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Rhinitis April 10, 2006

Rhinitis April 10, 2006. THE NOSE. CT of THE NOSE. The inside of THE NOSE. Therapeutic Options Allergic Rhinitis. Antihistamines Decongestants Anticholinergics Corticosteroids. Cromones/mast cell stabilizers Leukotriene receptor antagonists Immunotherapy.

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Rhinitis April 10, 2006

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  1. RhinitisApril 10, 2006

  2. THE NOSE

  3. CT of THE NOSE

  4. The inside of THE NOSE

  5. Therapeutic Options Allergic Rhinitis • Antihistamines • Decongestants • Anticholinergics • Corticosteroids • Cromones/mast cell stabilizers • Leukotriene receptor antagonists • Immunotherapy AAAAI. The Allergy Report. 2000. Dykewicz M et al. Ann Allergy Asthma Immunol. 1998;81:478–518.

  6. Therapeutic Options Allergic Rhinitis • Antihistamines • Decongestants • Anticholinergics • Corticosteroids • Cromones/mast cell stabilizers • Leukotriene receptor antagonists • Immunotherapy AAAAI. The Allergy Report. 2000. Dykewicz M et al. Ann Allergy Asthma Immunol. 1998;81:478–518.

  7. Pseudoephedrine and HR

  8. Pseudoephedrine and SBP

  9. Pseudoephedrine and DBP

  10. Every Patient is Different

  11. Therapeutic Options Allergic Rhinitis • Antihistamines • Decongestants • Anticholinergics • Corticosteroids • Cromones/mast cell stabilizers • Leukotriene receptor antagonists • Immunotherapy AAAAI. The Allergy Report. 2000. Dykewicz M et al. Ann Allergy Asthma Immunol. 1998;81:478–518.

  12. Benefits Are first-line therapy for persistent allergic rhinitis Relieve all symptoms Sneezing Nasal itching Rhinorrhea Nasal congestion Minimal side effects Drawbacks May cause nasal irritation and/or bleeding Patient compliance Patient concerns about steroids Intranasal Corticosteroids in Allergic Rhinitis: An Overview Urval KR. Primary Care. 1998;25(3):649-662. Suonpaa J. Ann Med. 1996;28:17-22. Dykewicz MS, Fineman S. Ann Allergy Asthma Immunol. 1998;81:463-468.

  13. INS or NSA

  14. Therapeutic Options Allergic Rhinitis • Antihistamines • Decongestants • Anticholinergics • Corticosteroids • Cromones/mast cell stabilizers • Leukotriene receptor antagonists • Immunotherapy AAAAI. The Allergy Report. 2000. Dykewicz M et al. Ann Allergy Asthma Immunol. 1998;81:478–518.

  15. LTRA in Allergic Rhinitis

  16. All Evidence is Not the Same

  17. Therapeutic Options Allergic Rhinitis • Antihistamines • Decongestants • Anticholinergics • Corticosteroids • Cromones/mast cell stabilizers • Leukotriene receptor antagonists • Immunotherapy AAAAI. The Allergy Report. 2000. Dykewicz M et al. Ann Allergy Asthma Immunol. 1998;81:478–518.

  18. Subcutaneous Immunotherapy (Hyposensitization) • Mechanism of action = Unknown (may shift immune response from TH2- to TH1-response to allergen) • Efficacy: • Demonstrated in AR • Only disease-modifying therapy for AR • Usage: In patients who do not respond adequately to pharmacotherapy • Side effects: local reactions, anaphylaxis AAAAI. The Allergy Report. 2000. Available at: http://www.theallergyreport.org/reportindex.html

  19. Types of Rhinitis • Allergic • Seasonal or Perennial • Intermittent or Persistent • Non Allergic • Vasomotor • Infectious • Viral or Bacterial • Drug induced • Antihypertensives, Afrin • Hormonal • Pregnancy, Hypothyroid • NARES, Atrophic, Anatomic

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