Nasal corticosteroid sprays and antihistamines

Corticosteroids have been used as drug treatment for some time. Lewis Sarett of Merck & Co. was the first to synthesize cortisone, using a complicated 36-step process that started with deoxycholic acid, which was extracted from ox bile . [43] The low efficiency of converting deoxycholic acid into cortisone led to a cost of US $200 per gram. Russell Marker , at Syntex , discovered a much cheaper and more convenient starting material, diosgenin from wild Mexican yams . His conversion of diosgenin into progesterone by a four-step process now known as Marker degradation was an important step in mass production of all steroidal hormones, including cortisone and chemicals used in hormonal contraception . [44] In 1952, . Peterson and . Murray of Upjohn developed a process that used Rhizopus mold to oxidize progesterone into a compound that was readily converted to cortisone. [45] The ability to cheaply synthesize large quantities of cortisone from the diosgenin in yams resulted in a rapid drop in price to US $6 per gram, falling to $ per gram by 1980. Percy Julian's research also aided progress in the field. [46] The exact nature of cortisone's anti-inflammatory action remained a mystery for years after, however, until the leukocyte adhesion cascade and the role of phospholipase A2 in the production of prostaglandins and leukotrienes was fully understood in the early 1980s.

Azelastine hydrochloride displayed no sensitising potential in the guinea pig. Azelastine demonstrated no genotoxic potential in a battery of in vitro and in vivo tests, nor any carcinogenic potential in rats or mice. In male and female rats, azelastine at oral doses greater than 3 mg/kg/day caused a dose-related decrease in the fertility index; no substance-related alterations were found in the reproductive organs of males or females during chronic toxicity studies, however, embryotoxic and teratogenic effects in rats, mice and rabbits occurred only at maternal toxic doses (for example, skeletal malformations were observed in rats and mice at doses of mg/kg/day).

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Nasal corticosteroid sprays help to shrink nasal tissue swelling over time. However nasal corticosteroids do not reach the inside of the sinus cavities. These sprays also keep drainage pathways open. They can relieve sinus inflammation caused by allergies, decrease nonallergic inflammation and shrink nasal polyps. Nasal corticosteroids have also been shown to decrease the severity and duration of acute sinusitis.

Nasal corticosteroids are most effective if they are used on a daily basis. Unlike decongestant nasal sprays, nasal corticosteroids are not addictive and do not cause a rebound effect. They can be applied to the nose through sprays, aerosols by nasal nebulizers, or by nasal drops.

Nasal Corticosteroids

Brand Name Ingredient Beconase AQ® beclomethasone Flonase® fluticasone Nasarel® flunisolide Nasonex® mometasone
 
There is some concern about the use of nasal corticosteroids in children. Physicians and parents are concerned about growth suppression. This concern is mostly focused on the long term regular use of nasal corticosteroids, frequent repeated short term use of oral corticosteroids, or persistent use of high dose inhaled corticosteroids for asthma. Fortunately very little corticosteroid is absorbed into the bloodstream from the majority of nasal corticosteroid sprays. Corticosteroid effects can be further minimized by using brands that permit only low absorption into the bloodstream and/or have been shown through studies not to affect growth. Children using any form of corticosteroids should have their height tracked using a stadiometer. Long term height assessments can then be used to assess whether growth suppression is an issue before it becomes a significant problem.
 

Nasal corticosteroid sprays and antihistamines

nasal corticosteroid sprays and antihistamines

Nasal corticosteroid sprays help to shrink nasal tissue swelling over time. However nasal corticosteroids do not reach the inside of the sinus cavities. These sprays also keep drainage pathways open. They can relieve sinus inflammation caused by allergies, decrease nonallergic inflammation and shrink nasal polyps. Nasal corticosteroids have also been shown to decrease the severity and duration of acute sinusitis.

Nasal corticosteroids are most effective if they are used on a daily basis. Unlike decongestant nasal sprays, nasal corticosteroids are not addictive and do not cause a rebound effect. They can be applied to the nose through sprays, aerosols by nasal nebulizers, or by nasal drops.

Nasal Corticosteroids

Brand Name Ingredient Beconase AQ® beclomethasone Flonase® fluticasone Nasarel® flunisolide Nasonex® mometasone
 
There is some concern about the use of nasal corticosteroids in children. Physicians and parents are concerned about growth suppression. This concern is mostly focused on the long term regular use of nasal corticosteroids, frequent repeated short term use of oral corticosteroids, or persistent use of high dose inhaled corticosteroids for asthma. Fortunately very little corticosteroid is absorbed into the bloodstream from the majority of nasal corticosteroid sprays. Corticosteroid effects can be further minimized by using brands that permit only low absorption into the bloodstream and/or have been shown through studies not to affect growth. Children using any form of corticosteroids should have their height tracked using a stadiometer. Long term height assessments can then be used to assess whether growth suppression is an issue before it becomes a significant problem.
 

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