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Precautions for the use of beta blockers (risk of discontinuation) Nevertheless, -blocker withdrawal in high-risk cardiovascular patients may trigger rebound hypertension, angina, or infarction, underscoring the need for gradual dose reduction 78

Considerations: Proper spray technique (appropriate angle, avoiding the septum) Alternating nostrils per dose Using a saline rinse periodically to support nasal mucosal health Discontinuation and route change if persistent irritation develops Patients with allergic rhinitis, chronic sinusitis, or significant septal deviation may be poor candidates for nasal delivery and should be considered for injection or oral spray instead

Jing T, Wei D, Xu X, et al

A., Salvin, E

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Gene and protein expression of key TCA enzymes is also reduced in these models, while milder impact models actually demonstrate a gradual increase in these enzymes as mice recover from impact [75]