Drug Uses
Flonase can relieve multiple nasal symptoms of congestion, sneezing, and itchy, runny nose. Flonase Nasal Spray is for topical administration to the nasal mucosa by means of a metering, atomizing spray pump.
How Taken
To get the best results with Flonase, you should use it regularly, as prescribed by your doctor, since its effectiveness depends on regular use. Because Flonase helps relieve inflammation, once you begin treatment you should use it once a day, every day as directed by your healthcare professional. The recommended starting dosage in adults is 2 sprays (50 mcg of Flonase Nasal Spray propionate each) in each nostril once daily (total daily dose, 200 mcg). The same dosage divided into 100 mcg given twice daily (e.g., 8 a.m. and 8 p.m.) is also effective. After the first few days, patients may be able to reduce their dosage to 100 mcg (1 spray in each nostril) once daily for maintenance therapy. Some patients (12 years of age and older) with seasonal allergic rhinitis may find as-needed use of 200 mcg once daily effective for symptom control. Greater symptom control may be achieved with scheduled regular use.
Warnings/Precautions
Before using this medication, tell your doctor if you have a viral, bacterial, or fungal infection of any kind. The absorption of this drug into your system can inhibit your body's ability to fight off infections. You may not be able to use Flonase Nasal Spray nasal if you have an infection.
Flonase Nasal Spray is in the FDA pregnancy category C. This means that it is not known whether Flonase Nasal Spray nasal will harm an unborn baby. Do not use this medication without first talking to your doctor if you are pregnant.
It is not known whether Flonase Nasal Spray passes into breast milk. Do not use Flonase Nasal Spray nasal without first talking to your doctor if you are breast-feeding a baby.
Flonase Nasal Spray nasal is not approved for use by children younger than 4 years of age.
Missed Dose
Use the missed dose as soon as remembered unless it is almost time for the next dose. If so, skip the missed dose and resume your regular dosing schedule. Do not "double-up" the doses to catch up.
Possible Side Effects
Serious side effects from Flonase Nasal Spray nasal are not likely to occur. Stop using Flonase Nasal Spray nasal and seek emergency medical attention if you experience an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives).
Other, less serious side effects may be more likely to occur. Continue to use Flonase Nasal Spray nasal and talk to your doctor if you experience stinging or burning of the nose; sneezing after application; yeast infection in the nose or throat (white patches); bleeding nose; perforated septum (inside left of nose); increased pressure in the eyes, glaucoma, or tearing of the eyes; headache or lightheadedness; nausea; cough; asthma symptoms; nasal stuffiness or a runny nose; or unpleasant (or loss of) taste or smell.
Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.
Storage
Store between 4° and 30°C (39° and 86°F). Keep your nasal spray out of the reach of children. Do not use your Flonase Nasal Spray after the date shown as "EXP" on the label or box.
Overdose
An overdose of this medication is not likely to occur. If you do think that an overdose has occurred, call an emergency room or poison control center.
More Information
Avoid items or activities that you know are allergens for you if they make your symptoms worse. Clean areas where dust or pet fur may aggravate your condition.
Avoid exposing yourself to known sources of infection. Stay away from people with chicken pox, measles, or any other type of infection. Your immune system may not be strong enough to fight off an infection while you are using Flonase Nasal Spray nasal.
Disclaimer
This drug information is for your information purposes only, it is not intended that this information covers all uses, directions, drug interactions, precautions, or adverse effects of your medication. This is only general information, and should not be relied on for any purpose. It should not be construed as containing specific instructions for any particular patient. We disclaim all responsibility for the accuracy and reliability of this information, and/or any consequences arising from the use of this information, including damage or adverse consequences to persons or property, however such damages or consequences arise. No warranty, either expressed or implied, is made in regards to this information.
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Sinusitis refers to inflammation of the sinuses. This is generally caused by a viral, bacterial, or fungal infection.
The sinuses are air-filled spaces in the skull (behind the forehead, cheeks, and eyes) that are lined with mucous membranes. Healthy sinuses are sterile (meaning that they contain no bacteria or other organisms) and open, allowing mucus to drain and air to circulate.
When inflamed, the sinuses become blocked with mucus and can become infected. Each year, over 30 million adults and children get sinusitis.
Sinusitis can be acute (lasting anywhere from 2 - 8 weeks) or chronic, with symptoms lingering much longer.
See also chronic sinusitis.
Alternative Names
Acute sinusitis; Sinus infection; Sinusitis - acute
Causes, incidence, and risk factors
Sinusitis can occur from one of these conditions:
* The small openings (ostia) from the sinuses to the nose become blocked
* Small hairs (cilia) in the sinuses, which help move mucus out, are not working properly
* Too much mucus is produced
When the sinus openings become blocked and mucus accumulates, this becomes a great breeding ground for bacteria and other organisms.
Sinusitis usually follows respiratory infections, such as colds, or an allergic reaction. Some people never get sinusitis, and others develop sinusitis frequently.
People more likely to get frequent sinusitis include those with cystic fibrosis and those with immune systems weakened by HIV or chemotherapy.
Other risks for developing sinusitis include:
* Having asthma
* Overusing nasal decongestants (rather than continuing to relieve congestion, the problem gets worse when these are used too often or for too long)
* Having a deviated nasal septum, nasal bone spur, or polyp
* Having a foreign body in your nose
* Frequent swimming or diving
* Dental work
* Pregnancy
* Changes in altitude (flying or scuba diving)
* Air pollution and smoke
* Gastroesophageal reflux disease (GERD)
* Hospitalization, especially if you are in the hospital because of a head injury or have had a tube placed into your nose (nasogastric tube)
Cystic fibrosis is one of a number of diseases that prevent the cilia from working properly. Other such diseases that put you at increased risk for sinusitis include Kartagener's syndrome and immotile cilia syndrome.
Symptoms
The classic symptoms of acute sinusitis usually follow a cold that does not improve, or one that worsens after 5 - 7 days of symptoms. They include:
* Nasal congestion and discharge
* Sore throat and postnasal drip (fluid dripping down the back of your throat, especially at night or when you lie down)
* Headache -- pressure-like pain, pain behind the eyes, toothache, or facial tenderness
* Cough, often worse at night
* Fever (may be present)
* Bad breath or loss of smell
* Fatigue and generally not feeling well
Symptoms of chronic sinusitis are the same as acute sinusitis, but tend to be milder and last longer than 8 weeks.
Signs and tests
Your doctor will test for sinusitis by:
* Tapping over a sinus area. Tenderness may indicate infection.
* Shining a light against the sinus (called transillumination). If dark, this indicates possible inflammation.
Other tests that might be considered include:
* Viewing the sinuses through a fiberoptic scope
* X-ray of the sinuses
* Cultures of the material from the nose
However, these tests are relatively insensitive for detecting sinusitis, and are often considered unnecessary.
A CT scan of the sinuses is a much better test to help diagnose sinusitis. If sinusitis is thought to involve tumor or fungal infections, an MRI of the sinuses may be necessary.
If you have chronic or recurrent sinusitis, further laboratory evaluation may be necessary to look for an underlying disorder. This may involve sweat chloride tests for cystic fibrosis, ciliary function tests, blood tests for HIV or other tests for immunodeficiency, allergy testing, or nasal cytology (checking the cells in the nasal secretions).
Treatment
Try the following measures to help reduce congestion in your sinuses:
* Use a humidifier.
* Spray with nasal saline several times per day.
* Inhale steam 2 - 4 times per day (for example, sitting in the bathroom with the shower running).
* Drink plenty of fluids to thin the mucus.
* Apply a warm, moist wash cloth to your face several times a day.
Be careful with over-the-counter spray nasal decongestants. They may help initially, but using them beyond 3 - 5 days can actually worsen nasal congestion.
Also, for sinus pain or pressure:
* Avoid temperature extremes, sudden changes in temperature, and bending forward with your head down.
* Try acetaminophen or ibuprofen.
* Avoid flying when you are congested.
If self-care measures are not working, your doctor will consider prescription medications, antibiotics, further testing, or referral to an ear, nose, and throat (ENT) specialist.
Nasal corticosteroid sprays may be used to decrease swelling, especially if you have swollen structures (such as nasal polyps) or allergies. These include fluticasone (Flonase), mometasone (Nasonex), and triamcinolone (Nasacort AQ).
Antibiotics are used to cure the particular infection causing sinus inflammation. Common antibiotics include ampicillin, amoxicillin, trimethoprim with sulfamethoxazole (Bactrim), Augmentin, cefuroxime, and cefprozil.
Other antibiotics may be used depending on the type of organism present. Acute sinusitis should be treated for 10 - 14 days, while chronic sinusitis should be treated for 3 - 4 weeks.
Surgery to clean and drain the sinuses may also be necessary, especially in patients with recurrent episodes of inflammation despite medical treatment. An ENT specialist, also known as an otolaryngologist, can perform this surgery.
Most fungal sinus infections require surgery. Finally, surgical repair of a deviated septum or nasal polyps may prevent recurrence.
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