To study the utilization pattern of nasal decongestants and their effects on heart rate and blood pressure

Abstract

Background: Nasal decongestants (NDs) are frequently prescribed over the counter (OTC) drugs for cough and cold. These are sympathomimetic drugs, which act through α1 and β1 adrenoceptors to cause vasoconstriction and positive inotropic, chronotropic and dromotropic effect on the heart. This study was conducted to assess the pattern of utilization of the NDs and their effect on heart rate (HR) and blood pressure (BP). Patients were observed for any other adverse drug reactions (ADRs). Materials and methods: Randomly 100 prescriptions containing NDs were collected from the otorhinolaryngology OPD and were analyzed. All these patients were examined for HR and BP on day 0, 3 and 7 of administration of NDs. Any ADRs were also recorded. Results: Mean ND used per patient was 1.08/patient. Commonly prescribed NDs were phenylephrine (72.2%), pseudoephedrine (12.9%), phenylpropanolamine (6.5%), xylometazoline (6.5%) and oxymetazoline (1.8%). Eight patients received two NDs orally and/or topically. There was a significant rise in heart rate on day 7 (p < 0.05). However, the rise in BP was insignificant both on days 3 and 7. Frequently observed ADR's included headache, palpitations and dizziness. Discussion: Some NDs are known to raise the HR and BP. Baseline BP monitoring should be done to avoid any further rise in BP and HR. being an OTC drug there are more chances of adverse effects of these NDs. It is suggested that NDs should be prescription only drugs, till adequate evidence is available regarding their safety.