Be wary of drops/nasal sprays containing corticosteroids (corticosteroids/steroids)

This is an automatically translated article.

The article was professionally consulted by Pharmacist Ngo Thi Thu Thuy - Dean and Pharmacist Nguyen Hoang Phuong Khanh - Faculty of Pharmacy - Vinmec Central Park International General Hospital.
Nasal drops/spray containing corticosteroids or, more precisely, glucocorticoids are commonly used in the treatment of allergic rhinitis. However, it is also necessary to be wary of corticosteroid drops / nasal sprays, especially nasal drops like Nemydexan, because if overused, the drug can cause some unwanted side effects, especially In young children, it can cause acute adrenal insufficiency.

1. What are corticosteroid drops/spray?

The main known use of glucocorticoid drops/nasal sprays is to greatly reduce inflammation of the nasal mucosa and improve mucosal pathology through an anti-inflammatory mechanism, so it is recommended as the first choice in Treatment of allergic rhinitis in both adults and children (depending on the drug, usually over 2 years of age).
There are 2 groups (2 generations) of glucocorticoids commonly used in nasal spray form, these substances are equally effective, but the 2nd generation glucocorticoids are less absorbed into the body, so systemic side effects are lower, bioavailability is lower. The uses of these agents are as follows:
1st Generation: Beclomethasone, flunisolide, triamcinolone, and budesonide (10 -50%) 2nd Generation: Fluticasone propionate (<2%), fluticasone furoate (<1%) and mometasone furoate (<2%) <0.1%). SEE ALSO: Using nasal drops can be addictive?

2. Beware of drops/nasal sprays containing glucocorticoids

Nasal drops/spray with glucocorticoid mainly have a local effect. However, if used incorrectly, for example, long-term use, high dose and no dose reduction before stopping will cause the following side effects:
Local side effects: irritation of the nasal mucosa, Nosebleeds or blood stains in the secretions of the nose, drying and atrophy of the nasal mucosa, ulceration of the nasal septum. Systemic side effects: Although many long-term studies of adverse growth effects in children are unknown, it is necessary to monitor the effects on growth in children when these drugs are used. Similarly, studies in osteoporosis, glaucoma, or ocular cataracts have also shown a possible (albeit low) risk with long-term use of glucocorticoids nasal sprays/drops. SEE ALSO: Nasal drop poisoning in children: Things to know

3. How to use corticosteroid nasal drops correctly?

In order to avoid the abuse of corticosteroid drops / nasal sprays causing bad side effects, especially for children, it is necessary to note the instructions of the doctor / pharmacist as follows to use the medicine correctly:
Do not arbitrarily buy and use nose drops / sprays without a doctor's prescription (for prescription drugs) or advice from a pharmacist (for over-the-counter drugs). In children, prolonged use of nasal sprays/drops can cause growth retardation, so if you must use nasal sprays/drops for your child for about 2 months out of a year, talk to your doctor. for children. It is important to identify and differentiate what causes nasal congestion, allergic rhinitis, and eliminate/avoid exposure if possible, e.g. pollen, pet dander, etc. If the cause is clear, first think about using physiological saline 0.9% NaCl or sea water solution in the form of a mist spray to wash your nose daily. When using, it is necessary to follow the dose and duration of use prescribed by the doctor or pharmacist. Generally, for patients with moderate to severe persistent symptoms, second-generation glucocorticoid nasal sprays are the best choice, starting with the highest recommended dose for age and reducing gradually to the lowest effective dose after control of symptoms. Your doctor will consider adding additional medications if your symptoms do not improve. Compared to other dosage forms of glucocorticoids (oral, injectable, inhaled), the nasal spray form is less absorbed into the bloodstream, so there are fewer side effects, however, you need to inform your doctor and should use the lowest dose possible effective and should also periodically check the nose when you use it for a long time.

Nasal drops / sprays with glucocorticoids are widely used in the treatment of allergic rhinitis. The drug is warned when used by overdose and long-term drug abuse can cause unwanted harm, especially for children.
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In case it is necessary to use nasal drops and nasal sprays to treat respiratory diseases, doctors at Vinmec will provide a treatment plan, and advise and guide patients to use drugs effectively. Avoid abuse, indiscriminate use of drugs that cause unwanted side effects to patients.

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