ABSTRACT

Topical nasal decongestants have a long history of use. In the early 1900s, the substances were mainly derived from ephedrine. During the 1940s, nose-drop abuse was reported in a few studies and, in 1945 some authors found that rebound swelling developed after long-term use of topical vasoconstrictors (1). The substances used at that time had both a-and b-receptor activity as well as an indirect action because of the release of noradrenaline from the nerve terminals. In the 1960s, the modern vasoconstrictors, xylo-and oxymetazoline, were synthesized from the imidazole, naphazoline. They acted directly on the a-adrenoreceptors and were not thought to induce rebound swelling to the same extent as the earlier vasoconstrictors. Many studies of the effectiveness of modern vasoconstrictors were performed. Few studies, however, were made on the long-term effects of the drugs, and the results of these studies were contradictory.