Rhinitis medical therapy: Difference between revisions
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|Moderate | |Moderate | ||
|Intranasal corticosteroid (+/- nonsedating oral or intranasal antihistamine) | |Intranasal [[corticosteroid]] (+/- nonsedating oral or intranasal [[antihistamine]]) | ||
| rowspan="2" |Persistent/uncontrolled symptoms after 2-4weeks of treatment: | | rowspan="2" |Persistent/uncontrolled symptoms after 2-4weeks of treatment: | ||
* Increase dose of intranasal steroid | * Increase dose of intranasal steroid | ||
* Consider targeted medications such as Ipratoprium for rhinorrhea, short-term(not >5 days) intranasal decongestant for nasal obstruction | * Consider targeted medications such as [[Ipratoprium]] for rhinorrhea, short-term(not >5 days) intranasal decongestant for nasal obstruction | ||
* +/- short course of oral corticosteroids in patients who continue to have persistent, severe symptoms (especially when the nasal mucosa is | * +/- short course of oral [[corticosteroids]] in patients who continue to have persistent, severe symptoms (especially when very significant edema of the nasal mucosa is seen) | ||
Failure of medical therapy: | Failure of medical therapy: | ||
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|Severe | |Severe | ||
|Intranasal corticosteroid (+/- nonsedating oral or intranasal antihistamine) | |Intranasal [[corticosteroid]] (+/- nonsedating oral or intranasal [[antihistamine]]) | ||
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'''Other Medications''' | '''Other Medications''' | ||
Revision as of 21:19, 24 January 2017
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Rhinitis Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Fatimo Biobaku M.B.B.S [2]
Overview
Rhinitis is a heterogegeous disorder that is often undertreated or overlooked( PMID 11449200)
Treatment
The treatment of allergic rhinitis includes the following key components:[1][2][3]
- Patient education on allergen avoidance and non-pharmacologic treatments such as saline douching of the nose
- Pharmacotherapy
- Allergen-specific immunotherapy in patients uncontrolled with pharmacotherapy
- Surgery in selected cases
Pharmacotherapy[1][4]
| Medical Treatment of Allergic Rhinitis | |||
|---|---|---|---|
| Severity of Rhinitis | Medication
(Use in conjunction with allergen avoidance and saline douching) |
Treatment Failure
(Ensure patient adherence to treatment before making changes to the treatment plan) |
Evaluation and treatment of associated conditions |
| Mild | Nonsedating oral/intranasal antihistamine | Consider intranasal steroids |
|
| Moderate | Intranasal corticosteroid (+/- nonsedating oral or intranasal antihistamine) | Persistent/uncontrolled symptoms after 2-4weeks of treatment:
Failure of medical therapy:
| |
| Severe | Intranasal corticosteroid (+/- nonsedating oral or intranasal antihistamine) | ||
Other Medications
- Leukotriene receptor antagonists- These can be prescribed especially when lower airway symptoms are also present. They are not recommended for use in adults with persistent allergic rhinitis, and they should not be offered as primary therapy for the treatment of allergic rhinitis.[4][1]
References
- ↑ 1.0 1.1 1.2 Lee S (2014). "Practical clinical approaches to the allergic rhinitis patient". Int Forum Allergy Rhinol. 4 Suppl 2: S66–9. doi:10.1002/alr.21389. PMID 25182359.
- ↑ Rotiroti, Giuseppina; Scadding, Glenis (July 2016). "Allergic Rhinitis-an overview of a common disease". Paediatrics and Child Health. Volume 26 (Issue 7): 298–303. Retrieved January 20, 2017.
- ↑ Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens WJ, Togias A; et al. (2008). "Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen)". Allergy. 63 Suppl 86: 8–160. doi:10.1111/j.1398-9995.2007.01620.x. PMID 18331513.
- ↑ 4.0 4.1 Seidman MD, Gurgel RK, Lin SY, Schwartz SR, Baroody FM, Bonner JR; et al. (2015). "Clinical practice guideline: Allergic rhinitis". Otolaryngol Head Neck Surg. 152 (1 Suppl): S1–43. doi:10.1177/0194599814561600. PMID 25644617.