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Komplikationen und Nebenwirkungen bei konservativer Therapie rhinologischer Erkrankungen

Complications and side effects of conservative treatment of rhinological diseases

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Zusammenfassung

Hintergrund

Die Gruppe der rhinologischen Erkrankungen ist vielfältig, so auch ihre medikamentöse Therapie. Es sind allein 1272 Präparate in der ATC-Gruppe (anatomisch-therapeutisch-chemische Klassifikation) mit einer R01-Codierung (Rhinologika) gelistet. Die konservative Therapie der rhinologischen Erkrankungen beinhaltet zusätzlich die systemische – meist orale – Anwendung von Kortikosteroiden, Antibiotika und Immunmodulatoren.

Ziel der Arbeit

Dargestellt werden die Komplikationen der im klinischen Alltag gebräuchlichen Medikamente (unterteilt in ihre Wirkstoffklassen), die zur Therapie rhinologischer Erkrankungen eingesetzt werden. Insbesondere werden nützliche Behandlungs- bzw. Präventionsmaßnahmen vorgestellt.

Material und Methoden

Auf der Basis der Fachinformationen der Medikamente der ATC-Codes der R01-Gruppe sowie der Literaturrecherche in den Datenbanken PubMed, der Cochrane Library und MEDLINE werden Medikamente, die bei rhinologischen Erkrankungen eingesetzt werden, auf ihre Nebenwirkungen und deren Häufigkeit hin untersucht.

Ergebnisse

Intranasal applizierte Medikamente können insbesondere lokale Irritation, Brennen, Trockenheit und Epistaxis verursachen. Oral oder intravenös verabreichte rhinologische Medikamente können zu Nebenwirkungen der unterschiedlichen Organsysteme, u. a. Herzrhythmusstörungen oder Blutbildveränderungen, führen. Bei der Medikamentenverordnung wird die patientenspezifische Auswahl des Therapeutikums und die individualisierte Aufklärung des Patienten empfohlen.

Schlussfolgerung

Insbesondere für Kinder, stillende Mütter und Schwangere sollte die Indikation aller Rhinologika streng geprüft werden. Da eine Vielzahl von Rhinologika zur Verfügung steht, sollte unter Berücksichtigung des Nebenwirkungsprofils die optimale individuelle Therapie ausgewählt werden.

Abstract

Background

The spectrum of rhinological diseases is wide, as is that of their drug-based treatment. Only 1272 compounds coded R01 (nasal preparations) are listed in the ATC group (Anatomical Therapeutic Chemical Classification). Conservative therapy of rhinological diseases additionally includes systemic (often oral) application of corticosteroids, antibiotics and immunomodulators.

Objective

The aim of this paper is to outline possible complications of medication (subdivided into classes of ingredients) commonly used to treat rhinological diseases in hospitals. Useful therapeutic and preventive measures will be presented.

Materials and methods

Based on the expert information in the current pharmacological drug index (ATC) for the R01 group as well as literature research in the PubMed, Cochrane Library and MEDLINE databases, medication used for the treatment of rhinological diseases was analysed in terms of side effects and their frequency.

Results

Common side effects of intranasally applied medication are local irritations, burning, dryness and epistaxis. Orally or intravenously applied rhinological medication can affect the organs and lead to side effects such as cardiac dysrhythmia or alterations of the blood count. It is recommended that the therapeutic be selected on an individual basis and that the patient be thoroughly informed about possible side effects.

Conclusion

Particularly when treating children or pregnant or breastfeeding women, the indications of all nasal preparations should be checked carefully. The huge variety of rhinologicals enables an optimal individual selection on the basis of consideration of known side effects.

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Authors and Affiliations

  1. Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Münster, Kardinal-von-Galen-Ring 10, 48155, Münster, Deutschland

    I. Küster, C. Rudack & A. Beule

  2. Klinik und Poliklinik für Hals-Nasen-Ohrenkrankheiten, Kopf- und Halschirurgie, Universitätsmedizin Greifswald, Sauerbruchstraße, 17475, Greifswald, Deutschland

    A. Beule

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Interessenkonflikt

I. Küster, C. Rudack und A. Beule geben an, dass kein Interessenkonflikt besteht. Die Autoren erklären ihre wirtschaftliche Unabhängigkeit bei der Erstellung des Artikels.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren. Alle Patienten, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts zu identifizieren sind, haben hierzu ihre schriftliche Einwilligung gegeben. Im Fall von nichtmündigen Patienten liegt die Einwilligung eines Erziehungsberechtigten oder des gesetzlich bestellten Betreuers vor.

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Zusatzmaterial: Rhinologika und ihre Komplikationen. Nach Wirkstoffklasse geordnete Übersicht der gebräuchlichen Rhinologika mit Nebenwirkungsprofil entsprechend den Angaben der Gelben Liste

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Küster, I., Rudack, C. & Beule, A. Komplikationen und Nebenwirkungen bei konservativer Therapie rhinologischer Erkrankungen. HNO 66, 419–431 (2018). https://doi.org/10.1007/s00106-018-0513-6

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