Decongestants – Visine for Your Nose?

A few weeks ago I traveled to Beijing for a golf tournament.  Unfortunately, I have terrible allergies to pollen and other air pollutants, so as soon as the plane landed in Peking and I stepped into the airport I immediately began my sneezing fit.  Ordinarily, after sneezing, your nose will feel congested for a few moments and then will return to “normal.”  However, because the air was so thick with pollutants, my nose remained congested and I continued to sneeze on approximately five-minute intervals.  Frustrated that I couldn’t breath well through my nose and because my mouth was becoming dry, I hesitantly decided to take a decongestant pill.  This has been a regular occurrence since I was a child: allergies act up, nose becomes congested, pop a pill, few minutes later I can breath again.  For the longest of time, I never questioned this process.   Then, a few months ago, I found that I was always congested, even on the days when pollution levels were low and there were little to no blooming flowers.  I couldn’t breath normally without taking a decongestant and ended up it everyday for approximately two and a half weeks.  As I look back, it was quite foolish of me to do so.  I didn’t know anything about the drug other than it helped me breath, and I didn’t think much of the fact that I couldn’t breath normally.  So as I arrived in Beijing two weeks ago, I wondered, what does this pill really do to me, how does it work, and did I harm myself beyond repair?

Typically, when people think of nasal congestion, they think it is a result of copious amounts of mucus or fluid forming in their nose.  However, this is not the case.  Nasal congestion occurs when the arterioles (small blood vessels) in the membranes of the nose dilate and become inflamed.  This results in a kind of swelling in the nose and makes it difficult to breath because the passage has narrowed or closed off.  (Kaneshiro, N. n.d.)

When individuals take nasal decongestants, such as pseudoephedrine hydrochloride (C10H16ClNO) (Pseudoephedrine Hydrochloride. n.d.)

Chemical Structure of Pseudoephedrine
Chemical Structure of Pseudoephedrine HCl

the chemical will bind to alpha receptors (receptors on the membranes of nerve cells) to send a signal to the membranes in the nasal passages to force the blood vessels to constrict.  (Guzman, F. n.d.)

This inhibits the dilation of the arterioles and reduces the inflammation, therefore relieving congestion and allowing the nasal passages to relax.  Based on principle, nasal decongestants are similar to red eye reducing eye drops in that the topical eye drops constrict the blood vessels in the eye to reduce redness.

While an addiction in the traditional sense cannot be developed from long-term use of decongestants, a kind of dependency and tolerance can build up over time from using them daily.  With daily use, the body will become tolerant to the decongestant and will begin to produce chemicals and antibodies to combat the effects of the drug.  In this case, it will begin to produce vasodilators in order to reverse the effects of the decongestant (which are now perceived by the body as unnecessary).  As a result, higher doses of the drug are needed to achieve the same decongestant effects as originally produced.  (Discovery Health “Can nasal sprays be addictive?”. n.d.)  With continued use for many months, or years, continuously using a decongestant can increase blood pressure as it constricts the blood vessels, or can create other, more severe side effects such as tachycardia and seizures.  (Pray, S., & Pray, J., n.d.)

Vasodilation in Arteries
Vasodilation in Arteries

Fortunately, the tolerance that may develop from continued use of decongestants can be reversed.  If use is discontinued for a few weeks, it gives the body the time it needs to return to “normal” and the changes it made to produce the antagonistic chemicals (to the effects of the drug) will disappear.  This implies that even if a tolerance and “dependency” is developed, they can easily be annulled and the body will lose its tolerance.  After the body has returned to a normal state, should the need arise, individuals may choose to take the decongestant and can expect to experience the full effects of the decongestant – open nasal passages and the ability to breath easy.  (Discovery Health “Can nasal sprays be addictive?”., n.d.)

After researching, I realized the severity of taking decongestants for extended periods of time.  Prior to researching, I had assumed that decongestants were not, “serious” drugs in that they couldn’t possibly have many negative long-term effects.  However, I now realize that drugs, regardless of their purpose and accessibility, are strong chemicals used to create chemical changes in our bodies.  While I will never take a decongestant for more than seven consecutive days, the occasional use of it is acceptable and in the long run, it will not harm my body and has not done any lasting damage to my body.

References

Discovery Health “Can nasal sprays be addictive?”. (n.d.). Discovery Health “Discovery Fit & Health”. Retrieved October 12, 2013, from http://health.howstuffworks.com/mental-health/question546.htm

Guzman, F. (n.d.). Alpha receptors | CME at Pharmacology Corner. Medical Pharmacology | Pharmacology Corner. Retrieved October 21, 2013, from http://pharmacologycorner.com/alpha-receptors-1-2/

Kaneshiro, N. (n.d.). Nasal congestion: MedlinePlus Medical Encyclopedia. National Library of Medicine – National Institutes of Health. Retrieved October 10, 2013, from http://www.nlm.nih.gov/medlineplus/ency/article/003049.htm

MedicineNet.com. (n.d.). Pseudoephedrine – Oral, Afrinol, Novafed, Sudafed . Retrieved October 10, 2012, from www.medicinenet.com/pseudoephedrine-oral/page5.htm

Pray, S., & Pray, J. (n.d.). Safe Use of Nasal Decongestants. Medscape Multispecialty . Retrieved October 13, 2012, from www.medscape.com/viewarticle/484014

Pseudoephedrine (Oral Route) – MayoClinic.com. (n.d.). Mayo Clinic. Retrieved October 13, 2013, from http://www.mayoclinic.com/health/drug-information/DR601759

Pseudoephedrine Hydrochloride. (n.d.). ChemicalBook—Chemical Search Engine. Retrieved October 11, 2013, from http://www.chemicalbook.com/ProductChemicalPropertiesCB1399716_EN.htm

Pseudoephedrine Information from Drugs.com. (n.d.). Drugs.com | Prescription Drug Information, Interactions & Side Effects. Retrieved October 12, 2013, from http://www.drugs.com/pseudoephedrine.html

Sudafed decongestant tablets and liquid (pseudoephedrine). (n.d.). NetDoctor.co.uk – The UK’s leading independent health website. Retrieved October 13, 2013, from http://www.netdoctor.co.uk/ear-nose-and-throat/medicines/sudafed-decongestant-tablets-and-liquid.html

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