Introduction 

For individuals to communicate effectively, vocal sound production is necessary, a small organ in the body, located in front of the neck contains a cord which aids in producing sounds, and breathing. This small organ is called the Larynx. 

Statistics have shown an incidence of 3.47 per 1000 people, and up to 21% of the population may develop laryngitis in their lifetime.¹

Some medications used can affect the larynx, the purpose of this article is to identify such medications and also discuss ways to ensure proper functioning of the larynx.

What is Laryngitis?

When the voice cord is swollen or infected, it causes the voice to be hoarse, which may temporarily lead to loss of voice. This process is called Laryngitis. It can either be;

• Acute laryngitis or
• Chronic laryngitis 

Acute laryngitis can either be infectious or non-infectious. Infectious acute laryngitis is related to viruses such as rhinovirus, and influenza virus, sometimes it could be a bacterial infection such as Haemophilus influenzae, streptococcus pneumoniae etc. while the Non- infectious laryngitis can be due to pollution in the environment, asthma, allergies, smoking and vocal misuse(such as yelling or shouting). vocal misuse can be seen mostly in athletes, singers and coaches.

Acute inflammation of the larynx can affect any age and it usually resolves within two (2) weeks.²

Chronic laryngitis occurs when the inflammation of the larynx has lasted more than three weeks, in this phase the individual struggles to produce sound.

Risk factors to Laryngitis

• Viral infection in the upper respiratory tract
• Medical diseases like gastroesophageal reflux (GERD), asthma
• Environmental factors like; smoking and pollution
• Medication like angiotensin-converting enzyme inhibitors(ACEI), decongestants, and antihistamines
• Voice straining during singing

The symptoms include; dry cough, loss of voice, dry throat, and sometimes difficulty in breathing.

Common medications and their effects on the throat

• Angiotensin-converting Enzyme inhibitors(ACEI): They are one of the classes of drugs used in treating hypertension. Severe dry cough is one of the side effects of this class of drug, continuous use can cause a strain on the voice, thereby leading to inflammation of the larynx³
• Non-steroidal anti-inflammatory drugs (NSAID): They are a class of pain-relief drugs that can worsen a disease condition known as Gastroesophageal reflux, causing acid reflux toward the oesophagus which can, in turn, affect the larynx⁴
• Anti-histamine: These are drugs that are used for allergic reactions, they could be sedative or non-sedative. It has anticholinergic properties, which cause fluid to dry up in the respiratory tract and could lead to hoarseness of the voice and then laryngitis
• Inhalers made with corticosteroids used by asthmatic patients can affect the larynx. Long-term administration can reduce the mast cells in the respiratory tract, hence affecting the larynx. Other examples include stimulants and caffeine

Decongestants and how it works?

They are drugs that prevent congestion in the nose. It would be used orally or as an intranasal spray.⁵

They work by constricting the blood vessels in the nasal region, reducing the volume of the nasal mucosa and opening clogged nasal passages.

Examples of these drugs include:

• Phenylephrine
• Ephedrine
• Pseudoephedrine
• Xylometazoline
• Oxymetazoline

Some of the common side effects of these drugs are;

• Anxiety
• Dry mouth
• Headaches

When a decongestant is used for more than 3 days it will cause a rebound congestion.

Impact of decongestant on the Larynx 

One of the side effects of this drug is drying of the throat, thereby reducing the mucus production which helps to keep the throat moist. when there is prolonged dryness due to the overuse of the drug, it can irritate the larynx, if the vocal cord is strained or inflamed, this could lead to laryngitis.

Management of Laryngitis caused by medication

• Use medication when necessary and at the right dose
• Take a lot of water to reduce the drying effect of the drug
• To keep the air moist, use a humidifier
• Use of alternatives to decongestant in severe cases
• In the case of underlying illness, consult a health practitioner
• Ensure proper resting of the voice especially when stressed¹

Conclusion

Laryngitis can result from overuse of decongestant or other medication, it is very important to use this medication appropriately and at the right dose. In severe cases, an alternative will be advised.

FAQ’s

Is laryngitis contagious?

 No, it’s not contagious because it is the inflammation of the larynx.

Are decongestants bad for a lost voice? 

Because of its drying ability when overused, it could have some effect on the voice.

What drugs make you lose your voice? 

Drugs like Antihistamine, ACEIs and decongestants.