Xylometazoline 70micrograms/dose / Ipratropium bromide 84micrograms/dose nasal spray

Objective:This study evaluated the efficacy of 0.1% xylometazoline-hydrochloride nasal decongestant spray compared to 0.9% saline nasal spray in relieving post-septoplasty clinical nasal findings and symptoms. Methods: This triple-blinded randomized-clinical-trial was conducted in 2 tertiary-care hospitals in Karachi-Pakistan. A total of 120 septoplasty patients were recruited from June 20, 2022, to June 20, 2023. Randomly equally-assigned participants received either 0.9% isotonic-saline (control group) or 0.1% xylometazoline-hydrochloride (intervention group) nasal sprays. Participants were instructed to use nasal sprays for 1 week, twice daily, with a 12 hour interval between the 2 doses as a single spray per nostril. Follow-up assessments were conducted on days 3 and 7 after surgery. Postoperative symptoms, nasal-endoscopic findings, adverse-effects, and patient satisfaction were compared using Chi-square test and a P value of <.05 was considered significant. Results: Of 120 participants, 106 were analyzed with 53 participants in each group. By the end of third postoperative day, intervention group exhibited significantly lower rates of self-reported symptoms, including bleeding (7.5%:54.7%), nasal obstruction (3.8%:45.3%), headache (1.9%:30.2%), pain (3.8%:7.5%), as well as clinical nasal findings, including nasal edema (1.9%:58.5%), crusting (11.3%:58.5%), nasal discharge (9.4%:22.6%), and nonhealed scarring (18.9%:58.5%), compared to control group ( P value < .001). On the seventh day, intervention group exhibited absence of self-reported symptoms and clinical nasal findings, whereas control group still experienced moderate symptoms ( P value < .001). Intervention group had significantly higher patient satisfaction ( P value < .001). Conclusions: Xylometazoline spray is highly effective in relieving post-septoplasty clinical nasal findings and symptoms, without adverse effects, indicating potential for wider clinical utilization. Trial Registration: UMIN Clinical-trial-registry: UMIN000052217. ( https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000059598 ).

Abstract licence: CC BY-NC

Background: The aim of the present study was to evaluate the effect of ipratropium bromide with violet flower extract, ipratropium bromide with budesonide, and ipratropium bromide alone on the cuff-leak of the endotracheal tube and changes in hemodynamic parameters in intubated patients admitted to the intensive care unit. Materials and Methods: The present randomized clinical trial study was performed on 195 intubated patients in three groups of 65 patients. The first group received nebulized ipratropium bromide with budesonide (I + B group), the second group in addition to ipratropium bromide, received one tablespoon of the violet flower extract syrup every 8 hours (I + V group), and the third group received nebulized ipratropium bromide alone (I group). Hemodynamic parameters and the cuff-leak ratio (CLR) of patients were evaluated up to 72 hours after intubation. Results: The results of the present study revealed that 12 hours after intubation, the mean of CLR was significantly lower in group I (with a mean of 0.14 ± 0.02) as compared with that of the I + V and I + B groups (with the means of 0.16 ± 0.05 and 0.23 ± 0.05, respectively) ( P < 0.001). In addition, 24 hours after intubation, the mean of CLR in group I + V was higher than that of I + B and I groups ( P < 0.05). Conclusion: According to the results of this study, the use of violet extract syrup in patients under intubation can significantly improve patients' ratio of cuff-leak and SpO2. It seems that the use of violet extract syrup is effective to prevent unwanted complications during intubation and to facilitate patients' breathing.

Abstract licence: CC BY-NC-SA

The article presents a differentiated approach to the therapy of nasal obstruction syndrome. The authors discuss the physiological aspects of nasal breathing, the need for mucociliary clearance of the mucous layer lining the nasal epithelium, the factors of nasal resistance, and the concept of nasal cycle. The article deals with the most common causes of breathing problems such as acute infectious and allergic rhinitis and provides detailed description of the etiology, pathogenesis and role of various microorganisms in the routine evaluation of acute rhinitis. Classifications of rhinitis including allergic one are presented. The paper reviews features of seasonal and year-round disease, pathogenesis of allergic inflammation. The authors suggest that topical decongestants are used for reliable relief of nasal obstruction syndrome. In case of abundant rhinorrhoea, the combined nasal spray Otrivin Complex containing xylometazoline and ipratropium bromide is advised. If nasal secretions are combined with congestion, the authors recommend using Vibrocil containing phenylephrine and dimethindene maleate.

Abstract licence: CC BY-NC-ND

The paper summarizes findings on the place of decongestants in current treatment approaches for various types of rhinitis, their benefits and disadvantages, as well as feasibility of combination with drugs in other pharmacological groups, in particular with the anticholinergic drug ipratropium bromide. Indications for use of xylometazoline in combination with ipratropium bromide are substantiated. The reviewed literature demonstrates that clinical use of the combination scheme with equal effectiveness in eliminating nasal congestion allows to significantly decrease rhinorrhea.

Abstract licence: CC BY-NC-ND

INTRODUCTION: Xylometazoline hydrochloride (HCl) is a nasal decongestant that causes vasoconstriction in the nasal submucosa. It has been used for more than 50 years for the treatment of nasal congestion caused by rhinitis/sinusitis. Iota-carrageenan is effective against a broad variety of respiratory viruses, which are the most common cause of infections of the upper respiratory tract. Therefore, it is used as the active component in the antiviral nasal spray Coldamaris prophylactic (1.2 mg/mL iota-carrageenan in 0.5% NaCl) and other medical device nasal sprays that are approved and marketed in the EU. Recently, we developed a nasal spray formulation containing both xylometazoline HCl (0.05%) and iota-carrageenan (0.12%) that provides decongestion and antiviral protection of the nasal mucosa at the same time. RESULTS: A set of in vitro experiments revealed that the vasoconstrictive properties of xylometazoline HCl and the antiviral effectiveness of iota-carrageenan against human rhinovirus (hRV) 1a, hRV8 and human coronavirus OC43 were maintained in the formulation containing these two compounds. Permeation experiments using bovine nasal mucosa showed that iota-carrageenan had no significant influence on the permeation of xylometazoline HCl. Finally, in the local tolerance and toxicity study, it was shown that the formulation was well tolerated at the application site with no occurrence of erythema or edema in the nostrils of all rabbits or any signs of toxicity in any of the organs and tissues inspected. CONCLUSION: Investigations on compatibility of xylometazoline HCl and iota-carrageenan demonstrated that the substances do not influence each other, allowing both to fulfill their known specific clinical efficacy (xylometazoline HCl) and effectiveness (iota-carrageenan).

Abstract licence: CC BY-NC