Q69) You are treating an 18-year-old white male college freshman for allergic rhinitis. It is September and he tells you that he has severe symptoms every autumn, which impair his academic performance. He has a strongly positive family history of atopic dermatitis. Which one of the following is the most appropriate management?
a) Intranasal decongestants
b) Intranasal glucocorticoids
c) Intranasal cromolym sodium
d) Intranasal antihistamine
e) RAST testing
e
d
e
b
rast testing can be helpful to identify what triggers but at the end of the day you will still need to stop /manage the symptons
cromolyn sodium prevents
B
ans is ddddddddddd
answer and drug of choice is intranasal steroids.
( from dr.red pulmonary lecture )
Topical intranasal glucocorticoids are currently believed to be the most efficacious medications for the treatment of allergic rhinitis. They are far superior to oral preparations in terms of safety.
Cromolyn sodium is also an effective topical agent for allergic rhinitis; however, it is more effective if started prior to the season of peak symptoms.
Because of the high risk of rhinitis medicamentosa with chronic use of topical decongestants, these agents have limited usefulness in the treatment of allergic rhinitis.
Some of the newer oral antihistamines have been found to be comparable in efficacy to intranasal steroids, but their use slightly increases the incidence of adverse effects and drug interactions. They are not as useful for congestion as they are for sneezing, pruritis, and rhinorrhea. Newer agents are relatively free of sedation. Overall, they are not as effective as topical glucocorticoids. Azelastine , an intranasal antihistamine, is effective in controlling symptoms but can cause somnolence and has a very bitter taste.