Adverse Cardiac Effects Of Decongestants Agents

Year 2013, Volume: 10 Issue: 12, - , 21.03.2016

Zeynettin Kaya Abdullah Tuncez

https://izlik.org/JA85LA77XU

Abstract

Especially in spring and winter months many people use excessive dose topical or systemic decongestant agents to relief the allergic or infectious nasal congestive symptoms without physicians\' prescription. Although these agents bring some symptomatic benefits, sometimes serious adverse cardiac events reported at all drug users, especially who had known cardiac disease. These agents may cause slightly elevation of blood pressure in hypertensive patients, can trigger mortal arrhythmias like ventricular tachycardia, can also trigger myocardial infarction patients with known coronary artery disease or normal coronary artery and may cause decompensation of heart failure. In conclusion all these decongestant agents give only symptomatic relief and they don\'t treat flu and allergic disease. For this reason if the symptoms are mild or moderate not using these agents will be more wisely.

Keywords

Decongestants , pseudoephedrine , phenylephrine , cardiac , arrhythmias

Adverse Cardiac Effects Of Decongestants Agents

https://izlik.org/JA85LA77XU

Abstract

ellikle bahar ve kış aylarında insanların birçoğu allerjik ya da enfeksiyona bağlı nasal konjesyonu gidermek için gereğinden fazla ve sıklıkla reçetesiz topikal veya sistemik dekonjestanları kullanmaktadırlar. Bu ilaçların semptomatik faydalarına karşın özellikle bilinen kardiyak hastalığı olanlar başta olmak üzere tüm kullanan kişilerde ciddi istenmeyen kardiyak olaylara neden olabildiği bildirilmiştir. Hipertansif hastalarda az da olsa kan basıncını yükselttiği, bazıları ventriküler taşikardi gibi ölümcül olabilen pek çok aritmiyi tetiklediği, bilinen koroner arter hastalığı olan ya da normal koroner anatomiye sahip kişilerde miyokard enfarktüsünü tetikleyebildiği, kalp yetmezliği olan hastalarda dekompansasyona neden olabildiği rapor edilmiştir. Sonuç olarak tüm dekonjestan ajanların allerjiyi, soğuk algınlığını tedavi etmediği sadece semptomatik rahatlama sağladığı unutulmamalıdır. Bu nedenle semptomlar hafif veya orta derecede ise öncelikle ilaç dışı yöntemlerin denenmesi mevcut yan etkiler düşünüldüğünde daha akıllıcadır

Keywords

Dekonjestanlar , psödoefedrin , fenilefrin , kardiyak , aritmi

References

• American Academy of Allergy, Asthma and Immunology. The Allergy Report. Available at: http://www.thealler- gyreport.org/reportindex.html. Accessed April 2, 2002
• Dollery C, ed. Therapeutic Drugs, 2nd edn. Edinburgh: Churchill Livingstone 1999
• International Conference on Allergic Rhinitis in Childhood. Allergy 1999;54(suppl 55):7-34
• Pentel P. Toxicity of over-the-counter stimulants. JAMA. 1984; 252:1898-1903/ Lake CR, Gallant S, Masson E, Miller P. Adverse drug effects attrbuted to phenylpro- panolamine: a review of 142 case reports. Am J Med 1990;89:195-208
• Radack K, Deck CC. Are oral decongestants safe in hyper- tension? An evaluation of the evidence and framework for assessing clinical trials. Ann Allergy 1986;56:396-401
• Morgan JP, Funderburk FR. Phenylpropanolamine and blood pressure:a review of prospective studies. Am J Clin Nutr 1992:55(supp)206S-10S
• Stephan M.S, Jeffrey L.J, Elizabeth P.B. Effect of oral pseudoephedrine on blood pressure and heart rate. Arch Intern Med 2005;165:1686-94
• US Food and Drug Administration. Center for Drug Evaluation and Resarch: phenylpropanolamine (PPA)page. Availableat:http//www.fda.gov/cder/drug/infopage/ ppa/default.htm. Accessed Dcember15, 2003
• Heman SN, Mevorach D, Ghamen J. Hypertensive crisis from chronic intoxication with nasal decongestant and cough medications. DICP 1991;25:1068-70
• Alpert JS. Miyocardial infarction with angiographically normal cooronary arteries. Arc Intern Med 1994;154:265-7
• Williams MJA, Restieaux NJ, Low CSJ. Miyocardial infarci- ton in young people with normal coronary arteries. Heart 1998;79:191-4
• Brecker SJD, Stevenson RN, Roberts R, et al. Acute mi- yocardial infarction with normal coronary arteries. BMJ1993;307:1255-6
• Rico Cepeda P, Palencia Herrejon E, Rodriguez Aguirregabiria MM. Kounis syndrome. Med Intensiva 2012;36:358-64
• Yanagawa Y, Nishi K, Tomiharu N, Kawaguchi T. A case of Takotsubo cardiomyopathy associated with Kounis syn- drome. Int JCardiol 2009;132:e65-7)
• Grzegorz G, Gwidon P, Zofia G, Jacek K. Myocardial Infarction with normal coronary arteriogram: the rol of ephedrine-like alkaloids. Med Sci Monit 2004;10:15-21
• Wiener I, Tilkian AG, Palazzolo M. Coronary artery spasm and myocardial infarction in a patient with normal coro- nary arteries, temporal ralationsip to pseudoephedrine ingestion. Cathet Cardiovasc Diagn 1990;20:51-3
• Derezza H, Fine MD, Sadaniantz A. Acute myocardial in- farction after use of pseudoephedrinefor sinus conges- tion. J Am Board Fam Pract, 1997;10:436-8
• Kayrak M, Ulgen MS, Koc F, Soylu A. Acute myocardial in- 35
• Bilici M, Turkay S, Yılmaz AE, et al. Effect of pseudo- ephedrine on cardiac rhytm of children with rhinitis. Indian J Pediatr 2011;78:1361-4
• Bektas F, Eken C, Oktay C. Pseudoephedrine-induced par- oxysmal supraventricular tachycardia: a case report. J Emerg Med 2010;38:53-7
• Khan A, Dewhurst N. Use of sympathomimetic nasal spray in association with cardiac fibroma: an unusual cause of ventricular tachycardia. Br J Clin Pract 1997;51:192-3 24. Onuıgbo M, Alikhan M. Over-the-Counter
• Sympathomimetics: A Risk Factor for Cardiac Arrhythmias
• in Pregnancy. Southern Med J 1998;91:1153-5