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Назальные деконгестанты: возможно ли повысить их безопасность?
Поляков Д.П. Назальные деконгестанты: возможно ли повысить их безопасность? Consilium Medicum. Болезни органов дыхания (Прил.). 2016; с. 5–10.
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Polyakov D.P. Nasal decongestants: is it possible to increase their safety? Consilium Medicum. Respiratory Organs Diseases (Suppl.). 2016; с. 5–10.
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Аннотация
Назальные деконгестанты – средства с высокой эффективностью в отношении отека слизистой оболочки полости носа любой этиологии. Однако их применение сопряжено с рядом побочных эффектов и нежелательных явлений (цито- и цилиотоксическое действие, системные симпатомиметические эффекты, эффект «рикошета», психологическая зависимость). С целью повышения профиля безопасности препаратов данной фармакологической группы обосновано применение комбинированных средств, включающих a2-адреномиметики и декспантенол. Приведен анализ экспериментальных и клинических исследований данной комбинации лекарственных веществ.
Ключевые слова: назальные деконгестанты, сосудосуживающие препараты, декспантенол, ксилометазолин.
Ключевые слова: назальные деконгестанты, сосудосуживающие препараты, декспантенол, ксилометазолин.
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Nasal decongestants are means with high efficacy against edema of nasal mucosa of any etiology. However, their use is associated with a number of side effects and adverse events (cyto- and cyliotoxic action, systemic sympathomimetic effects, effect of "rebound" psychological dependence). In order to improve the safety profile of drugs in this pharmacological group it is quite justified to use the combined resources, including a2-adrenoceptor agonists and dexpanthenol. The analysis of experimental and clinical studies of this combination of drugs is presented below.
Key words: nasal decongestants, vasoconstrictor drugs, dexpanthenol, xylometazoline.
Полный текст
Список литературы
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23. Klocker N, Verse T, Rudolph P. The protective effect of dexpanthenol in nasal sprays and ciliary-toxic studies in vitro. Laryngorhinootologie 2003; 82 (3): 177–82.
24. Klocker N, Rudolph P, Verse T. Evaluation of protective and therapeutic effect of dexpanthenol on nasal decongestants and preservatives: results of cytotoxic studies in vitro. Am J Rhinol 2004; 18 (5): 315–20.
25. Kehrl W, Sonnemann U, Dethlefsen U. Advance in therapy of acute rhinitis – comparison of efficacy and safety of xylometazoline in combination xylometazoline-dexpanthenol in patients with acute rhinitis. Laryngorhinootologie 2003; 82 (4): 266–71.
26. Jagade Mahan V, Langade Deepak G, Pophale Rupesh R, Prabhu Arun. Oxymetazolyn and dexpanthenol in nasal congestion. Indian J Otolaryngol Head Neck Surg 2008; 60: 393–7.
27. Kehrl W, Sonnemann U. Dexpanthenol nasal spray as an effective therapeutic principle for treatment of rhinitis sicca anterior. Laryngorhinootologie 1998; 77 (9): 506–12.
28. Kehrl W, Sonnemann U. Improving wound healing after nose surgery by combined flvinistration of xylometazoline and dexpanthenol. Laryngorhinootologie 2000; 79 (3): 151–4.
29. Gouteva I, Shah-Hosseini K, Meiser P. Clinical efficacy of a spray containing hyaluronic Acid and dexpanthenol after surgery in the nasal cavity (septoplasty, simple ethmoid sinus surgery, and turbinate surgery). J Allergy Volume 2014, Article ID 635490, 10 pages http://dx.doi.org/10.1155/2014/635490
30. Данные компании КРКА. / Dannye kompanii KRKA. [in Russian]
2. Bénard-Laribière A, Jové J, Lassalle R et al. Drug use in French children: a population-based study. Arch Dis Child 2015 May 14. pii: archdischild-2014-307224
3. Лопатин А.С. Назальные деконгестанты: старые препараты и новые формы. Доктор.ру. 2011; 6 (65): 17–23. / Lopatin A.S. Nazal'nye dekongestanty: starye preparaty i novye formy. Doktor.ru. 2011; 6 (65): 17–23. [in Russian]
4. Stewart M, Ferguson BJ, Fromer L. Epidemiology and burden of nasal congestion. Int J Gen Med 2010; 3: 37–45.
5. Naclerio RM, Bachert C, Baraniuk JN. Pathophysiology of nasal congestion. Int J Gen Med 2010; 3: 47–57
6. http://glav-otolar/documents
7. Лопатин А.С. Ринит. М.: Литерра, 2010. / Lopatin A.S. Rinit. M.: Literra, 2010. [in Russian]
8. Shaikh N, Wald ER. Decongestants, antihistamines and nasal irrigation for acute sinusitis in children. Cochrane Database Syst Rev 2014; 10: CD007909
9. Coleman C, Moore M. Decongestants and antihistamines for acute otitis media in children. Cochrane Database Syst Rev 2008; 3: CD001727
10. Griffin G, Flynn CA. Antihistamines and/or decongestants for otitis media with effusion (OME) in children. Cochrane Database Syst Rev 2011; 9: CD003423
11. Hofmann T, Wolf G, Koidl B. In vitro studies of the effect of vasoconstrictor nose drops on ciliary epithelium of human nasal mucosa. Laryngorhinootologie 1995; 74 (9): 564–7.
12. Mickenhagen A, Siefer O, Neugebauer P, Stennert E. The influence of different alpha-sympathomimetic drugs and benzalkoniumchlorid on the ciliary beat frequency of in vitro cultured human nasal mucosa cells. Laryngorhinootologie 2008; 87 (1): 30–8.
13. Graf P, Hallen H. Effect on the nasal mucosaof long-term treatment with oxymetasoline, bensalconium chloride, and placebo nasal sprays. Laryngoscope 1996; 106 (5; Pt. 1): 605–9.
14. Knipping S, Holzhausen HJ, Riederer A, Bloching M. Ultrastructural changes in human nasal mucosa in rhinitis medicamentosa. HNO 2006; 54 (10): 742–8.
15. Кунельская Н.Л., Царапкин Г.Ю., Артемьев М.Е. и др. Консервативное лечение химического повреждения. Мед. совет. 2013; 3: 63–4. / Kunel'skaia N.L., Tsarapkin G.Iu., Artem'ev M.E. i dr. Konservativnoe lechenie khimicheskogo povrezhdeniia. Med. sovet. 2013; 3: 63–4. [in Russian]
16. Proctor DW, Adams GK. Physiology and pharmacology of nasal function and mucous secretion. Pharmacol Ther Bull 1976; 2: 493–509.
17. Montalban J, Ibanez L, Rodriguez C et al. Cerebral infarction after excessive use of nasal decongestants. J Neurol Neurosurg Psychiatry 1989; 52: 541–43.
18. Wenzel S, Sagowski C, Laux G et al. Course and therapy of intoxication with imidazoline derivate naphazoline. Int J Pediatr Otorhinolaryngol 2004; 68 (7): 979–83.
19. Калашникова О.В., Челпаченко О.Е. Клинико-лабораторная характеристика отравлений топическими деконгестантами у детей. Вестник ОГУ. 2013; 9 (158): 96–9. / Kalashnikova O.V., Chelpachenko O.E. Kliniko-laboratornaia kharakteristika otravlenii topicheskimi dekongestantami u detei. Vestnik OGU. 2013; 9 (158): 96–9. [in Russian]
20. Hosemann W, Göde U, Länger F, Wigand ME. Experimental studies of wound healing in the paranasal sinuses. II. Spontaneous wound healing and drug effects in a standardized wound model. HNO 1991; 39 (2): 48–54.
21. Hosemann W, Wigand ME, Göde U et al. Normal wound healing of the paranasal sinuses: clinical and experimental investigations. Eur Arch Otorhinolaryngol 1991; 248 (7): 390–4.
22. Verse T, Klöcker N, Riedel F et al. Dexpanthenol nasal spray in comparison to dexpanthenol nasal ointment. A prospective, randomised, open, cross-over study to compare nasal mucociliary clearance. HNO 2004; 52 (7): 611–5.
23. Klocker N, Verse T, Rudolph P. The protective effect of dexpanthenol in nasal sprays and ciliary-toxic studies in vitro. Laryngorhinootologie 2003; 82 (3): 177–82.
24. Klocker N, Rudolph P, Verse T. Evaluation of protective and therapeutic effect of dexpanthenol on nasal decongestants and preservatives: results of cytotoxic studies in vitro. Am J Rhinol 2004; 18 (5): 315–20.
25. Kehrl W, Sonnemann U, Dethlefsen U. Advance in therapy of acute rhinitis – comparison of efficacy and safety of xylometazoline in combination xylometazoline-dexpanthenol in patients with acute rhinitis. Laryngorhinootologie 2003; 82 (4): 266–71.
26. Jagade Mahan V, Langade Deepak G, Pophale Rupesh R, Prabhu Arun. Oxymetazolyn and dexpanthenol in nasal congestion. Indian J Otolaryngol Head Neck Surg 2008; 60: 393–7.
27. Kehrl W, Sonnemann U. Dexpanthenol nasal spray as an effective therapeutic principle for treatment of rhinitis sicca anterior. Laryngorhinootologie 1998; 77 (9): 506–12.
28. Kehrl W, Sonnemann U. Improving wound healing after nose surgery by combined flvinistration of xylometazoline and dexpanthenol. Laryngorhinootologie 2000; 79 (3): 151–4.
29. Gouteva I, Shah-Hosseini K, Meiser P. Clinical efficacy of a spray containing hyaluronic Acid and dexpanthenol after surgery in the nasal cavity (septoplasty, simple ethmoid sinus surgery, and turbinate surgery). J Allergy Volume 2014, Article ID 635490, 10 pages http://dx.doi.org/10.1155/2014/635490
30. Данные компании КРКА. / Dannye kompanii KRKA. [in Russian]
________________________________________________
1. http://www.imshealth.com
2. Bénard-Laribière A, Jové J, Lassalle R et al. Drug use in French children: a population-based study. Arch Dis Child 2015 May 14. pii: archdischild-2014-307224
3. Lopatin A.S. Nazal'nye dekongestanty: starye preparaty i novye formy. Doktor.ru. 2011; 6 (65): 17–23. [in Russian]
4. Stewart M, Ferguson BJ, Fromer L. Epidemiology and burden of nasal congestion. Int J Gen Med 2010; 3: 37–45.
5. Naclerio RM, Bachert C, Baraniuk JN. Pathophysiology of nasal congestion. Int J Gen Med 2010; 3: 47–57
6. http://glav-otolar/documents
7. Lopatin A.S. Rinit. M.: Literra, 2010. [in Russian]
8. Shaikh N, Wald ER. Decongestants, antihistamines and nasal irrigation for acute sinusitis in children. Cochrane Database Syst Rev 2014; 10: CD007909
9. Coleman C, Moore M. Decongestants and antihistamines for acute otitis media in children. Cochrane Database Syst Rev 2008; 3: CD001727
10. Griffin G, Flynn CA. Antihistamines and/or decongestants for otitis media with effusion (OME) in children. Cochrane Database Syst Rev 2011; 9: CD003423
11. Hofmann T, Wolf G, Koidl B. In vitro studies of the effect of vasoconstrictor nose drops on ciliary epithelium of human nasal mucosa. Laryngorhinootologie 1995; 74 (9): 564–7.
12. Mickenhagen A, Siefer O, Neugebauer P, Stennert E. The influence of different alpha-sympathomimetic drugs and benzalkoniumchlorid on the ciliary beat frequency of in vitro cultured human nasal mucosa cells. Laryngorhinootologie 2008; 87 (1): 30–8.
13. Graf P, Hallen H. Effect on the nasal mucosaof long-term treatment with oxymetasoline, bensalconium chloride, and placebo nasal sprays. Laryngoscope 1996; 106 (5; Pt. 1): 605–9.
14. Knipping S, Holzhausen HJ, Riederer A, Bloching M. Ultrastructural changes in human nasal mucosa in rhinitis medicamentosa. HNO 2006; 54 (10): 742–8.
15. Kunel'skaia N.L., Tsarapkin G.Iu., Artem'ev M.E. i dr. Konservativnoe lechenie khimicheskogo povrezhdeniia. Med. sovet. 2013; 3: 63–4. [in Russian]
16. Proctor DW, Adams GK. Physiology and pharmacology of nasal function and mucous secretion. Pharmacol Ther Bull 1976; 2: 493–509.
17. Montalban J, Ibanez L, Rodriguez C et al. Cerebral infarction after excessive use of nasal decongestants. J Neurol Neurosurg Psychiatry 1989; 52: 541–43.
18. Wenzel S, Sagowski C, Laux G et al. Course and therapy of intoxication with imidazoline derivate naphazoline. Int J Pediatr Otorhinolaryngol 2004; 68 (7): 979–83.
19. Kalashnikova O.V., Chelpachenko O.E. Kliniko-laboratornaia kharakteristika otravlenii topicheskimi dekongestantami u detei. Vestnik OGU. 2013; 9 (158): 96–9. [in Russian]
20. Hosemann W, Göde U, Länger F, Wigand ME. Experimental studies of wound healing in the paranasal sinuses. II. Spontaneous wound healing and drug effects in a standardized wound model. HNO 1991; 39 (2): 48–54.
21. Hosemann W, Wigand ME, Göde U et al. Normal wound healing of the paranasal sinuses: clinical and experimental investigations. Eur Arch Otorhinolaryngol 1991; 248 (7): 390–4.
22. Verse T, Klöcker N, Riedel F et al. Dexpanthenol nasal spray in comparison to dexpanthenol nasal ointment. A prospective, randomised, open, cross-over study to compare nasal mucociliary clearance. HNO 2004; 52 (7): 611–5.
23. Klocker N, Verse T, Rudolph P. The protective effect of dexpanthenol in nasal sprays and ciliary-toxic studies in vitro. Laryngorhinootologie 2003; 82 (3): 177–82.
24. Klocker N, Rudolph P, Verse T. Evaluation of protective and therapeutic effect of dexpanthenol on nasal decongestants and preservatives: results of cytotoxic studies in vitro. Am J Rhinol 2004; 18 (5): 315–20.
25. Kehrl W, Sonnemann U, Dethlefsen U. Advance in therapy of acute rhinitis – comparison of efficacy and safety of xylometazoline in combination xylometazoline-dexpanthenol in patients with acute rhinitis. Laryngorhinootologie 2003; 82 (4): 266–71.
26. Jagade Mahan V, Langade Deepak G, Pophale Rupesh R, Prabhu Arun. Oxymetazolyn and dexpanthenol in nasal congestion. Indian J Otolaryngol Head Neck Surg 2008; 60: 393–7.
27. Kehrl W, Sonnemann U. Dexpanthenol nasal spray as an effective therapeutic principle for treatment of rhinitis sicca anterior. Laryngorhinootologie 1998; 77 (9): 506–12.
28. Kehrl W, Sonnemann U. Improving wound healing after nose surgery by combined flvinistration of xylometazoline and dexpanthenol. Laryngorhinootologie 2000; 79 (3): 151–4.
29. Gouteva I, Shah-Hosseini K, Meiser P. Clinical efficacy of a spray containing hyaluronic Acid and dexpanthenol after surgery in the nasal cavity (septoplasty, simple ethmoid sinus surgery, and turbinate surgery). J Allergy Volume 2014, Article ID 635490, 10 pages http://dx.doi.org/10.1155/2014/635490
30. Dannye kompanii KRKA. [in Russian]
Авторы
Д.П.Поляков*
ФГБУ Научно-клинический центр оториноларингологии ФМБА России. 123182, Россия, Москва, Волоколамское ш., д. 30, корп. 2
*child.lor@yandex.ru
ФГБУ Научно-клинический центр оториноларингологии ФМБА России. 123182, Россия, Москва, Волоколамское ш., д. 30, корп. 2
*child.lor@yandex.ru
________________________________________________
D.P.Polyakov*
Research and Clinical Center of Otorhinolaryngology. 123182, Russian Federation, Moscow, Volokolamskoe sh., d. 30, korp. 2
*child.lor@yandex.ru
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