A 31-Year-Old Man Comes to the Office Due to Persistent

A 31-year-old man comes to the office due to persistent nasal congestion and rhinorrhea.  The patient has a history of allergic rhinitis and recently moved across the country to start a new job.  His nasal symptoms worsened after the move, and he started using an over-the-counter intranasal decongestant spray that initially provided prompt relief.  However, after a few days, he had to increase the frequency and number of sprays per nostril needed for adequate symptom control.  On examination, the nasal turbinates are swollen and pale with a clear nasal discharge.  Which of the following mechanisms is most likely responsible for this patient's increased medication use?

A) Accelerated drug metabolism
B) Decreased receptor affinity
C) Depletion of receptor-associated G proteins
D) Increased receptor internalization
E) Reduced parasympathetic activity

Correct Answer:

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