Dysbarism Medication

Updated: Sep 13, 2017
  • Author: Stephen A Pulley, DO, MS, FACOEP; Chief Editor: Joe Alcock, MD, MS  more...
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Medication

Medication Summary

Inpatient and outpatient medications may include topical and systemic decongestants (eg, pseudoephedrine) and analgesics (eg, acetaminophen, ibuprofen, narcotics) if needed.

If bleeding or evidence of effusion is present, an appropriate antibiotic should be prescribed (eg, amoxicillin, erythromycin, trimethoprim/sulfamethoxazole [TMP/SMZ], or hydrocortisone-neomycin-polymyxin topical [Cortisporin otic] if the tympanic membrane is intact).

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Decongestants

Class Summary

By promoting nasal or sinus drainage, these agents may prevent ear discomfort. However, their exact mechanism of action is not yet understood.

Pseudoephedrine (Actifed, Sudafed)

Pseudoephedrine stimulates vasoconstriction by directly activating alpha-adrenergic receptors of respiratory mucosa, which may improve sinus drainage.

Oxymetazoline hydrochloride 0.05% nasal spray (Afrin, Sinarest, Allerest)

Oxymetazoline hydrochloride 0.05% nasal spray stimulates alpha-adrenergic receptors and causes vasoconstriction when applied directly to mucous membranes. Decongestion occurs without drastic changes in blood pressure (BP), vascular redistribution, or cardiac stimulation.

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Bronchodilators

Class Summary

These agents act to decrease muscle tone in both the small and large airways in the lungs, thereby increasing ventilation.

Ipratropium bromide nasal spray (Atrovent)

Ipratropium bromide is chemically related to atropine. It has antisecretory properties, and when applied locally, inhibits secretions from serous and seromucous glands lining nasal mucosa.

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Corticosteroids, Intranasal

Class Summary

These agents have anti-inflammatory properties and cause profound and varied metabolic effects. In addition, these agents modify the body's immune response to diverse stimuli.

Beclomethasone, intranasal (Beconase AQ, QNASL)

Beclomethasone intranasal inhibits bronchoconstriction mechanisms, produces direct smooth muscle relaxation, may decrease number and activity of inflammatory cells, and may decrease airway hyperresponsiveness.

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Antiplatelet agents

Class Summary

Because dysbaric illness has the potential for activation of coagulation factors, as discussed in the article on DCS, therapy aimed at mitigating this effect may be helpful. Guidance should be obtained from either a diving medicine or HBO specialist.

Aspirin (Anacin, Ascriptin, Bayer Aspirin)

Aspirin blocks prostaglandin synthetase action, which, in turn, inhibits prostaglandin synthesis and prevents formation of platelet-aggregating thromboxane A2. It acts on hypothalamus heat-regulating center to reduce fever.

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