View source for Nasal, decongestant, and anaphylaxis agents

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''Nursing pharmacology study reference (NCLEX-style monograph). Numeric values are standard teaching ranges for study and '''must be verified against current manufacturer labeling before clinical use'''. This is educational content, not prescribing guidance.''
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'''Nasal, decongestant, and anaphylaxis agents''' (brand names Afrin, EpiPen) &mdash; Allergy and ENT agents; Intranasal corticosteroids, intranasal antihistamine, oral and topical decongestants, adrenergic agonist (epinephrine), mast cell stabilizer (cromolyn).

== Identification ==
* '''Therapeutic class:''' Allergy and ENT agents.
* '''Pharmacologic class:''' Intranasal corticosteroids, intranasal antihistamine, oral and topical decongestants, adrenergic agonist (epinephrine), mast cell stabilizer (cromolyn).

== Pharmacology ==
* '''Mechanism of action:''' Reduce nasal inflammation (steroids), block histamine (azelastine), constrict nasal vessels (decongestants), reverse anaphylaxis (epinephrine), or stabilize mast cells (cromolyn).
* '''Onset / peak / duration:''' Intranasal steroids build over days; decongestants and epinephrine act quickly.
* '''Half-life / therapeutic level:''' Varies; no routine level.

== Clinical use ==
* '''Indications:''' Allergic rhinitis (steroids, azelastine, cromolyn), nasal congestion (decongestants), anaphylaxis (epinephrine).
* '''Usual dose, route, frequency:''' Intranasal sprays daily; pseudoephedrine PO; oxymetazoline nasal short term; epinephrine IM for anaphylaxis.
* '''Maximum dose / adjustments:''' Oxymetazoline limited to 3 days (rebound congestion); pseudoephedrine caution with hypertension.

== Safety ==
* '''Contraindications:''' Decongestants in uncontrolled hypertension, severe coronary disease; with MAO inhibitors.
* '''Black box warning:''' None for these.
* '''Interactions:''' Decongestants with MAO inhibitors (hypertensive crisis) and other stimulants; epinephrine with beta blockers (blunted response).
* '''Pregnancy / lactation:''' Use intranasal steroids and epinephrine when needed.
* '''High-alert:''' No.

== Adverse effects ==
* '''Common side effects:''' Nasal irritation and epistaxis (steroids), bitter taste (azelastine), insomnia and elevated blood pressure (decongestants).
* '''Serious effects to report:''' Rebound congestion (oxymetazoline overuse), severe hypertension (decongestants), epinephrine cardiac effects.
* '''Antidote / reversal:''' Supportive care.

== Nursing process ==
* '''Assessment before administration:''' Allergy symptoms, blood pressure (decongestants), anaphylaxis assessment (epinephrine).
* '''Interventions during therapy:''' For anaphylaxis, give epinephrine IM in the lateral thigh immediately and call emergency services; aim nasal sprays away from the septum.
* '''Monitor:''' Symptom relief, blood pressure (decongestants), response to epinephrine.
* '''Evaluation / expected outcome:''' Reduced allergy symptoms or reversed anaphylaxis.

== Patient teaching ==
* '''Patient teaching:''' Nasal steroids take days and may cause nosebleeds (aim away from the septum); do not use Afrin more than 3 days; carry and know how to use the epinephrine autoinjector and seek emergency care after using it.
* '''Notify provider if:''' Severe nosebleeds, palpitations or high blood pressure, any anaphylaxis (after using epinephrine, still seek emergency care).
* '''Administration tips:''' Epinephrine IM lateral thigh for anaphylaxis; oxymetazoline short term only.

[[Category:Nasal Agents, Decongestants, and Anaphylaxis]]