Post-nasal drip (PND) is caused by excessive mucus production by the sinuses and results in a sensation of mucus accumulation in the throat or back of the nose. It can be caused by nasal or sinus infections, allergies or gastroesophageal reflux disease (GERD). A full physical evaluation for PND helps determine the cause of the condition to choose the correct medication.
Antihistamines
Antihistamines, including diphenhydramine (Benadryl) and loratadine (Claritin), inhibit the release of histamine that occurs with exposure to certain environmental allergens. They prevent the local inflammation that occurs as a result of the body's hypersensitivity to these allergens. As a result, less mucus is produced as the allergic response is suppressed.
Decongestants
Nasal decongestants come in two forms. Topical ones, such as oxymetazoline (Afrin) can be sprayed locally in the nose, while systemic medications, such as pseuroephedrine (Sudafed) are taken by mouth. Both types of medications work by stimulating an adrenergic response. They work by constricting the blood vessels in your nose and sinuses and decreasing the amount of mucus that you produce.
Nasal Irrigation
Nasal irrigation, typically done with an over-the-counter salt water solution, helps soothe your nasal passages by moistening the lining of the nose. It helps flush out the excess mucus and debris from the nose and sinuses. This is a very safe and benign treatment that can be beneficial for many causes of nasal irritation. Nasal irrigation can also sometimes refer to the use of saline nasal spray or nebulizers used to moisten the nose.
Nasal Steroid Sprays
PND is commonly caused by nasal allergies, and symptoms can be relieved by directly treating the local allergic response. Steroid sprays, such as fluticasone (Flonase), or mometasone (Nasonex), are applied directly to the nose and act to prevent irritation in the lining of the nose and sinuses. If your PND is caused by allergies, these drugs can be very effective, especially when combined with oral antihistamines. The side effects are rare and mild and include minor nasal irritation and mild nose bleeds.
References
- Papsin B, McTavish A (February 2003). "Saline nasal irrigation: Its role as an adjunct treatment". Can Fam Physician 49: 168--73.
- Orban NT, Saleh H,Durham SR. Allergic and non-allergic rhinitis. In: Adkinson NF Jr., Yunginger JW, Busse WW, Bochner BS, Holgate ST, eds. Middleton's Allergy: Principles and Practice. 6th ed. Philadelphia, Pa; Mosby Elsevier; 2003: chap 55.
- Rabago D, Pasic T, Zgierska A, Mundt M, Barrett B, Maberry R (July 2005). "The efficacy of hypertonic saline nasal irrigation for chronic sinonasal symptoms". Otolaryngol Head Neck Surg 133 (1): 3--8.
