Drug-induced rhinitis (PLNN) is most often the result of overuse of nasal drops. So, if you've been trying to unblock your stuffy nose with these types of remedies for a long time and your runny nose persists or even gets worse, you're probably struggling with drug-induced rhinitis. What other drugs can cause rhinitis? What is the treatment of the disease?

Contents:

    1. Drug-induced rhinitis - causes
    2. Drug-induced rhinitis - symptoms
    3. Drug-induced rhinitis - diagnosis
    4. Drug-induced rhinitis - treatment
    5. Drug-induced rhinitis - prevention

Drug-induced rhinitis(PLNN) is a side effect of both topical (nasal) and oral use of certain medications. Drug-induced rhinitis leads to hypertrophic changes in the tissues of the turbinates, which are responsible for moisturizing, heating and cleaning the air flowing through the nose, as well as for drainage and ventilation of the paranasal sinuses. As a consequence, nasal patency is impaired, and in some cases also the development of sinus headache.

Drug-induced rhinitis - causes

Drug-induced rhinitis is most often the result ofabuse of nasal drops(taking them for too long - over 7-10 days), which contain substances such as: xylomentazoline, oxymetazoline, naphazoline , tetrisoline, thymazoline.

In drug-induced rhinitis, nasal drops that are supposed to fight rhinitis eventually become its cause. Nasal drops that are used for more than 7 days reduce the blood flow in the nasal mucosa. Consequently, it is not well supplied with nutrients. The mucosa begins to atrophy, becomes dry, swollen, and prone to infections.

These types of preparations constrict the nasal blood vessels dilated during a runny nose, thus reducing the swelling and congestion of the nasal mucosa. However, if they are taken for too long, the body "gets used" to these drops. As a result of the chronic use of decongestants, our nose becomes lazy and ceases to produce substances that restore it to its normal state. The result is a continuous runny nose despite the disappearance of other symptoms of a cold or allergy.

Drug-induced rhinitisit can also be caused by the use of nasal steroids used in the treatment of rhinitis, e.g. allergic rhinitis. Nasal steroids are a very effective group of drugs, but in some patients it can cause, for example, nasal dryness, irritation or slight bleeding.

Drug-induced rhinitis can also be a side effect of taking medications used to treat arterial hypertension (e.g. reserpine, hydralazine) and depression (e.g. amitriptyline, thioridazine). Some contraceptives and oral decongestants can also lead to the development of this condition.

Drug-induced rhinitis - symptoms

A characteristic symptom of the disease is a runny nose which, instead of disappearing, worsens, and the effectiveness of topical decongestants is negligible or none. In addition, there are:

  • nose swelling
  • irritation of the nasal mucosa
  • nasal dryness
  • olfactory disorder
  • feeling of stretching at the root of the nose
  • sleep disturbance (wheezing, snoring, apnea)
  • morning hoarseness
  • drying of the oral mucosa, pharynx, larynx
  • necessity to drink water frequently (also at night)
  • sometimes there are scabs of dried secretion

Drug-induced rhinitis - diagnosis

In order to diagnose the disease, nose examination is performed. During the examination, redness and swelling of the nasal mucosa are visible, moreover, its surface is not smoothly smooth. Histological examination of a mucosa segment can also be performed. Then it is stated, inter alia, absence of cilia and an increase in the number of submucous glands. Withdrawal from sympathomimetics can be supported with oral medications having a similar effect.

Drug-induced rhinitis - treatment

In the first place, you should stop taking drugs that caused rhinitis. Only then will the treatment be effective. In general, however, this is not possible overnight. Therefore, specialists advise to gradually reduce the doses (or extend the intervals between applications) while replacing the drug with solutions that moisturize the nasal mucosa. They usually contain pseudoephedrine or phenylephrine, the effect of which is to constrict blood vessels, making breathing much easier. Although their mechanism of action is similar to that of sympathomimetics (they affect the same receptors in the nasal mucosa), the rebound effect of these agents is much smaller than that of topical drops. Unfortunately, the possibility of using these drugs is limited by contraindications towhich include high blood pressure, arrhythmias, glaucoma, thyroid disease, and prostatic enlargement.

In order to protect the nasal mucosa from irritation, light bleeding or dryness, it is worth using a cover. For this purpose, you can use over-the-counter protective sprays available at the pharmacy. Those containing pharmaceutically purified olive oil and vitamin E will soothe irritations, moisturize and support the regeneration of the nasal mucosa.

There are several treatments for drug-induced rhinitis. Hypertonic solutions are very effective in this respect. Due to the fact that their concentration is higher than the concentration of physiological fluids, they draw water from the blood vessels, and thus their constriction, reduction of congestion and nose swelling. Some doctors also recommend the use of nasal glucocorticosteroids, and if they don't help, nasal antihistamines.

If this type of treatment does not bring the expected results, it is recommended to perform the so-calledconchoplasty , i.e. correction of nasal turbinates. The aim of the procedure is to reduce the abnormally enlarged (hypertrophied) nasal congestion. The procedure is short (it takes about 15 minutes) and is performed under local anesthesia.

The nose is usually unobstructed shortly after the end of the procedure, but in some cases the process may be gradual. This means that the nose can be swollen and blocked for weeks or even months.

Drug-induced rhinitis - prevention

To prevent the development of drug-induced rhinitis, use the nasal drops briefly - only for about 5 days.

Important

Nasal drops should not be used for more than 7 days. At this time, it is worth moisturizing the nasal mucosa with sea s alt solutions or other moisturizing preparations (panthenol, hyaluronic acid, sesame oil).

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