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Nasal decongestant
Nasal congestion
Caused by vasodilatation Reduce smell acuity
Nasal decongestant
Sympathomimetic
ex. PPA=phenyl-propanol-amine, etc
Loss of acuity occurs primarily by drug inactivation of receptor function through inhibition of tastant/odorant receptor: binding; Gs protein function; inositol trisphosphate function; channel (Ca++,Na++) activity; other receptor inhibiting effects; or some combination of these effects
Distortions occur primarily by a drug inducing abnormal persistence of receptor activity (i.e. normal receptor inactivation does not occur) or through failure to activate: various receptor kinases; Gi protein function; cytochrome P450 enzymes; or other effects which usually
turn off receptor function; inactivate tastant/odorant receptor binding; or some combination of these effects.
Treatment which inhibits sensory distortions requires : reactivation of biochemical inhibition at the receptor or inactivation of inappropriate stimulus receptor binding and/or correction of other steps initiating pathology including
dopaminergic antagonists, gamma-aminobutyric acid (GABA)-ergic agonists, calcium channel blockers and some orally active local anaesthetic, antiarrhythmic drugs.
SMELL
Smell
Olfactory disorders
ANOSMIA
HYPOSMIA
HYPEROSMIA enhanced smell sensitivity distortion in odour perception DYSOSMIA (includes parosmia & phantosmia) distortion of perception of PAROSMIA external stimulus smell perception with no external PHANTOSMIA stimulus
% patients
19* 17* 16* 17 5 5 2 1 9 6 1
Zicam-induced hyposmia
Zicam is a zinc containing drug. Zicam is an over the counter drug used as a nasal spray to relieve symptoms associated with colds and influenza. While zinc is critical for maintenance of normal smell function through its action as a cofactor in carbonic anhydrase VI, given directly into the nostrils at high concentrations, it can initiate direct toxic destruction of the olfactory epithelium with which it comes into contact in its spray form. The associated nasal burning is another manifestation of this local toxicity.
Treatment
Systemic corticosteroids are potent antiinflammatory substances that act by reducing the nasal mucous membrane, allowing the odorant to reach the olfactory neuroepithelium Intranasal topical corticosteroids are a reasonable alternative.
Taste
Taste bud receptors detect gustatory stimuli. Receptors signal the five qualities of taste (humans): sweet, salty, sour, bitter, umami (savory). Taste buds are located on several kinds of papillae on the tongue and in the pharynx and larynx. Taste buds contain chemoreceptor cells arranged around a taste pore. These cells are innervated by taste afferent fibers of cranial nerves VII, IX, X. Taste fibers synapse in the nucleus of the solitary tract. Higher pathways differ in different species, but typically include thalamus, cortex, vomiting centers.
Taste Sensations
Aversive Tastes
(5) Bitter (6) Sour
Orosensation (trigeminal)
Energy Tastes
(7) Fatty acid taste?
Heat Taste
(8) Vanilloid receptor
Saltiness
Salt-sensitive taste cells
Special Na+ selective channel
Sourness
Sourness- acidity low pH Protons causative agents of acidity and sourness
Bitter, Sweet, Umami G-protein coupled receptor Activates Phospholipase C Increases messenger inositol triphosphate (IP3) Ca2+
Taste Disorders
Hypoguesia decreased taste sensation Ageusia absence of the taste sensation Caused by
head injuries, damage to glossopharyngeal and facial nerves.
Taste Disorders
A large number of substances and disease processes may impact the sense of taste. Toxic substances may cause taste dysfunction from their effects on the gustatory system from the salivary gland, to the taste bud, to the central neural pathways. A number of external toxins, including industrial compounds, tobacco, and alcohol, may adversely affect taste, most commonly through local effects in the oral cavity. Blood-borne toxins, such as medications and those present in autoimmune and other systemic disorders (e.g. renal or liver failure), have access to all parts of the gustatory system, and thus may exhibit varied effects on taste function.
Garlic aroma
Plain MSG