Rhinitis medicamentosa is a specific complication of prolonged use of which type of nasal preparation, and what is its pathophysiology?

• A Topical decongestants (alpha-adrenergic agonists); rebound vasodilatation from downregulation of alpha-adrenergic receptors ✓
• B Intranasal corticosteroids; adrenal axis suppression
• C Intranasal antihistamines; mucosal atrophy
• D Saline nasal sprays; disruption of mucociliary clearance

Explanation

Rhinitis medicamentosa is caused by prolonged use (>3–5 days) of topical nasal decongestants containing alpha-adrenergic agonists (oxymetazoline, xylometazoline). Chronic receptor stimulation leads to downregulation and desensitisation of alpha-1 and alpha-2 adrenoreceptors, causing rebound vasodilatation and nasal congestion when the drug wears off, creating a vicious cycle. Treatment involves gradual withdrawal, intranasal corticosteroids to reduce rebound, and patient education. Intranasal corticosteroids are safe for long-term use without this complication.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.