How Do Drugs Work - Decongestants

Hello Everyone,

As "Cedar Fever" gets worse in South Texas, more and more patients are reaching for over the counter (OTC) remedies to help them cope with the runny noses, itchy eyes and increased sinus, head or nasal congestion. An earlier article covered antihistamines which works well for the runny nose and itching.

Today we are going to discuss medications that patients take to fight that congested feeling. There are usually two types of congestion that patients experience. Chest congestion or nasal congestion. Most of the medications that we are going to discuss today are for nasal, head or sinus congestion.

Congestion problems? What medications can you take to fight that congestion. DECONGESTANTS! Be careful.... they are not for everyone.

Decongestants belong to a class of medications called sympathomimetics. That is... they mimic the action of the chemical in the body (neurotransmitter) that controls the sympathetic nervous system. The chemical in the body is norepinephrine, commonly called "adrenaline".

Adrenaline is the chemical in the body that controls the "Fight or Flight Response" in the body. You know the feeling..... something scares you and all of a sudden, your heart is beating faster, you are breathing faster, your blood pressure goes up and you feel anxious.

It speeds up the heart by stimulating the receptors in the heart causing it to beat faster.
It increases blood pressure by causing a the blood vessels to constrict (get smaller)
It stimulates breathing and opens your airways because if you are going to fight or run you need more oxygen.
It can give you more energy reserves by causing the liver to convert stored sugar to glucose that your cells can readily use for energy.
It can keep you awake.

It SPEEDS things up. SPEED! You have heard that term referring to illicit drugs. Well, speed belongs to the same family of drugs. In fact, there are many medications that belong to that same class of medication. Sympathomimetics have many medicinal uses... Attention Deficit Hyper Activity Disorders, Appetite Control, Weight Loss, Low Blood Pressure, Asthma Control, Nasal Decongestants.

So, Nasal Decongestants, How Do They Work? Medications like psuedoephedrine, phenylephrine, ephedrine and topical decongestants like oxymetazoline work by stimulating the receptors on the blood vessels in the sinuses causing them to constrict and relieving that stuffy feeling. That simple.

Recently the sale of psuedoephedrine was restricted. This medication is now kept behind the counter with the Pharmacist in an effort to control large sales of psuedoephedrine. Why is this? Psuedoephedrine is used in the manufacture of the illicit substance - methamphetamine.

Above I mentioned that nasal decongestants are not for everyone. This is why....

It speeds up the heart by stimulating the receptors in the heart causing it to beat faster.
If you have a heart condition, the increase in heart rate can cause problems.

It increases blood pressure by causing a the blood vessels to constrict (get smaller).
If you have high blood pressure, the increase in blood pressure can cause problems.

It can give you more energy reserves by causing the liver to convert stores sugar to glucose that your cells can readily use for energy.
If you have diabetes, the increase in blood sugar can cause problems.

It can keep you awake.
If you take decongestants late at night, it can cause restlessness and inability to sleep.

Decongestants should not be taken with other medical conditions. If you have any chronic illness, please check with your Pharmacist or Physician to see if these medications are safe for you.

Many of the combination cough and cold remedies have decongestants in them. Please take time to read the ingredient list before you make a purchase. If needed, please ask your Pharmacist for assistance. Remember, if the package says it is a non-drowsy formula, chances are it has a decongestant in it.

I am trying to keep these explanations easy to understand. If they are not clear or you would like more information, please let me know.

Thank you for your support.

Dr. Paul