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Toronto Notes 2019
Common Medications
Otolaryngology OT47
Table 23. Nasal Sprays
Generic Name (Brand Name)
Steroid
flunisolide (Rhinalar®)
budesonide (Rhinocort®) triamcinolonoe (Nasacort®) beclomethasone (Beconase®) mometasone furoate, monohydrate (Nasonex®)
fluticasone furoate (Avamys®)
Antihistamine
levocarbastine (Livostin®)
Decongestant
xylometazoline (Otrivin®) oxymetazoline (Dristan®) phenylephrine (Neosynephrine®)
Antibiotic/Decongestant
framycetin, gramicidin, phenylephrine (Soframycin®)
Anticholinergic
ipratropium bromide (Atrovent®)
Lubricants
saline, NeilMed®, Rhinaris®, Secaris®, Polysporin®, Vaseline®
Source: Dr. MM Carr
Indications
Allergic rhinitis Chronic sinusitis
Allergic rhinitis
Acute sinusitis Rhinitis
Acute sinusitis
Vasomotor rhinitis
Dry nasal mucosa
Notes
Requires up to 4 wk of consistent use to have effect Long-term use
Dries nasal mucosa; may cause minor bleeding Patient should stop if epistaxis
May sting
Flonase® and Nasonex® not absorbed systemically
Immediate effect
Dikscontinue if no effect by day 3 Use during allergy season
Careful if patient has hypertension
Short-term use (<5 d)
If long-term use, can cause decongestant addiction (i.e. rhinitis medicamentosa)
Careful not to spray into eyes as can cause burning or precipitation of narrow angle glaucoma
Increased rate of epistaxis when combined with topical nasal steroids
Use prn
Rhinaris® and Secaris® may cause stinging