Potential of bioregulatory therapy in the treatment of patients with rhinitis medicamentosa

• Published in: Medicinskij sovet no. 18; pp. 133 - 138
• Main Authors: Karpishchenko, S. A., Kolesnikova, O. M., Alekseenko, S. A.
• Format: Journal Article
• Language: English
• Published: 13-11-2024
• ISSN: 2079-701X; 2658-5790
• DOI: 10.21518/ms2024-495

Chronic rhinitis is a common condition characterized by inflammation of the mucous membrane of the nose. It can lead to troublesome symptoms like itching, runny nose, nasal congestion, sneezing and irritation. Rhinitis can significantly lower the quality of life, have a detrimental effect on productivity and negatively affect social communications. Therefore, it is important to diagnose and treat this disease in due time. There are two main types of rhinitis: allergic rhinitis and non-allergic rhinitis. Non-allergic rhinitis refers to patients who have nasal symptoms, but skin tests do not show any allergic reactions. In this case, additional tests are necessary before making an accurate diagnosis. In turn, several subgroups of non-allergic rhinitis can be distinguished according to the causes and mechanisms of its development. The article discusses the features of the treatment of rhinitis medicamentosa. The use of different drugs can cause nasal symptoms, including nasal congestion. Rhinitis medicamentosa can be divided into two subgroups: rhinitis caused by adverse effects of systemic drugs and rhinitis due to overuse of antioedemic nasal therapy. Topically active vasoconstrictors are used to relieve nasal congestion caused by various reasons. However, the long-term use of such drugs can lead to the development of rhinitis medicamentosa and other adverse reactions. There are several hypotheses as to why rhinitis medicamentosa occurs. They include activation of beta-adrenergic receptors, the decreased production of presynaptic endogenous norepinephrine, and the development of tachyphylaxis. The overuse of topical nasal decongestants can bring on vicious cycle: the more frequently the patients use the drugs, the more likely thery are to get increased adverse effects. It is important to understand the potential risks and limitations of using topical nasal decongestants. If symptoms of nasal congestion or other adverse effects develop, it is necessary to consult a doctor to adjust the treatment.