueous solution of table salt, taken in the amount of one teaspoon per glass of water.
• Bury a mixture of aloe juice and sea buckthorn oil in your nose.

Complication

Prolonged use of vasoconstrictor drops causes a persistent increase in blood pressure, increases the risk of infection of the frontal, nasal sinuses, occurrence,. Even more dangerous consequences of chronic disturbance of nasal breathing are heart disease, endocrine diseases.

With long-term treatment with drugs containing corticosteroids, there is a dysfunction of the adrenal glands, hypothalamus, pituitary gland.

Topical use of hormones in the treatment of rhinitis medication can cause dryness of the mucous membrane, nosebleeds, burns or swelling of the mucous membrane of the nasal concha.

Prophylaxis

• Use decongestants for vasoconstrictor no longer than 3-5 days;
• Water aerobics classes, swimming in the pool, hardening of the body, walks in nature, spa treatment are recommended.

Forecast

The disease is cured, the sense of smell, nasal breathing are fully restored.

Video about vasomotor rhinitis

After hypothermia of the body, a runny nose very often develops. Most people do not consider this ailment a serious problem and try to deal with it without the help of doctors. It often happens that self-treatment consists in the use of vasoconstrictor drops, which significantly alleviate the condition. But, over time, the situation is somewhat aggravated, and the treatment of medication rhinitis should already be started.

With prolonged and uncontrolled use of drops with vasoconstrictor properties, an effect such as tachyphylaxis develops first. What the people mistakenly call addiction. Against the background of the fact that the dose of the drug must be constantly increased, the mucous membrane is injured and inflamed, a runny nose develops, which is the main symptom of medication rhinitis.

The cause of this pathology is the side effects of these very vasoconstrictor drops, because the blood vessels are not able to narrow at their own will. When the drops are stopped, the vessels are overfilled with blood, which leads to swelling and atrophy of the mucous membrane and difficulty breathing. Also, the secretion of mucus in the nose is disturbed.

The development of drug rhinitis may occur as early as the third week of uncontrolled intake of vasoconstrictor drops. It often happens that a person simply does not notice the onset of the disease, while eliminating nasal congestion by burying the nose, which is already quite familiar to him, gradually increasing the dose. Few people think they should visit an ENT.

The most common substances that can cause rhinitis medication in a child or adult are:

• Ximetazoline;
• Oxymetazoline;
• Phenylephrine;
• Naphazoline and others.

These substances are very effective, but the duration of the effect is very short, which forces the patient to use them again.

Clinical picture

This disease is a chronic vasomotor process, therefore rhinitis medicamentous and its symptoms bother the patient for a long period of time. The most common ones are:

• Swelling of the nasal mucosa, as a result of which nasal breathing becomes difficult;
• Painful and persistent nasal discharge of a mucous nature;
• Decreased sense of smell;
• Pressing headaches of a diffuse nature;
• Arterial hypertension and tachycardia;
• Sleep disturbances, increased irritability and irritability;
• Unpleasant sensations in the region of the heart;
• Dependence on the intake of vasoconstrictor drops.

The defining symptom in the diagnosis of medicinal rhinitis is the latter, when the patient subconsciously uses a vasoconstrictor. He also determines that medication rhinitis and its treatment are protracted. Therapy for this pathology can take a long time - up to several months with the correct prescription of drugs.

Rhinitis medication during pregnancy is also a rather unpleasant problem, due to the fact that the clinical picture provokes hypoxia of the female body and the fetus. This can have a very negative effect on the health of the baby, and lead to extremely undesirable consequences.

Treatment

Most often, medicinal rhinitis is treated with various medicines in the form of nasal sprays. How to treat rhinitis medication should be determined exclusively by a specialist based on the stage of the disease and the individual characteristics of the organism.

Medication treatment for this disease involves taking several groups of drugs:

• Local glucocorticosteroid agents;
• Antihistamines;

Local glucocorticosteroids

These drugs contain hormones derived from the adrenal cortex. The most famous among them are Nazonex, Fliksonase,. Taking these medicines consists in injecting the drug twice into each nostril for at least one month. Dexamethasone and diprospan are used a little differently: dexamethasone cannot be used for more than one week, twice a day, and diprospan is used once a day for no more than 10 days.

Antihistamines

Antihistamines block receptors in the body that are sensitive to the inflammatory mediator, histamine. Due to this, the swelling of the nasal mucosa is reduced. Their dosage regimen is very simple - one tablet of the drug once a day. The most famous drugs in this group are: Aleron, Erius, Eden, Cetirizin and others.

Rinsing the nose

In addition to the standard methods of treating rhinitis medication, nasal lavage is very often prescribed. For this purpose, solutions of the following drugs are used: Aquamaris, Aqualor, Delufen, Protargol and others.

It is also possible to put ointments in the nasal passages. Most often, erythromycin and hydrocortisone ointments are used.

Folk methods

How to get rid of medication rhinitis can be suggested by various folk recipes and remedies that do not require the use of medications and have rather sparing properties.

Treatment with folk remedies also involves rinsing and lubricating the nasal mucosa. For this purpose, Dr. Komarovsky recommends sea salt and chamomile infusion, as well as olive oil or tea tree oil.

It is also possible to put turundas in the nasal passages, which were previously treated with boromenthol ointment, or a solution of honey and lemon juice.

Traditional medicine helps to cure vasomotor rhinitis by instilling aloe juice into the nasal passages with the addition of chloramphenicol with diphenhydramine. Olive and camphor oils, propolis and other medicinal infusions can be used for the same purpose.

Physiotherapy

Physiotherapy methods can also help cure rhinitis medicamentosa. The most commonly used:

• Electrophoresis;
• Acupuncture;
• Phonophoresis.

Dealing with addiction

It is very important to stop using vasoconstrictor drugs in time. In order to get rid of addiction, it is necessary to gradually reduce their dose, while starting to take more gentle drugs, such as Vibrocil. You can use the placebo effect, to which children respond very well - instead of the usual drops, use saline solutions, and also replace adult dosages with children.

Operative treatment

If the effect of conservative therapy does not occur, then the patient undergoes surgery. The most commonly used methods are:

• Laser moxibustion;
• Destruction of the nasal mucosa - vasotomy;
• Conichotomy - an operation in which the mucous membrane is removed;
• Reconstruction of the nasal septum - septoplasty.

Preventive measures

Since rhinitis medication and its treatment is a rather long and difficult process, it is easier to prevent the disease than to treat it. With proper prevention, there will be no questions: "how to cure this disease?"

To prevent pathology, one should deal with the general improvement of the body and the strengthening of its defenses. For this, the following measures are suitable:

• Daily walks;
• Visit to the bathhouse and swimming pool;
• Aroma and speleotherapy;
• Reception of enterosorbents at the slightest sign of a cold.

The most effective preventive measure will be the intake of vasoconstrictor drops strictly according to the doctor's prescription. It should be borne in mind that the maximum admission period is one week. Usually this time is enough for the symptoms of a cold to go away. If the patient's condition continues to be unhealthy, you should consult an ENT.