Steroid nasal spray ear infection

In patients where the nasal polyps do not seem to respond to the above protocol (or if patient is refusing surgery), the addition of a very strong drug called Zyflo (zileuton) may be of benefit. This drug can cause liver damage (in <10% of patients) and as such, liver function bloodwork (AST/ALT) is required every month for 3 months and yearly thereafter. As long as the AST/ALT numbers do not exceed 150 (yes, it is higher than what is considered normal), it is generally considered safe to continue with this drug (though would check bloodwork weekly if that happens to ensure stability). Getting an immunologist involved in the care of such patients would also be beneficial, especially for those patients where the nasal polyps are particularly resistant to standard treatment.

Steroid nasal sprays rarely cause side-effects. This is because they are applied directly to the nose and very little of this medicine is absorbed into the body. Therefore, they are much less likely to cause side-effects in other parts of the body. Occasionally, they cause dryness, crusting, and bleeding of the nose. If this occurs, stop it for a few days and then restart. There have been reports of nasal steroids possibly having an effect on behaviour, particularly in children. This is thought to be rare. However, a few people have reported hyperactivity, problems sleeping, anxiety, depression, and aggression.

The precise mechanism through which fluticasone propionate affects rhinitis symptoms is not known. Corticosteroids have been shown to have a wide range of effects on multiple cell types (., mast cells, eosinophils, neutrophils, macrophages, lymphocytes) and mediators (., histamine, eicosanoids, leukotrienes, cytokines) involved in inflammation. In 7 trials in adults, fluticasone propionate nasal spray has decreased nasal mucosal eosinophils in 66% of patients (35% for placebo) and basophils in 39% of patients (28% for placebo). The direct relationship of these findings to long-term symptom relief is not known.

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Steroid nasal spray ear infection

steroid nasal spray ear infection

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