Pharmacological background to decongesting and anti-inflammatory treatment of rhinitis and sinusitis

A review is given of the literature concerning effects of oral and topical decongestants and anti-inflammatory drugs in rhinitis and sinusitis. Oral vasoconstrictors, effective in decongesting the nasal mucosa, need to be taken in doses that may induce disturbing systemic side-effects. Nonsteroidal anti-inflammatory drugs (NSAIDs) have weak effects in allergic rhinitis as compared with glucocorticosteroids. No controlled clinical trials of systemic glucocorticosteroids in sinusitis have been published. Four studies in which different glucocorticosteroids were administered topically for sinusitis have been performed, but these gave very weak support for any positive effects of such a treatment.