Podcast
Questions and Answers
What is the first step in the treatment guidelines for allergic rhinitis?
What is the first step in the treatment guidelines for allergic rhinitis?
- Administration of corticosteroids
- Immunotherapy
- Use of antihistamines
- Avoidance and environmental control (correct)
In the treatment of mild intermittent allergic rhinitis, which medication is recommended?
In the treatment of mild intermittent allergic rhinitis, which medication is recommended?
- Intranasal corticosteroid
- Intranasal antihistamine (correct)
- Immunotherapy
- Long-acting nasal decongestant
What potential side effect should patients be aware of when taking antihistamines?
What potential side effect should patients be aware of when taking antihistamines?
- Drowsiness (correct)
- Increased heart rate
- Persistent cough
- Excessive sweating
Which of the following is a recommended corticosteroid for allergic rhinitis?
Which of the following is a recommended corticosteroid for allergic rhinitis?
Which agent is indicated when rhinorrhea is the predominant symptom in allergic rhinitis?
Which agent is indicated when rhinorrhea is the predominant symptom in allergic rhinitis?
Which of the following is NOT a common side effect of intranasal corticosteroids?
Which of the following is NOT a common side effect of intranasal corticosteroids?
For patients starting treatment for chronic rhinitis, when can improvement typically be expected?
For patients starting treatment for chronic rhinitis, when can improvement typically be expected?
Why should patients avoid sneezing or blowing their noses for at least 10 minutes after administering nasal corticosteroids?
Why should patients avoid sneezing or blowing their noses for at least 10 minutes after administering nasal corticosteroids?
Flashcards
What is Allergic Rhinitis (AR)?
What is Allergic Rhinitis (AR)?
Allergic rhinitis (AR) is an inflammatory response of the nasal mucous membranes triggered by allergens, leading to symptoms like sneezing, runny nose, and nasal congestion.
What is Step 1 in treating AR?
What is Step 1 in treating AR?
Step 1 of treating AR involves avoiding allergens and controlling the environment by minimizing exposure to triggers. This includes keeping the home clean, using air purifiers, and avoiding specific allergens like dust mites or pet dander.
What is an intranasal antihistamine in AR treatment?
What is an intranasal antihistamine in AR treatment?
Intranasal antihistamines, like azelastine, block histamine receptors, reducing inflammation and symptoms.
How do nasal decongestants work in AR?
How do nasal decongestants work in AR?
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What are intranasal corticosteroids used for in AR?
What are intranasal corticosteroids used for in AR?
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What is immunotherapy in AR treatment?
What is immunotherapy in AR treatment?
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How do oral antihistamines work in AR?
How do oral antihistamines work in AR?
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What are the advantages of intranasal corticosteroids over oral corticosteroids?
What are the advantages of intranasal corticosteroids over oral corticosteroids?
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Study Notes
Allergic Rhinitis (AR) Treatment Guidelines
- Step 1: Avoidance and environmental control
- Step 2: Antihistamines, decongestants, and mast cell stabilizers. Recommended for mild, intermittent symptoms. Includes intranasal antihistamines, cromoglycate, or short-acting antihistamines. Short-term nasal decongestants like pseudoephedrine may be effective. Nasal Ipratropium bromide might be used if rhinorrhea is the main symptom.
Step 3: Corticosteroids
- Useful for chronic symptoms. Intranasal glucocorticosteroids are effective for all symptoms and more effective than antihistamines or cromoglycate.
Step 4: Immunotherapy
- Optional treatment
Pharmacotherapy Options for AR
I. Antihistamines (H₁-receptor blockers)
- Examples: Azelastine, levocabastine (intranasal)
- Side Effects: Sedation, drowsiness, and potential for anticholinergic effects (increased intraocular pressure, hyperthyroidism, or cardiovascular disease). Advise patients not to skip doses or take double doses. Taking with meals or with a full glass of water can minimize gastrointestinal problems.
II. Alpha-Adrenergic Agonists (Nasal Decongestants)
- Examples include: Epinephrine (long-acting), oxymetazoline (long-acting), phenylephrine (short-acting), and pseudoephedrine (oral)
- Note: Available as nasal sprays or oral medications.
III. Corticosteroids (Anti-Inflammatory)
- Topical: Examples include beclomethasone, budesonide, fluticasone, mometasone, and triamcinolone.
- Advantages: Minimal systemic absorption, primarily localized side effects.
- Considerations: Improvement often takes 1-2 weeks. Nasal passages should be cleared before treatment with decongestants or saline. Patients should refrain from sneezing or blowing their nose for at least 10 minutes after treatment.
- Contraindications: Avoid in patients with nasal ulcers or recent nasal surgery/trauma.
Other Agents
- Leukotriene Modifiers (e.g., montelukast): Less effective than other treatments.
- Anticholinergics (e.g., ipratropium bromide): Used for rhinorrhea but may not control sneezing or nasal congestion.
- Cromolyn and nedocromil: Helpful for seasonal rhinitis. Often used intranasally. Nonprescription forms are available.
Immunotherapy
- Omalizumab: Can be an additional option in some cases.
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Description
This quiz covers the treatment guidelines for Allergic Rhinitis (AR), including avoidance strategies, pharmacotherapy options, and the use of corticosteroids and immunotherapy. Test your knowledge on the various antihistamines and their side effects. Get ready to dive into effective management techniques for AR symptoms!
