Summary
Although nasal airways flow/resistance (R n) measurements distinguish drug-induced changes in nasal patency better than investigator observations, it has not been shown that these alterations reflect useful clinical effects. Forty-eight patients with elevatedR n values from colds were studied for their responses to 10.0, 15.0 and 25.0 mg single doses of phenylephrine, and to placebo, given orally in a double-blind crossover protocol. Nasal flow/resistance was determined by electronic posterior rhinometry, and subjective estimates of nasal congestion using a five-ranked scale, before and over 120 min after, therapy each day. The meanR n changes observed for all three drug doses were significantly better than those following placebo at 14 of 15 time periods, with like significance for the mean subjective scores. Mean per cent changes inR n separated the effects of 25.0 mg from 10.0 and 15.0 mg doses of phenylephrine, and distinguished all three active tablet doses from placebo, whereas the subjective estimates could only differentiate the three phenylephrine doses from placebo, but not from one another. While these data confirm the sharp ranking of nasal decongestant potency possible withR n recording, contrasted with more blurred patient impressions, they suggest that statistically valid changes in nasal airways flow/resistance commonly imply favorable clinical activity as well as increased nasal passage patency.
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Read at the Fifth International Congress on Pharmacology, San Francisco, California, July 23–28, 1972.
Associate Professor of Clinical Medicine, The New Jersey College of Medicine and Dentistry; Attending Physician, Elizabeth General Hospital.
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Cohen, B.M. Clinical and physiologic “significance” of drug-induced changes in nasal flow/resistance. Eur J Clin Pharmacol 5, 81–86 (1972). https://doi.org/10.1007/BF00561750
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DOI: https://doi.org/10.1007/BF00561750