DECONGESTANTS ADRENERGIC AGONIST

 

Four synthetic adrenergic angonist phenylephrine, naphazoline, oxymetazoline and tetrahydrozoline are currently available as ocular decongestants

 

Mechanism of Action

Phenylephrine is a synthetic adrenergic agonist. Phenylephrine causes vasoconstriction by direct stimulation of receptors on conjunctival vasculature. The resultant clinical effect is usually a decrease in conjunctival hyperemia and edema. At the 0.12% concentration used for ocular decongestion, phenylephrine can occasionally dilate the pupil. Naphazoline, oxymetazoline and tetrahydrozoline differ structurally from other adrenergic agonists by replacement of the benzene ring with an unsaturated ring. In general, these agents exhibit greater a-than b-adrenergic receptor activity. After topical application to the eye, they induce a marked vasoconstriction

 

Indications

Conjunctival hyperemia and edema

 

Dosage

Adults: 1 drop 2-4 times daily. Preferably be infrequent

 

Children: Can be used

 

Contraindications

Cardiovascular disease, hyperthyroidism, diabetes, angle-closure glaucoma, potentially occludable angles and traumatized cornea

 

Special Precautions

Rebound congestion can occur with extended use. Infrequent use is preferred

 

Adverse Drug Reactions

Transient stinging can occur with all decongestant preparations after instillation. Dosage frequency is generally 2 to 4 times daily but should be as infrequent as possible to minimize possible ocular side effects. Pupillary dilation, blurred vision, epithelial erosions and rebound congestion can occur with extended use. Upper lid retraction has been associated. Systemic absorption can cause central nervous system (CNS) and respiratory depression, including bradycardia and hypotension. Long-term use of phenylephrine can cause a rebound conjunctival congestion and result in conjunctivitis medicamentosa. Imidazole derivatives

 

Status in

1. Pregnancy : Use with caution

2. Lactation : Use with caution

3. Old age : Can be used

4. Children : Can be used in reduce frequency

 

 

Brands available and preparations of DECONGESTANTS

 

Pharmaceutical Company

Brand Name

Intas

ANDRE EYE DROPS  (Boric Acid 1.25% sodium chloride 0.05%, Chlorobutanol 0.035%, naphazoline hcl. 0.056%, zinc sulp. 0.012%, chlorpheniramine maleate 0.01%, all w/v)

10ml Dps 

 

Novartis

CLEARINE                      

(Naphazoline HCI, boric acid, borex, glycerol, Benzalkonium chloride)

10ml Dps    

 

Klan Sehen

DECOMIC DPS.             

(Phenylephire HCI 0.12%, Chlorphenirine maleate 0.2%, boric acid 1.25%, hydroxypropyl methyl cellulose 0.5%, Phenylethyl alcohol USP 0.5%, all v/v)

10ml Dps   

 

Syntho Pharma

MEZOL  (Naphazoline hydrocloride 0.1%, Benzalkonium chloride 0.02%, Chlorpheniramine meleate 0.01%, Methyl cellulose 0.2%)

10ml Dps   

 

Milmet

MIL (Boric acid 1.25%, Naphazoline hcl 0.056%, Chlorpheniramine maleate 0.01%, Zinc sulph. 0.12%)

10ml Dps   

 

FDC

OCUCEL EYE DROPS   (Naphazoline)

5ml Dps       0.01% w/v   

 

East India

ZOAMET EYE DPS.  (Oxymetazoline HCl 0.025%)

5ml Dps