{"id":1428,"date":"2021-11-29T20:48:11","date_gmt":"2021-11-29T19:48:11","guid":{"rendered":"https:\/\/sfrms-app.fr\/?p=1428"},"modified":"2022-10-17T09:01:52","modified_gmt":"2022-10-17T07:01:52","slug":"les-traitements-par-voie-nasale","status":"publish","type":"post","link":"https:\/\/sfrms-app.fr\/index.php\/2021\/11\/29\/les-traitements-par-voie-nasale\/","title":{"rendered":"Les traitements par voie nasale"},"content":{"rendered":"<h2><span style=\"font-size: 14pt;\">Mode d&rsquo;action<\/span><\/h2>\n<ul>\n<li>Les traitements par voie nasale utilis&eacute;s en m&eacute;decine du <a href=\"https:\/\/sfrms-app.fr\/index.php\/glossary\/sommeil\/\" title=\"Glossary: Sommeil\"  class=\"glossaryLink\">sommeil<\/a> agissent en diminuant l&rsquo;inflammation locale et\/ou la r&eacute;activit&eacute; de la muqueuse nasale, permettant la d&eacute;sobstruction nasale et rhinopharyng&eacute;e.<\/li>\n<li>Il s&rsquo;agit de traitement dont la voie d&rsquo;administration est nasale.<\/li>\n<li>Les principales classes de traitement par voie nasale utilis&eacute;es sont :\n<ul>\n<li><strong>Les glucocortico&iuml;des<\/strong>, avec notamment :\n<ul>\n<li>Le beclom&eacute;thasone &ndash; RHINOMAXIL&reg;,<\/li>\n<li>Le bud&eacute;sonide &ndash; RHINOCORT&reg;.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Les associations glucocortico&iuml;des et anti-histaminiques H1<\/strong>, avec notamment :\n<ul>\n<li>L&rsquo;az&eacute;lastine &amp; le fluticasone &ndash; DYMISTA&reg;.<\/li>\n<\/ul>\n<\/li>\n<li><strong>Les anti-histaminiques H1<\/strong>, avec notamment :\n<ul>\n<li>L&rsquo;az&eacute;lastine &ndash; ALLERGODIL&reg;.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>Les vasoconstricteurs par voie nasale sont &agrave; &eacute;viter.<\/li>\n<\/ul>\n<h2><span style=\"font-size: 14pt;\">Indications<\/span><\/h2>\n<p>Mauvaise <a href=\"https:\/\/sfrms-app.fr\/index.php\/glossary\/tolerance\/\" title=\"Glossary: Tol&eacute;rance\"  class=\"glossaryLink\">tol&eacute;rance<\/a> nasale de la PPC (cf. Fiche : <a href=\"https:\/\/sfrms-app.fr\/index.php\/2021\/11\/28\/pression-positive-continue-ppc\/\"><strong>PPC<\/strong><\/a>) associ&eacute;e &agrave; une <strong>rhinite de type hyper r&eacute;active (allergique ou non)<\/strong> en l&rsquo;absence d&rsquo;anomalie septale et\/ou turbinale.<\/p>\n<h2><span style=\"font-size: 14pt;\">Contre-indications<\/span><\/h2>\n<p>Pas de contre-indication absolue<\/p>\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"366\" height=\"511\" src=\"https:\/\/sfrms-app.fr\/wp-content\/uploads\/2021\/11\/Capture-41.png\" alt=\"\" class=\"wp-image-1430\" srcset=\"https:\/\/sfrms-app.fr\/wp-content\/uploads\/2021\/11\/Capture-41.png 366w, https:\/\/sfrms-app.fr\/wp-content\/uploads\/2021\/11\/Capture-41-215x300.png 215w\" sizes=\"auto, (max-width: 366px) 100vw, 366px\"\/><\/figure>\n<\/div>\n\n\n<h2 class=\"wp-block-heading\">Bilan pr&eacute; th&eacute;rapeutique<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>Rechercher une muqueuse inflammatoire de la fosse nasale par <strong>rhinoscopie ant&eacute;rieure.<\/strong><\/li><li>Rechercher des signes en faveur du caract&egrave;re allergique.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">R&egrave;gles de prescription<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>Type de traitement par voie nasale<ul><li><strong>Glucocortico&iuml;des si rhinite non allergique,<\/strong><\/li><li><strong>Association glucocortico&iuml;des et anti-histaminiques si rhinite allergique.<\/strong><\/li><\/ul><\/li><li>Une pulv&eacute;risation dans chaque narine matin et soir.<\/li><li>Associ&eacute; &agrave; un lavage de nez pr&eacute;alable par solution iso-osmotique quotidien.<\/li><li>Modalit&eacute; des pulv&eacute;risations<ul><li>Flacon vertical,<\/li><li>T&ecirc;te pench&eacute;e l&eacute;g&egrave;rement en avant,<\/li><li>Pulv&eacute;risation sans inspiration,<\/li><li>Laisser couler l&rsquo;exc&egrave;dent vers l&rsquo;avant (ne pas d&eacute;glutir).<\/li><\/ul><\/li><li>Dur&eacute;e de prescription<ul><li>La dur&eacute;e d&eacute;pend de la symptomatologie.<\/li><li>Il s&rsquo;agit de rechercher <strong>une dose minimale efficace<\/strong> :<ul><li>Diminuer progressivement,<\/li><li>Reprendre si r&eacute;apparition des sympt&ocirc;mes.<\/li><\/ul><\/li><\/ul><\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Surveillance des effets ind&eacute;sirables<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>&Agrave; court terme : &eacute;pistaxis, rhinite cro&ucirc;teuse, irritation, s&eacute;cheresse nasale.<\/li><li>&Agrave; long terme : aucun, si modalit&eacute;s de pulv&eacute;risation respect&eacute;es pour &eacute;viter les effets syst&eacute;miques.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Suivi d&rsquo;efficacit&eacute;<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>Si effets ind&eacute;sirables &agrave; court terme : fen&ecirc;tre <a href=\"https:\/\/sfrms-app.fr\/index.php\/glossary\/therapeutique\/\" title=\"Glossary: Th&eacute;rapeutique\" class=\"glossaryLink\">th&eacute;rapeutique<\/a> d&rsquo;une semaine, et si nouvelle <a href=\"https:\/\/sfrms-app.fr\/index.php\/glossary\/recidive\/\" title=\"Glossary: R&eacute;cidive\"  class=\"glossaryLink\">r&eacute;cidive<\/a> d&rsquo;effets ind&eacute;sirables : anti-histaminiques H1.<\/li><li>Si &eacute;chec de traitement et persistance de sympt&ocirc;mes nasaux : examen ORL sp&eacute;cialis&eacute; avec <strong>naso-fibroscopie<\/strong> pour rechercher une anomalie obstruant les fosses nasales :<ul><li>Anomalie septale et turbinale,<\/li><li>Pathologie tumorale polypeuse ou non.<\/li><\/ul><\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Mode d&rsquo;action Les traitements par voie nasale utilis&eacute;s en m&eacute;decine du sommeil agissent en diminuant l&rsquo;inflammation locale et\/ou la r&eacute;activit&eacute; de la muqueuse nasale, permettant la d&eacute;sobstruction nasale et rhinopharyng&eacute;e. Il s&rsquo;agit de traitement dont la voie d&rsquo;administration est nasale. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":4061,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12,29],"tags":[],"class_list":["post-1428","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-traitement","category-traitements-des-troubles-respiratoires-du-sommeil"],"featured_image_src":"https:\/\/sfrms-app.fr\/wp-content\/uploads\/2021\/11\/UTwTq5an_normal.png","blog_images":{"medium":"https:\/\/sfrms-app.fr\/wp-content\/uploads\/2021\/11\/UTwTq5an_normal.png","large":"https:\/\/sfrms-app.fr\/wp-content\/uploads\/2021\/11\/UTwTq5an_normal.png"},"_links":{"self":[{"href":"https:\/\/sfrms-app.fr\/index.php\/wp-json\/wp\/v2\/posts\/1428","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sfrms-app.fr\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/sfrms-app.fr\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/sfrms-app.fr\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/sfrms-app.fr\/index.php\/wp-json\/wp\/v2\/comments?post=1428"}],"version-history":[{"count":8,"href":"https:\/\/sfrms-app.fr\/index.php\/wp-json\/wp\/v2\/posts\/1428\/revisions"}],"predecessor-version":[{"id":4086,"href":"https:\/\/sfrms-app.fr\/index.php\/wp-json\/wp\/v2\/posts\/1428\/revisions\/4086"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/sfrms-app.fr\/index.php\/wp-json\/wp\/v2\/media\/4061"}],"wp:attachment":[{"href":"https:\/\/sfrms-app.fr\/index.php\/wp-json\/wp\/v2\/media?parent=1428"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/sfrms-app.fr\/index.php\/wp-json\/wp\/v2\/categories?post=1428"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/sfrms-app.fr\/index.php\/wp-json\/wp\/v2\/tags?post=1428"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}