Definition
"Sinusitis" means inflammation of the nasal sinuses: the inflammatory process can occur suddenly (acute sinusitis) or last so long that it becomes chronic (over 12 months).
Causes
In general, sinusitis is the result of frequent and poor bacterial, viral or fungal insults to the upper respiratory tract; in some patients, sinusitis is the result of allergic phenomena or particular environmental conditions. Risk factors include: hormonal alterations, bronchial asthma, deviation of the nasal septum, continuous exposure to irritants, stuffy nose, nasal polyps, immoderate use of drugs.
Symptoms
The typical symptom of sinusitis is a stuffy nose (nasal obstruction), associated with the emission of yellowish or greenish mucus. To these prodromes, they are associated: alteration of the perception of food taste, halitosis, nasal congestion, weakness, dyspnea, facial and tooth pain, fever, swollen eyes, closed ears, rhinorrhea and cough.
Natural Care
Information on Sinusitis - Medications for the Treatment of Sinusitis is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Sinusitis - Medications for Sinus Treatment.
drugs
The cardinal goal for the treatment of chronic sinusitis is undoubtedly to reduce the inflammation of the nasal sinuses: when an alleged simple cold tends to last for too long, dragging with it breathing difficulties, nasal congestion, weakness and fever, sinusitis could be the most immediate explanation to all this. In such situations, it is advisable to consult your primary care physician: in fact, a maltreated or neglected sinusitis could generate rather serious complications (eg meningitis and orbital infection).
Antibiotics : they are administered in cases of acute bacterial sinusitis. It is not uncommon, however, that the antibiotic chosen for the treatment of sinusitis is ineffective: in similar situations, it is possible that the chosen drug does not perform its therapeutic action against that pathogen, which is actually responsible for the manifestation of the disease. To avoid these problems, before prescribing a pharmacological cure, the analysis of the mucus is recommended, taken from the paranasal sinus of the affected patient. Generally, antibiotic therapy should last for 10-14 days, depending on the severity of the disease. For example:
- Amoxicillin (ES. Augmentin, Klavux): take a dose equal to 250-500 mg of drug 3 times a day for 10-14 days; alternatively, take the antibiotic at a dosage of 500-875 mg orally twice a day. Do not prolong therapy beyond 4 weeks.
- Azithromycin (Ex. Zitrobiotic, Rezan): indicated for the treatment of acute sinusitis with bacterial etiology. Take the drug from the first symptoms at a dose of 500 mg orally, once a day for 3 days. In case of severity (moderate and severe forms of sinusitis), take 2 grams of active per day.
- Moxifloxacin (eg. Vigamox, Avalox, Octegra) take 400 mg of oral or intravenous active every 24 hours, for 10 days. Also in this case, the antibiotic should be administered exclusively to treat acute sinusitis caused by bacteria.
Nasal decongestants: these are over-the-counter drugs (also available without a prescription) available in the form of tablets, liquids and nasal sprays; their administration should not be prolonged for long, as they can cause serious side effects, sometimes worsening the symptoms.
- Pseudoefredina (eg. Actifed, Actigrip): pseudoephedrine is probably the most used drug in therapy as a nasal decongestant, also (but not only) in the context of sinusitis; the drug is used both in combination with other drugs (eg antihistamines, paracetamol), and in monotherapy. Start the treatment by taking 30-60 mg of the drug orally every 4-6 hours, as needed. Continue therapy by taking 120 mg of active twice daily. Do not exceed 240 mg a day. Consult your doctor
- Oximetazoline hydrochloride, 0.025-0.05% solution (eg Vicks sinex, Oxilin, Equimet): apply 4-6 sprays in each nostril twice a day, as needed for the 0.025% solutions and 2-3 applications for each nostril twice daily for 0.5% solutions.
Nasal washings : saline solutions (physiological solution: eg Libenar, Naset Spray) help to irrigate and clear the nose of excess mucus, thus proving to be a valid remedy to clean the canal of the breath and at the same time soothe the nasal membranes, speeding up the healing from sinusitis.
Nasal corticosteroids: useful for combating severe inflammation in the context of sinusitis:
- Fluticasone (eg. Avamys, Fluspiral, Flixonase, Nasofan): although widely used in therapy for the treatment of rhinitis, the drug is also useful for lightening the typical symptoms of sinusitis. Patients previously treated exclusively with bronchodilator drugs can take fluticasone at a dose of 100 mcg on the first day, progressively increasing the dose from day to day, up to a maximum of 500 mcg twice a day. Patients previously treated with oral corticosteroids can take fluticasone at a dose of 880 mcg per day.
- Budesonide (eg. Biben, Pulmaxan): The drug is administered by inhalation: to repeat two applications (200-400 mcg) twice a day. Do not exceed 400 mcg per day. In case of previous treatment with corticosteroids, it is possible to increase the dose up to 800 mcg per day (divided into 4 inhalations twice a day).
- Triamcinolone (eg Kenakort, Triamvirgi, Nasacort): apply 2 sprays in each nostril once a day. It is possible to increase the dose after 4-7 days, applying 4 sprays in each nostril once a day, or two sprays per nostril twice a day. Maintenance dose for the treatment of sinusitis on an allergic basis: 1 spray per nostril once a day.
- Beclometasone (eg Rinoclenil, nasal Becotide) the drug, widely used in therapy against allergic sinusitis, should be taken by inhalation, at the dosage of 1-2 sprays (42-84 mcg) in each nostril, twice a day (168-336 mg per day). The dosage just described refers to the spray drug, 0.042% solution.
Oral or injectable corticosteroids
The use of these drugs is reserved for the treatment of high-grade sinusitis, especially when associated with the presence of nasal polyps. Generally, administration of oral corticosteroids is recommended only in cases of asthma associated with severe sinusitis.
- Prednisone (eg . Deltacortene, Lodotra ) is recommended to take 1-2 mg / kg divided into two doses, for 3-5 days. The drug can also be taken intravenously at a dosage of 2-4 mg / kg, divided into 3-4 doses during 24 hours.
- Methylprednisolone (eg Advantan, Metilpre, Depo-Medrol, Medrol, Urbason) is generally administered orally or for IV, in case of complications associated with sinusitis, or in any case for the treatment of severe forms. Take 40-80 mg of drug per day, divided into 1-2 doses, for a period varying from 3 to 10 days.
Antitussives: to be taken in case of sinusitis associated with cough.
Dextromethorphan (eg. Aricodiltosse, Bisolvon Tosse, Ozopulmin) is generally administered in the form of syrups or tablets, at a dose of 15-60 mg 2-3 times a day. Do not exceed 120 mg per day. At a dose of 200-300 mg per day the drug creates visual hallucinations and possible alteration of the heart rhythm.
Antihistamines : indicated to treat sinusitis in the context of an allergy.
- Diphenhydramine (eg Aliserin, Difeni C FN) indicated for treating sinusitis on an allergic basis. Take 25 mg of medication (tablets / sachets) every 4 hours, as needed. Do not exceed 150 mg per day.
- Chlorphenamine (eg Trimeton, tablets or solution for injection): the drug is often associated with phenylpropanolamine, a substance widely used for the formulation of products for the treatment of cooling symptoms. It is recommended to take 4 mg of active every 4-6 hours. Do not exceed 32 mg a day.
Therapeutic aids: to be used as an adjunct to the treatment of sinusitis
- Paracetamol or acetaminophen (eg. Tachipirina, Efferalgan, Sanipirina, Piros, Tachidol) the administration of this drug is useful for lowering fever, a symptom that often accompanies sinusitis. Paracetamol is administered at a dosage of 325-650 mg per day every 4-6 hours; alternatively, take 1 gram every 6-8 hours. The dosage depends on the patient's condition, age and weight. The drug can also be taken intravenously: 1 gram every 6 hours or 650 mg every 4 hours for adults and adolescents weighing more than 50 kilos: if the patient weighs less than 50 kilos, give 15 mg / kg every 6 hours or 12, 5 mg / kg every 4 hours.
- Ibuprofen (eg. Brufen, Kendo, Moment, Momentact, Buscofen): take orally from 200 to 400 mg of active ingredient (tablets, effervescent sachets) every 4-6 hours, as needed. In some cases, the analgesic can also be taken intravenously at a dose of 400-800 mg every 6 hours, as needed.
Notes: how to prevent chronic sinusitis
- Allergy is a possible risk factor for sinusitis: having said that, it is clear that the precise management of allergic phenomena is fundamental to prevent sinusitis
- Sinusitis can be the result of a continuous chain of colds and bacterial and viral insults: for this reason it is essential to avoid contact with cooled subjects.
- Wash your hands often, especially before meals
- Smoking and smog are further elements of risk for bronchial and pulmonary diseases: avoid smoking as much as possible and frequenting polluted environments
- The use of a humidifier for the environment reduces the risk of sinusitis and general respiratory problems
