Saluran pernapasan dibagi menjadi daerah : jalan nafas nasofaring ( saluran pernapasan atas ) dan tracheobronchial dan saluran

udara paru ( saluran pernapasan bagian bawah ) . Anterior sepertiga dari rongga hidung dilihat dalam penampang mengungkapkan septum tengah membagi dua rongga . Daerah ini , termasuk bagian proksimal turbinat rendah dan menengah , non - bersilia ( Gambar 13.1 ) . The meatuses adalah ruang yang dibentuk oleh lipatan dua turbinates rendah dan menengah . Dalam posterior dua pertiga dari rongga hidung , pembersihan partikel diendapkan terjadi dengan lambat penyebaran lapisan lendir ke daerah bersilia sepanjang meatuses rendah dan menengah , diikuti oleh clearance mukosiliar lebih cepat ke nasofaring dari mana mereka tertelan ( Mygind 1979) . Fungsi hidung baik sebagai lorong untuk pergerakan udara ke dalam pernapasan saluran dan sebagai " pendingin " dengan menyaring polusi lingkungan dan pemanasan dan hu midifying udara . Partikel besar terperangkap dalam filter hidung menjalani clearance yang relatif cepat ( menit dibandingkan dengan jam atau minggu untuk bronki dan alveoli , espectively ) . Di wilayah ante rior dari hidung ( sekitar 1,5 cm di dari nares ) , saluran udara yang tercekat di setiap sisi untuk luas penampang hanya sekitar 30 sampai 40 mm 2 di lokasi katup hidung ( Proctor 1982) . Selanjutnya , aliran udara mengalami perubahan bergolak tajam dalam Director, tion hampir 90 setelah masuk ke turbinates.In vitro menggunakan cetakan dari hidung manusia , dan in vivo pada manusia menggunakan gamma skintigrafi dalam kondisi pernapasan alami , telah menunjukkan bahwa partikel disampaikan oleh perangkat semprot intranasal disimpan di daerah anterior dari rongga hidung terutama antara katup hidung dan bersilia epithe - lium ( turbinates frontal ) ( Kim et al 1985; . Hallworth dan Padfield 1986; Newman et al.1987a ) . Partikel dampak ke lapisan lendir yang menutupi permukaan , yang mendasari yang ada lapisan sel epitel bersilia mengalahkan menuju faring . Situs deposisi partikel dan tingkat clearance merupakan kepentingan utama untuk obat sengau diberikan yang bertindak lo otomatis. Partikel ? 5-10 ? M dengan diameter ( khas semprotan intranasal ) tidak menembus pul - monary saluran udara , tetapi cenderung untuk deposit pada situs impaksi mereka dalam saluran pernapasan bagian atas . Partikel ? 5 ? M dianggap sebagai terhirup dan disimpan di dalam paru-paru . ? Partikel 1 m yang terhirup jauh ke dalam saluran udara paru , tetapi menjalani sedikit gravitasi set- tling dan kemungkinan akan dihembuskan tanpa deposisi selama pernapasan tidal normal ( Bates et al 1966; . Otak dan Valberg 1979) . Untuk penyerapan hidung baik obat terjadi , dosis harus dicapai di wilayah di atas tingkat langit-langit hidung . Wilayah di bawah ini ( efektif " anterior " daerah terlihat dari rongga hidung luar) menunjukkan penyerapan yang buruk . Pengetahuan tentang anatomi hidung dan pentingnya ukuran partikel pada deposisi telah memungkinkan produsen perangkat hidung untuk merancang sistem pengiriman mereka sesuai. Hal ini dibahas lebih lanjut dalam bagian "Device Seleksi Pertimbangan " .

Kebanyakan sediaan berbentuk larutan dan diberikan sebagai obat tetes hidung atau obat semprot (sprays); beberapa sediaan terdapat pula dalam bentuk jeli. Beberapa contoh produk yang sudah beredar dipasaran dapat dilihat pada tabel dibawah ini. Nama Produk Nama Produsen Bahan Aktif Penggunaan /

indikasi Afrin nasal Spray, Afrin Nose Drops Beconase AQ Nasal Spray Glaxo Smith Kline Schering - plough Ozymetazole HCl 0.05% Beclometasone dipropionate 0.042% Adrenergic. decongestant Syntetic corticosteroid for relief of seasonal, perennial allergic, vasommotor rhinitis Diapid Nasal Spray Sandoz Lopressin 0.185 mg/mL Antidiuretic, control, prevention of diabetes insipidus of deficiency of endogenous posterir pituitary antidiuretic hormone. Nasalcrom Nasal Spray Nasalide Nasal Solution Neo-Synephrine Nose Drops, Spray Neo-Synephrine Maximum Strength 12 Hour Ocean Mist Fleming Sodium chloride 0.65% Restore moisture, relieve dry, crusted, inflamed nasal membranes Pivine HCl Nasal Solution Syntocinon Nasal Spray Sandoz Novartis Naphazoline HCl 0.05% Oxytocin 40U/ml Adrenergic, decongestant Synthetic oxytocin for initial milk let-down preparatory to breast feeding Tyzine Pediatric Nose Drops Key Tetrahydrozoline HCl (0.05%) Adrenergic, decongestant Sanofi Winthrop Sanofi Winthrop Phenylephrine HCl 0.125 to 1.0% Ozymetazoline HCl 0.05% Dura Flunisolide 0.025% Pharmaci & Upjohn Cromolyn sodium 4% Prevention and treatment of symtoms of allergic rhinitis Symptoms of seasonal or perennial rhinitis Adrenergic, decongestant Adrenergic, decongestant

Afrin Adult Drop 10 Ml

Oksimetazolin HCl. Generik : Oksimetazolin Hcl.

Hidung tersumbat. Pengobatan dan pencegahan infeksi telinga tengah. Memudahkan pemeriksaan intranasal. Persiapan operasi.
1

Harga Eceran Rp. 81.100 / Botol Botol

Harga Murah Rp. 73.100 / Botol

1

Botol

Kontra Indikasi
Idiosinkrasi terhadap simpatomimetik, hipertiroidisme, hipertensi, penyakit koroner.

Efek Samping
Adakalanya timbul rasa panas di hidung atau tenggorokan, iritasi lokal, mual, sakit kepala, mukosa hidung kering. Hidung tersumbat kembali terjadi/kambuh (pada penggunaan jangka panjang). Kesulitan bernapas, kolaps pada bayi.

Dosis
2 kali sehari 2-3 tetes pada masing-masing lubang hidung

Kemasan
Tetes hidung 0,05 % x 10 mL. Brand:: Product Code:: Komposisi: Indikasi: Dosis: Kontra Indikasi: Perhatian: Efek Samping: Interaksi Obat: Kemasan: Schering-Plough W Oxymetazoline HCl Pengobatan hidung tersumbat. Pengobatan dan pencegahan infeksi telinga tengah. Pemeriksaan intranasal di klinik. Sebelum operasi 2 kali sehari 2-3 tetes Hipersensitif, hipertiroidisme, hipertensi, penyakit jantung, anak <6 tahun Penderita dalam terapi dengan MAOI, penggunaan jangka panjang, penyakit jantung, DM Rasa terbakar pada hidung/tenggorokan, iritasi lokal, mual, sakit kepala, mukosa hidung kering. Kongesti nasal (penggunaan jangka lama). Apnu dan kolaps tiba-tiba pada bayi MAOI, antihipertensi Tetes hidung dewasa 0.05% x 10 mL x 1

Rx Only DESCRIPTION Tyzine Nasal Solution contains tetrahydrozoline hydrochloride, 2-(1,2,3,4-Tetrahydro1, naphthyl)-2-imidazoline monohydrochloride, as a nasal decongestant. The chemical structure is:

Nasal Solution is available for topical nasal application as 0.1% nasal solution and as 0.05% pediatric nasal drops. The nasal solution is a solution of tetrahydrozoline hydrochloride in water, with sodium chloride, sodium citrate, edetate disodium, and benzalkonium chloride, with hydrochloric acid to adjust to the pH. CLINICAL PHARMACOLOGY Tyzine Nasal Solution (tetrahydrozoline hydrochloride), a sympathomimetic amine, possesses vasoconstrictor and decongestant actions when applied to nasal mucosa, resulting in vasoconstriction of the smaller arterioles of the nasal passages. Information on the absorption, distribution and elimination of the drug is not available. INDICATIONS AND USAGE Tyzine Nasal Solution is indicated for decongestion of nasal and nasopharyngeal mucosa. CONTRAINDICATIONS Tyzine Nasal Solution is contraindicated for patients who have shown previous hypersensitivity to its components. The 0.1% solution is contraindicated in children under six years of age. Tyzine Nasal Solution is not to be used for infants under two years of age. Tyzine Pediatric Nasal Drops (0.05%) should be used for children

between the ages of 2 and 6 years (See "Dosage and Administration"). Tyzine Nasal Solution should not be used by patients under treatment with Monoamine Oxidase (MAO) Inhibitors. WARNINGS Overdose in children may produce profound sedation. This may be accompanied by profuse sweating, hypotension or even shock (See "Overdosage"). General Avoid doses greater or more frequent than those recommended below. Excessive dosage in children may, on rare occasions, cause severe drowsiness. Profuse sweating may accompany this effect. Overdosage may also cause marked hypotension or even shock. Use cautiously in patients with cardiovascular disease (e.g., coronary artery disease, hypertension), and metabolic-endocrine diseases (e.g., hyperthyroidism, diabetes). Information for Patients Patients should be advised to follow the prescribed dosage regimen. The spray should be administered with the head held upright. To spray, squeeze bottle quickly and firmly and sniff briskly. Instillation of the nose drops can be most conveniently accomplished with the patient in the lateral head-low position. Drug Interactions
DRUG EFFECT

Monoamine Oxidase Hypertension (MAO) Inhibitors

Pregnancy Pregnancy Category C Animal reproduction studies have not been conducted with Tyzine. It is also not known whether Tyzine Nasal Solution can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Tyzine Nasal Solution should be given to a pregnant woman only if clearly needed. Nursing Mothers It is not known whether this drug is secreted in human milk. Because many drugs are secreted in human milk, caution should be exercised when TyzineNasal Solution is administered to a nursing woman. ADVERSE REACTIONS Local application of Tyzine Nasal Solution can be associated with burning, stinging, sneezing or dryness of the mucosa. Occasionally, systemic sympathomimetic effects can occur, including headaches, drowsiness, weakness, tremors, light-headedness, insomnia, and palpitations. Rebound congestion can also occur, and is characterized by chronic swelling of the nasal mucosa resulting in chronic redness, swelling and rhinitis. If adverse reactions occur, discontinue use. OVERDOSAGE The administration or ingestion of overdoses of Tyzine (tetrahydrozoline hydrochloride) Nasal Solution may result in oversedation in young children. Overdoses have caused hypertension, bradycardia, drowsiness and rebound hypotension in adults; a shock-like syndrome with hypotension and bradycardia may also occur. In either case, the treatment of overdosage is usually that of watchful expectancy and general supportive measures. The patient should be kept warm, fluid balance should be maintained orally, if possible, and parenterally, if necessary.

If the respiratory rate drops to 10 or below, the patient should be given oxygen, and respiration assisted. Blood pressure should be watched carefully to prevent a hypotensive crisis. There is no known antidote for Tyzine Nasal Solution. The use of stimulants is contraindicated. To date, we have had no report of fatalities resulting from overdosages of Tyzine Nasal Solution and while the symptoms resulting from Tyzine Nasal Solution overdosage may be alarming, they are self-limiting and the patient recovers with no sequelae. DOSAGE AND ADMINISTRATION Adults and Children 6 Years and Over Tyzine 0.1% Nasal Solution It is recommended that 2 to 4 drops of Tyzine 0.1% Nasal Solution be instilled in each nostril as needed, never more often than every three hours. Less frequent administration is usually sufficient since relief is maintained for four hours or longer in most cases, and often for as long as eight hours. Bedtime instillation usually assures sleep undisturbed by the need for remedication before morning, or by insomnia from central stimulation. Tyzine 0.1% Nasal Spray It is recommended to squeeze quickly and firmly three or four times Tyzine 0.1% Nasal Spray in each nostril as needed, never more often than every three hours. Less frequent administration is usually sufficient since relief is maintained for four hours or longer in most cases, and often for as long as eight hours. Bedtime instillation usually assures sleep undisturbed by the need for remedication before morning, or by insomnia from central stimulation.

Children 2 to 6 Years of Age Tyzine 0.05 % Pediatric Nasal Drops Note: Do not use Tyzine 0.1% Nasal Solution or Tyzine 0.1% Nasal Spray It is recommended that 2 to 3 drops of Tyzine 0.05% Pediatric Nasal Drops be instilled in each nostril as needed, and never more often than every three hours. Relief usually lasts for several hours, so that instillation is usually needed only every four to six hours. Instillation of nose drops can be most conveniently accomplished with the patient in the lateral head-low position. HOW SUPPLIED Tyzine Nasal Solution (0.1%) is available in: 30 mL bottles - NDC 0482-4760-30 15 mL Nasal Spray Bottles- NDC 0482-4760-15 Tyzine Pediatric Nasal Drops (0.05%) is available in: 15 mL bottles - NDC 0482-4770-15 Recommended Storage Store below 86F (30C). Rx Only Mfd. for: KENWOOD THERAPEUTICS A dIVISION OF BRADLEY PHARMACEUTICALS Inc. Fairfield, New Jersey 07004-2402 www.bradpharm.com By Denison Pharmaceuticals, Inc. Pawtucket, Rhode Island 02862

Copyright 2000 Kenwood Therapeutics Revised 4/99 IL062-R2 PACKAGE LABEL PRINCIPAL DISPLAY PANEL 15mL Container NDC 0482-4770-15 Rx Only PEDIATRIC NASAL DROPS TYZINE (tetrahydrozoline hydrochloride) 0.05% SOLUTION 15 mL (1/2 FL. OZ.) KENWOOD THERAPEUTICS

PACKAGE LABEL PRINCIPAL DISPLAY PANEL 15mL Carton NDC 0482-4770-15 Rx Only

PEDIATRIC NASAL DROPS TYZINE (tetrahydrozoline hydrochloride) 0.05% SOLUTION 15 mL (1/2 FL. OZ.) KENWOOD THERAPEUTICS KENWOOD THERAPEUTICS

PACKAGE LABEL PRINCIPAL DISPLAY PANEL 15mL Container NDC 0482-4760-15 Rx Only NASAL SPRAY TYZINE (tetrahydrozoline hydrochloride) 0.1% SOLUTION 15 mL (1/2 FL. OZ.) KENWOOD THERAPEUTICS

PACKAGE LABEL PRINCIPAL DISPLAY PANEL 15mL Carton NDC 0482-4760-15 Rx Only NASAL SPRAY TYZINE

(tetrahydrozoline hydrochloride) 0.1% SOLUTION 15 mL (1/2 FL. OZ.) KENWOOD THERAPEUTICS

NEO-SYNEPHRINE Mild Formula, Regular Strength, Extra Strength (Bayer Healthcare)

Active Ingredients:
Neo-Synephrine Extra Strength Drops Neo-Synephrine Extra Strength Spray Active Ingredient: Purpose: Phenylephrine Hydrochloride 1.0% .............. Nasal decongestant Neo-Synephrine Regular Strength Drops Neo-Synephrine Regular Strength Spray Active Ingredient: Purpose: Phenylephrine Hydrochloride 0.5% .............. Nasal decongestant Neo-Synephrine Mild Formula Spray Active Ingredient: Purpose:

Phenylephrine Hydrochloride 0.25% ............ Nasal decongestant Uses: Temporarily relieves nasal congestion:

due to common cold due to hay fever or other respiratory allergies (allergic rhinitis) associated with sinusitis Temporarily relieves stuffy nose. Helps clear nasal passages; shrinks swollen membranes. Temporarily restores freer breathing through the nose. Helps decongest sinus openings and passages; temporarily relieves sinus congestion and pressure.

Warnings:
Ask a doctor before use if you have

heart disease high blood pressure thyroid disease diabetes difficulty in urination due to enlargement of the prostate gland

When using this product

do not exceed recommended dosage

do not use more than 3 days. Frequent or prolonged use may cause nasal congestion to recur or worsen. temporary discomfort may occur such as burning, stinging, sneezing and increase in nasal discharge use by more than one person may spread infection.

Stop use and ask a doctor if symptoms persist more than 3 days. If pregnant or breast-feeding, ask a health professional before use. Keep out of reach of children. If swallowed, get medical help or contact a Poison Control Center right away. Directions: use as directed. Neo-Synephrine Extra Strength Drops Neo-Synephrine Regular Strength Drops

Adults and children 12 years of age and over

2 or 3 drops in each nostril not more often than every 4 hours. Ask a doctor.

Children under 12 years

Neo-Synephrine Extra Strength Spray Neo-Synephrine Regular Strength Spray To spray, squeeze bottle quickly and firmly.

Adults and children 12 years of age and over

2 or 3 sprays in each nostril not more often than every 4 hours. Ask a doctor.

Children under 12 years

Neo-Synephrine Mild Formula Spray To spray, squeeze bottle quickly and firmly.

Adults and children 6 to under 12 years of age (with 2 or 3 sprays in each nostril not more often than adult supervision) every 4 hours. Children under 6 years
Other Information:

Ask a doctor.

Store at room temperature.

Protect from light.

Inactive Ingredients: benzalkonium chloride, citric acid, sodium chloride, sodium citrate, water

How Supplied:
Neo-Synephrine Regular Strength Drops; Neo-Synephrine Extra Strength Drops: 15 mL (0.5%). DO NOT USE IF IMPRINTED BOTTLE OVERWRAP IS BROKEN OR MISSING. Neo-Synephrine Regular Strength Spray; Neo-Synephrine Extra Strength Spray: 15 mL (1.0%). USE ONLY IF NECKBAND PRINTED WITH "Bayer" IS INTACT. Neo-Synephrine Mild Formula Spray: 15 mL (0.25%). USE ONLY IF NECKBAND PRINTED WITH "Bayer" IS INTACT. Questions or comments? 1-800-331-4536 or www.bayercare.com

PRODUCT PHOTO(S):
NOTE: These photos can be used only for identification by shape, color, and imprint. They do not depict actual or relative size. The product samples shown here have been supplied by the manufacturer. While every effort has been made to assure accurate reproduction, please remember that any visual identification should be considered preliminary. In cases of poisoning or suspected overdosage, the drug's identity should be verified by chemical analysis.

Active ingredient

Purpose

Phenylephrine Hydrochloride USP 0.125%...................Nasal Decongestant Uses

temporarily relieves nasal congestion, due to common cold, hay fever, or other upper respiratory allergies helps clear nasal passages; shrinks swollen membranes temporarily restores freer breathing through the nose helps decongest sinus openings and passages; temporarily relieves sinus congestion and pressure

Warnings

do not exceed recommended dosage do not use with any other products containing decongestants

Ask a doctor before use if the child has

heart disease high blood pressure thyroid disease diabetes

When using this product temporary discomfort may occur such as:

burning stinging sneezing increase in nasal discharge the use of this dispenser by more than one person may spread infection

Stop use and ask a doctor if

nervousness, dizziness, or sleeplessness occurs symptoms persist. Do not use for more than 3 days. Use only as directed. Frequent or prolonged use may cause nasal congestion to recur or worsen.

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center right away. Directions (Nasal use only)

children 2 to under 6 years (with adult supervision): 2 to 3 drops into each nostril, not more often than every 4 hours children under 2 years of age: Consult a physician

Other information

do not use if solution is brown or contains a precipitate protect from light store at 20-25oC (68-77oF)

see bottle or box for lot number and expiration date

Inactive ingredients Benzalkonium Chloride, Edetate Disodium, Glycerin, Polyethylene Glycol, Potassium Phosphate Monobasic, Purified Water, Sodium Phosphate Dibasic