Oxymetazoline

Class Decongestant
Chemistry

Imidazoline derivative

Routes of administration

intranasal

Absorption

Almost 100% bioavailability

Solubility

pKa = 10.15, good water solubility

Distribution

VOD= 19L/kg, 56% protein-bound

Metabolism

Minimally metabolised

Elimination

Mostly eliminated renally

Time course of action

Half-life is 5 hours

Target receptor

Alpha-1 and alpha-2 noradrenaline receptors

Mechanism of action

Imidazoline-derived alpha agonists have a direct vasoconstrictor effect via alpha-1 receptors, and an indirect sympatholytic effect via alpha-2 agonism which is only observed in overdose, when these agents cross the blood brain barrier

Clinical effects

Increased peripheral resistance, increased afterload, increased blood pressure; redistribution of blood flow from splanchnic circulation and skeletal muscle. Sedation, bradycardia and hypotension in overdose

Literature reference

Khan et al, 1999

CICM details of understanding Not specifically listed in the CICM syllabus
Mentioned around Deranged Physiology
Related SAQs