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'Rhinitis Medicamentosa' (111)


Dec
1969

This study was designed to prospectively evaluate the role of nebulized hyaluronic acid (HA) administered for 10 days as treatment for patients with rhinitis medicamentosa (RM). RM is a pathological condition of the nasal mucosa induced by prolonged, excessive or improper use of topical decongestants. It is characterized by persistent nasal congestion that can lead the patient to increase the frequency of application and the quantity of the substance being applied, resulting in dependence on topical nasal decongestants.

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Nov
2017

[Research progress on rhinitis medicamentosa].

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017 Nov;52(11):872-875
Y N Wang, Z L Luan, H T Wang
Rhinitis medicamentosa (RM) refers to nonallergic inflammation in the nasal mucosa which is caused by the abuse of nasal decongestant and it often occurs in patients with allergic/nonallergic rhinitis along with nasal congestion. RM is characterized by nasal congestion based on long-term use of nasal decongestant, without rhinorrhoea or sneezing. The signs of RM include nasal swelling, thickening, loss of elasticity, and loss of sensitivity to the decongestant.

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Mar
2016

The recommended drug for moderate to severe chronic rhinitis is intranasal steroids (INS). However, nasal congestion could be refractory and need additional treatments.
We sought to explore the benefit of oxymetazoline (Oxymet) plus INS on nasal congestion without inducing rhinitis medicamentosa.

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Dec
2016

To better understand the causes of the exacerbation of rhinitis medicamentosa (RM) induced by oxymetazoline (OMZ) or benzalkonium chloride (BKC), we examined the impact of pretreatment with OMZ or BKC on cultured human nasal epithelial cells. We also examined the effect of mometasone furoate (MF) on the cultured human nasal epithelial cells treated with OMZ or BKC.
Cells of the human nasal epithelial cell line HNEpC were treated with OMZ or BKC, and the OMZ- and BKC-induced expression of histamine H1 receptor (H1R) mRNA was assayed using real-time polymerase chain reaction.

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Jan
2015

Rebound erythema secondary to use of topical brimonidine in the setting of rosacea is an important, possibly significantly distressing potential side effect that may be under-reported; there is little photo-documentation in the literature to date. This article documents such a case.
A 28-year-old woman (Fitzpatrick II) with a long-standing history of untreated rosacea presented for initiation of treatment of what was noted to be primarily erythematotelangiectatic rosacea and was offered Mirvaso for daily use.

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Nov
2014

We aimed to determine the presence of oxidative stress in rhinitis medicamentosa (RM) and to evaluate the effect of erdosteine (ED) on mucosal changes in a rat model. Twenty-four male rats were used in this experimental study. Three groups were created.

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Dec
2013

Long-term use of decongestant nasal spray (alpha adrenergic agonist) causes nasal congestion by rhinitis medicamentosa.
We clinically reviewed the cases of 33 patients of rhinitis medicamentosa (23 men, 10 women; mean age, 44.4±15.

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May
2014

Kinetic oscillation stimulation (KOS) of nasal mucosa at low frequency seems to be a possibly effective and safe short-term treatment of non-allergic nasal stuffiness.
To assess the relief of rhinitis symptoms, especially stuffiness, by comparing active treatment, i.e.

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Dec
1969

The aim was to study the peculiarities of differential diagnosis, prevention and treatment of different forms of rhinitis in Kazakhstan children and adolescents.
124 children and adolescents aged 1-17 years were randomly enrolled in our hospital based study in 2010 and 2011. Skin prick tests and total serum IgE level were assessed in all allergic patients.

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Dec
1969

Chapter 14: Nonallergic rhinitis.

Am J Rhinol Allergy 2013 May-Jun;27 Suppl 1:S48-51
Russell A Settipane, Michael A Kaliner
Rhinitis is characterized by one or more of the following nasal symptoms: congestion, rhinorrhea (anterior and posterior), sneezing, and itching. It is classified as allergic or nonallergic, the latter being a diverse syndrome that is characterized by symptoms of rhinitis that are not the result of IgE-mediated events. Excluding infectious rhinitis and underlying systemic diseases, clinical entities that can be classified among the disorders that make up the nonallergic rhinitis syndromes include gustatory rhinitis, nonallergic rhinitis with eosinophilia syndrome (NARES), atrophic, drug-induced (rhinitis medicamentosa), hormone induced, senile rhinitis (of the elderly), rhinitis associated with chronic rhinosinusitis with or without nasal polyps, and the idiopathic variant formerly known as vasomotor rhinitis but more accurately denoted as nonallergic rhinopathy (NAR).

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May
2013

Rhinitis is characterized by one or more of the following nasal symptoms: congestion, rhinorrhea (anterior and posterior), sneezing, and itching. It is classified as allergic or nonallergic, the latter being a diverse syndrome that is characterized by symptoms of rhinitis that are not the result of IgE-mediated events. Excluding infectious rhinitis and underlying systemic diseases, clinical entities that can be classified among the disorders that make up the nonallergic rhinitis syndromes include gustatory rhinitis, nonallergic rhinitis with eosinophilia syndrome (NARES), atrophic, drug-induced (rhinitis medicamentosa), hormone induced, senile rhinitis (of the elderly), rhinitis associated with chronic rhinosinusitis with or without nasal polyps, and the idiopathic variant formerly known as vasomotor rhinitis but more accurately denoted as nonallergic rhinopathy (NAR).

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Jun
2013

Systemic and topical nasal decongestants are widely used in otorhinolaryngology and general practice for the management of acute rhinosinusitis and as an adjuvant in certain forms of chronic rhinosinusitis. These products, very effective to rapidly improve nasal congestion, are sometimes available over the counter and can be the subject of misuse, which is difficult to control. The Société Française d'ORL has recently issued guidelines concerning the use of these decongestants in the doctor's office and the operating room.

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Dec
1969

Rhinologic issues in pregnancy.

Allergy Rhinol (Providence) 2012 21;3(1):e13-5. Epub 2012 Jun 21.
Gregg Goldstein, Satish Govindaraj
The diagnosis and treatment of rhinitis, sinusitis, and epistaxis during pregnancy present unique challenges to the otolaryngologist. Poorly controlled sinonasal disease may have significant adverse effects on the mother's quality of life and pregnancy outcomes and the lack of adequately controlled safety data limits the clinician's ability to make informed decisions about management. At the conclusion of this discussion, the reader should be familiar with the available literature and evidence-based guidelines regarding the safety and indications for radiographic imaging, clinical testing, medical intervention, and surgical treatment of sinonasal disease in pregnant patients.

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Dec
1969

Chapter 6: Nonallergic rhinitis.

Allergy Asthma Proc 2012 May-Jun;33 Suppl 1:19-21
Rachna Shah, Kris G McGrath
Nonallergic rhinitis represents a non-IgE-mediated group of disorders that share the symptoms of nasal congestion, rhinorrhea, sneezing, and/or postnasal discharge but not pruritus that characterizes allergic rhinitis. Nonallergic rhinitis may be divided into two broad categories, inflammatory and noninflammatory etiologies. The inflammatory causes include postinfectious (viral and bacterial), rhinitis associated with nasal polyps, and nonallergic rhinitis with eosinophilia, where eosinophils are present in nasal smears but skin testing for aeroallergens is negative.

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Aug
2011

It is important to consider a comprehensive differential of possible rhinitis types when considering the diagnosis of chronic rhinitis, including at least 9 subtypes of nonallergic rhinitis: drug-induced rhinitis, gustatory rhinitis, hormonal-induced rhinitis, infectious rhinitis, nonallergic rhinitis with eosinophilia syndrome, occupational rhinitis, senile rhinitis, atrophic rhinitis, and nonallergic rhinopathy. This article focuses on some of the most common types of chronic rhinitis, including mixed rhinitis (allergic and nonallergic overlap), rhinitis medicamentosa, hormonal rhinitis, rhinitis of the elderly, and gustatory rhinitis.

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Apr
2011

In clinical trials, only about 60% of subjects report an excellent response to intranasal steroids, suggesting a need to add therapies to intranasal steroids to provide additional efficacy.
To determine whether the combination of fluticasone furoate and oxymetazoline is more efficacious than either agent alone, and to determine whether rhinitis medicamentosa develops after treatment.
We performed a double-blind, double-dummy, randomized, placebo-controlled parallel study.

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Oct
2010

Rhinitis medicamentosa occurs with repeated and prolonged use of topical decongestants. The resultant reduced ability to respond to decongestants mediated via enlarged capillary endothelial gaps can lead to profuse bleeding during turbinate surgery. We recommend that patients with rhinitis medicamentosa be weaned off topical decongestants prior to elective turbinate surgery to minimize this complication.

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Mar
2010

Drug-induced rhinitis.

Clin Exp Allergy 2010 Mar;40(3):381-4
M Varghese, M C Glaum, R F Lockey
Rhinitis is characterized by inflammation of the mucous membranes lining the nose and can be divided into two categories, allergic and non-allergic. Drug-induced is a type of non-allergic rhinitis.
A review of the literature was conducted.

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Apr
2010

Common cold is one of the most prevalent conditions that family doctors encounter. One of the first symptoms to occur is nasal congestion, which can have a negative impact on daily life and prompts many patients to seek treatment for relief. Xylometazoline nasal spray (Otrivin*) is a topical decongestant that has been used successfully for many years and is generally recognized as an effective and safe therapy.

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Dec
1969

The aim of this study was to investigate the frequency of rhinitis medicamentosa (RM) in patients attending the ENT outpatient clinic of the General Hospital of Rethymnon (Crete, Greece) before and after the launch of an intensive nasal decongestant advertising campaign in Greece.
We reviewed the medical records of the patients with RM seen at the ENT outpatient clinic in May, June and July of 2003 and 2006. We analyzed and recorded the gender, age, and related clinical information of the patients with RM.

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May
2009

Inflammatory processes play a central role in the pathogenesis of chronic rhinosinusitis (CRS), however, the impact of apoptosis in CRS in unclear. The aim of this study was a comparison of caspase 3 activity, a key enzyme in the apoptosis cascade, in samples of nasal tissue from patients with different types of rhinosinusitis.
Immunohistochemical analyses were carried out to detect caspase 3 in samples of nasal tissue from patients with CRS and nasal polyps (NP), allergic rhinitis (AR), rhinitis medicamentosa (RM) and atrophic rhinitis.

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Jun
2009

Many patients have nasal syndromes that are nonallergic and noninfectious and not caused by mechanical or anatomic abnormalities. There are at least 8 recognized nonallergic rhinitis syndromes: drug-induced rhinitis including rhinitis medicamentosa, gustatory rhinitis, hormonally induced rhinitis including the rhinitis of pregnancy, nonallergic rhinitis with eosinophilia syndrome, senile rhinitis, atrophic rhinitis, cerebral spinal fluid leak, and vasomotor rhinitis. Few studies have explored etiologic causes.

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May
2009

Rhinitis medicamentosa: what an otolaryngologist needs to know.

Eur Arch Otorhinolaryngol 2009 May 19;266(5):623-5. Epub 2008 Dec 19.
Jayesh Doshi
Rhinitis medicamentosa (RM) is a drug induced non-allergic rhinitis associated with prolonged use of topical nasal decongestants. This review discusses the nasal mucosa microcirculation, basic pharmacology of topical decongestants and the theories of the pathophysiology of RM. Diagnostic problems are discussed in addition to the current opinion on how to treat RM.

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May
2009

The purpose of this study was to evaluate long-term outcomes of an outpatient-based diode laser inferior turbinate reduction (ITR) in therapy-refractory rhinitis medicamentosa (RM).
In a prospective clinical investigation, 42 consecutive RM patients underwent videoendoscopic ITR with a diode laser after topical anesthetic preparation. Intra- and perioperative details were recorded including the occurrence of bleeding, crusting, pain, or discomfort.

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Dec
2007

Rhinitis of allergic and viral origin is often self-treated by patients with locally applied vasoconstrictor decongestant drugs. In turn, prolonged use of these agents produce an inflammatory condition termed rhinitis medicamentosa. Cationic drugs are sequestered into cells via various mechanisms, including mitochondrial concentration and V-ATPase-driven trapping in vacuoles that swell by an osmotic mechanism.

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Jan
2007

Prolonged application of nasal vasoconstrictors causes rhinitis medicamentosa (RM). Nasal obstruction is induced by rebound swelling when the decongestive effect has disappeared. The aim of this study was to demonstrate ultrastructural changes in RM.

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Dec
1969

Rhinitis medicamentosa.

Clin Allergy Immunol 2007 ;19:295-304
Peter M Graf

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Nov
2006

Rhinitis medicamentosa and the stuffy nose.

J Allergy Clin Immunol 2006 Nov 24;118(5):1017-8. Epub 2006 Jul 24.
Richard F Lockey

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Nov
2006

Nasal decongestants are the most powerful drugs in the reduction of nasal obstruction. Despite their large use, local and systemic adverse reactions are frequent. The authors focus on the pharmacology of these kinds of drugs in light of the most recent knowledge on nasal pathophysiology.

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Jun
2006

Nasal septal perforation is a rarely reported complication of rhinitis medicamentosa. We describe such a complication in a 54-year-old man, and we discuss the clinical, pathologic, and imaging aspects of this case.

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Dec
1969

Rhinitis medicamentosa.

J Investig Allergol Clin Immunol 2006 ;16(3):148-55
J T Ramey, E Bailen, R F Lockey
Rhinitis medicamentosa (RM) is a condition induced by overuse of nasal decongestants. The term RM, also called rebound or chemical rhinitis, is also used to describe the adverse nasal congestion that develops after using medications other than topical decongestants. Such medications include oral beta-adrenoceptor antagonists, antipsychotics, oral contraceptives, and antihypertensives.

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May
2006

Allergic rhinitis, the most common type of rhinitis, generally can be differentiated from the numerous types of nonallergic rhinitis through a thorough history and physical examination. Allergic rhinitis may be seasonal, perennial, or occupational. The most common cause of nonallergic rhinitis is acute viral infection.

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Oct
2006

Long-term abuse of decongestive nasal drops causes rhinitis medicamentosa due to cytotoxic and ciliary-toxic effects. Nasal obstruction is caused by rebound swelling when the decongestive effect has disappeared. The patient starts using nasal drops more frequently as a result of tachyphylaxis.

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Jan
2006

To review the literature on postnasal drip syndrome (PNDS)-induced cough and the various causes of PNDS. Hereafter, PNDS will be referred to as upper airway cough syndrome (UACS).
MEDLINE search (through May 2004) for studies published in the English language since 1980 on human subjects using the medical subject heading terms "cough," "causes of cough," "etiology of cough," "postnasal drip," "allergic rhinitis," "vasomotor rhinitis," and "chronic sinusitis.

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Dec
2005

Thirty-six persistent allergic rhinitis (PAR) sufferers were studied, to both compare and correlate 15 minute response to nasal xylometazoline (XYLO) with 28 day response to nasal mometasone furoate (MF). 0.1% XYLO (1 spray each nostril) response was measured on two occasions, then a randomised double blind cross-over comparison of MF (200 mcg daily) to placebo conducted.

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Sep
2005

Long term use of topical vasoconstrictors for the nose may result in rhinitis medicamentosa, the rebound swelling of the nasal mucosa. Usually discovery of any underlying reason for decongestant use is impossible, therefore treatment could be problematic. The aim of this study was to establish the nasal mucosal cytology of patients with rhinitis medicamentosa and evaluation of usefulness of exfoliative cytology in diagnostics of underlying reason of nasal decongestants overuse.

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Jul
2005

Pregnancy rhinitis is a common condition that is not yet fully recognized by the public. This form of rhinitis affects approximately one in five pregnant women, can start in almost any gestational week, and disappears after delivery. However, as it reduces quality of life, and also possibly affects the fetus, treatment is often required.

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Apr
2005

We aimed to investigate, histopathologic changes in the nasal mucosa of guinea pig's after prolonged administration of oxymetazoline and the development of rhinitis medicamentosa, and the efficacy of mometasone furoate aqueous nasal spray and saline in reversing the ultrastructural changes attributable to rhinitis medicamentosa.
In the study, 24 male guinea pigs (500 to 600 gr) were used. Oxymetazolin (0.

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Dec
1969

Rhinitis medicamentosa (RM) is a drug-induced, nonallergic form of rhinitis that is associated with prolonged use of topical vasoconstrictors, i.e. local decongestants.

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Dec
1969

Rhinitis medicamentosa ("nose-drop-nose") is a term used for pathological condition of the nasal mucous membrane that results from long-term abuse with intranasal vasoconstrictors. The aim of this work was to examine what lead the patients with nosedropnose rhinitis to the initial usage of intranasal vasoactive drugs. In this prospective study, 92 patients with rhinitis medicamentosa were included.

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Jun
2004

Pregnancy rhinitis is a very common condition. Defined as "nasal congestion present during the last 6 or more weeks of pregnancy without other signs of respiratory tract infection, and with no known allergic cause, disappearing completely within 2 wk after delivery," it strikes one in five pregnant women, and it starts in almost any gestational week. The pathogenesis is not clear, but placental growth hormone is suggested to be involved.

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Feb
2004

Mucosal changes in rhinitis medicamentosa.

Ann Otol Rhinol Laryngol 2004 Feb;113(2):147-51
Chun-Yu Lin, Po-Hsu Cheng, Sheen-Yie Fang
To evaluate the nasal mucosal changes in rhinitis medicamentosa (RM), especially those related to goblet cells and subepithelial glands, we studied specimens of the inferior turbinate mucosa from 8 patients with RM, 8 patients with chronic hypertrophic rhinitis (CHR), and 5 patients with normal nasal mucosa. All specimens were assessed by electron microscopy and immunohistochemical study. Under a scanning electron microscope, hyperplasia of goblet cells was most prominent in the RM group, and an increased number of gland openings was evident in the RM and CHR groups.

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Jan
2004

For most multiuse aqueous nasal, ophthalmic, and otic products, benzalkonium chloride (BKC) is the preservative of choice. The American College of Toxicology has concluded that BKC can be safely used as an antimicrobial agent at concentrations up to 0.1%.

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Dec
1969

Pregnancy rhinitis is defined as nasal congestion in the last 6 or more weeks of pregnancy, without other signs of respiratory tract infection and with no known allergic cause, with complete resolution of symptoms within 2 weeks after delivery. Pregnancy rhinitis occurs in approximately one-fifth of pregnancies, can appear at almost any gestational week, and affects the woman and possibly also the fetus. The pathogenesis of pregnancy rhinitis is not clear, but placental growth hormone is suggested to be involved.

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Mar
2001

To investigate the functional and morphological characteristics of cells in allergic rhinitis (AR) guinea-pigs with Cold or Heat Syndrome.
The Cold Syndrome or Heat Syndrome guinea-pig model was made, and then reformed into AR model or rhinitis medicamentosa (RM) model by using nose drops of 10% toluene di-isocyanate (TDI) or 0.1% naphazoline hydrochloride.

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Dec
2002

Pregnancy rhinitis and rhinitis medicamentosa.

J Am Acad Nurse Pract 2002 Dec;14(12):527-30
Betty Rambur
To present guidelines for the recognition, management, and referral of pregnancy rhinitis with a goal of improving the quality of the pregnancy experience for women afflicted with this condition.
A case study illustrating the presentation of a severe case of pregnancy rhinitis is followed a literature review of etiology, diagnosis, and management strategies.
Pregnancy rhinitis is a condition of clinical importance that is frequently exacerbated by use of intranasal decongestant sprays.

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Dec
1999

[The rebound of nasal resistance after decongestant used in nose].

Lin Chuang Er Bi Yan Hou Ke Za Zhi 1999 Dec;13(12):560-1
J Shen, X Huang, J Xiang, H Shu
To investigate the effect of decongestant on nasal resistance so as to provide theories for studing rhinitis medicamentosa.
The changes of nasal blockage in 92 cases of acute rhinitis and chronic rhinitis after using decongestants were recorded, and the nasal resistance in 39 cases were measured by active anterior rhinomanometry.
According to the diseases and decongestants used, the percentage of nasal resistance rebound were 63.

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Dec
2001

Epinephrine and lidocaine have been used for the diagnosis and treatment of nasal diseases. However, watery rhinorrhea and frequent sneezing occur in many patients after topical application of these drugs to the nasal mucosa. This study was aimed at characterizing these side effects, and developing a means to prevent such side effects.

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Sep
2001

Recent studies have suggested that benzalkonium chloride (BKC), an antimicrobial agent used as a preservative in nasal sprays, lacks deleterious effects on the nasal ciliated epithelium. Other data, including recent in vivo findings, suggest that BKC may, in fact, produce adverse clinical effects on human nasal tissue, including the aggravation of rhinitis medicamentosa. Toxic effects have also been reported.

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