Because of the inhibitory effect of corticosteroids on wound healing, a nasal corticosteroid should be used with caution in patients who have experienced recent nasal septal ulcers, recurrent epistaxis, nasal surgery or trauma, until healing has occurred. Although systemic corticoid effects typical of Cushing's syndrome are minimal with recommended doses of topical steroids, this potential increases with excessive doses. If recommended doses are exceeded with long-term use, or if individuals are particularly sensitive, symptoms of hypercorticism could occur including suppression of hypothalamic-pituitary-adrenal function and/or retardation of growth in pediatric patients. Therefore, larger than recommended doses of NASAREL should be avoided.
Patients should take the medication as directed and should not exceed the prescribed dosage. The patient should contact the physician if symptoms do not improve after two weeks, or if the condition worsens. Patients who experience recurrent episodes of epistaxis (nosebleeds) or nasal septum discomfort while taking this medication should contact their physician. For proper use of RHINOCORT AQUA (budesonide) Nasal Spray and to attain maximum improvement, the patient should read and follow the accompanying patient information carefully. Do not use RHINOCORT AQUA (budesonide) Nasal Spray after the labeled number of sprays have been used (does not include priming) or after the expiration date shown on the carton or bottle label.
At the Everest base camp medical clinic, conditions are cold and hostile, nearly every case is urgent, and routine treatment we rely on in urban hospital environments is sometimes impossible to carry out. Having the ability to administer medications intranasally, obviating the need for IV access (and thawing out of our IV fluids!) can be not only an easier and timelier solution, but downright lifesaving! In our recent 2008 season, our staff had the opportunity to treat a brisk nosebleed patient by administering intranasal oxymetazoline and lidocaine to facilitate insertion of a posterior packing device. We have our nasal drug delivery systems at the ready to administer midazolam, metoclopramide, glucagon, naloxone and opiates if the need arises as well... Luanne Freer, MD - Medical Director of Everest Base camp, Medical Director Yellowstone .