Jones N S, Quraishi S, Mason J D
Dept of Otorhinolaryngology, University Hospital, Nottingham, UK.
Int J Clin Pract. 1997 Jul-Aug;51(5):308-11.
Systemic drugs are increasingly being administered intranasally. We highlight the potential problems and the effect of nasal pathology on absorption and bioavailability. There is insufficient information to evaluate the effect of these factors on therapeutic effectiveness. However, there is evidence that nasal pathology can influence mucociliary clearance and absorption, so the prescriber should recognise and consider the effect of any intranasal pathology. We suggest that, until the effects of these factors are quantified, patients who are about to embark on long-term intranasal medication should have a rhinological assessment, particularly if they have any nasal symptoms. By doing this, factors that may cause reduced bioavailability can be identified. It would also prevent pre-existing mucosal changes being wrongly attributed to nasal drugs.
全身用药越来越多地通过鼻腔给药。我们强调了潜在问题以及鼻腔病理状况对吸收和生物利用度的影响。目前尚无足够信息来评估这些因素对治疗效果的影响。然而，有证据表明鼻腔病理状况会影响黏液纤毛清除和吸收，因此开处方者应认识并考虑任何鼻腔病理状况的影响。我们建议，在这些因素的影响被量化之前，即将开始长期鼻腔用药的患者应进行鼻科评估，尤其是那些有任何鼻部症状的患者。这样做可以识别可能导致生物利用度降低的因素。这也能防止将预先存在的黏膜变化错误地归因于鼻腔药物。
