Corticosteroids allergic rhinitis

Beclomethasone diproprionate Suspension Allergic rhinitis/corticosteroid Beconase , Nasobec ,Qnasl and generics... 

The corticosteroids are used in the management and prophylactic treatment of the inflammation associated with chronic asthma or allergic rhinitis. 

Budesonide (Rhinocort) 32 meg spray, 1-4 sprays in each nostril daily Preferred corticosteroid for allergic rhinitis. 

Antihistamines and intranasal corticosteroids are considered first-line therapy for allergic rhinitis, whereas decongestants, mast cell stabilizers, leukotriene modifiers, and systemic corticosteroids are secondary treatment options. 

The anti-inflammatory actions of intranasal corticosteroids make them highly effective agents for allergic rhinitis treatment, especially as first-line treatment for patients presenting with persistent or moderate to severe allergic rhinitis. 

Intranasal corticosteroids are the most effective anti-inflammatory agents used in pediatric patients with allergic rhinitis. Although fewer studies have been conducted in children, results demonstrate that intranasal corticosteroids are effective and well tolerated, with an adverse-effect profile similar to placebo. Mometasone is indicated for children as young as 2 years of age, fluticasone is indicated for children 4 years of age and older, and beclomethasone, budesonide, flunisolide, and triamcinolone are indicated for children 6 years and older.15 Because concerns regarding effect of intranasal steroids on growth exist, the growth of pediatric patients prescribed intranasal steroids should be monitored routinely via stadiometry. 

Transgrund AJ, Whitaker AL, Small RE. Intranasal corticosteroids for allergic rhinitis. Pharmacotherapy 2002 22 1458-1467. van Cauwenberge P, Bachert C, Passalacqua G, et al. Consensus statement on the treatment of allergic rhinitis. Allergy 2000 55 116-134. 

Intranasal corticosteroids are the most effective treatment for allergic rhinitis during pregnancy. Beclomethasone and budesonide have been used most. Nasal cromolyn and first-generation antihistamines (chlorpheniramine, tripelennamine, and hydroxyzine) are also considered first-line therapy. Loratadine and cetirizine have not been as extensively studied. 

Both budesonide and fluticasone are corticosteroids but fluticasone is more potent than budesonide and has a higher first-pass effect, hence more of the drug is metabolised leading to fewer adverse effects. A dose of 100 pg of budesonide is equivalent to 50 pg of fluticasone. Both budesonide and fluticasone are indicated for the prophylaxis of allergic rhinitis (hay fever). 

Fluticasone is a potent corticosteroid that is available as a nasal spray indicated in allergic rhinitis (hay fever) and as an inhaler used in asthma. 

Salib RJ, Howarth PH. Safety and tolerability profiles of intranasal antihistamines and intranasal corticosteroids in the treatment of allergic rhinitis. Drug Saf 2003 26 863-93. 

Bennett ML, Fountain JM, McCarty MA, Sherertz EF. Contact allergy to corticosteroids in patients using inhaled or intranasal corticosteroids for allergic rhinitis or asthma. Am J Contact Dermat 2001 12(4) 193-6. 

Studies of omalizumab in asthmatic volunteers showed that its administration over 10 weeks lowered plasma IgE to undetectable levels and significantly reduced the magnitude of both the early and the late bronchospastic responses to antigen challenge. Clinical trials have shown repeated intravenous or subcutaneous injection of anti-IgE MAb to lessen asthma severity and reduce the corticosteroid requirement in patients with moderate to severe disease, especially those with a clear environmental antigen precipitating factor, and to improve nasal and conjunctival symptoms in patients with perennial or seasonal allergic rhinitis. 

Corticosteroids—a group of anti-inflammatory drugs similar to the natural corticosteroid hormones produced by the cortex of the adrenal glands. The disorders that often improve upon corticosteroid treatment include asthma, allergic rhinitis, eczema, and rheumatoid arthritis. 

Antihistamines and intranasal corticosteroids are the first-line treatments for allergic rhinitis. Sodium cromoglicate, ipratropium bromide and decongestants, are alternative or add-on treatments. Drug treatment should be selected according to the severity, frequency and duration of symptoms ... 

Q4 Perennial allergic rhinitis can be treated with antihistamines and corticosteroids. 

Treatment of allergic rhinitis includes antihistamines, Hi receptor antagonists, such as axelastine, and corticosteroids, such as beclometasone or budesonide. However, cromoglicate is the first choice for children. 

Weiner J M, Abramson M J, Puy R M1998 Intianasal corticosteroids versus oral Hj-receptor antagonists in allergic rhinitis systematic review of randomised controlled trials, British Medical Journal 317 1624-1629... 

Quintiliani R. Hypersensitivity and adverse reactions associated with the use of newer intranasal corticosteroids for allergic rhinitis. Curr Ther Res Clin Exp 1996 57 478-88. 

HPI KG is a 39-year-old woman with asthma on fluticasone and albuterol complaining of SOB associated with exercise. Three months ago she started an aerobic exercise program that has been hampered by chest tightness and SOB shortly after she begins running. She admits to poor compliance with her corticosteroid inhaler and requests an oral medication to control her asthma symptoms. Her PMH is significant for mild, persistent asthma for 35 years and allergic rhinitis. Her medications include fluticasone and albuterol inhalers and fexofenadine. Pulmonary function tests (PFTs) reveal her forced expiratory volume in the first second (FEV,) = 89% of predicted. 

Indications Allergic rhinitis, Asthma Category Corticosteroid, inhaled Half-life N/A... 

Indications Allergic rhinitis, asthma Category Corticosteroid Half-life 5-7 hours... 

The reasons for not including or only briefly mentioning this subject may include (1) a misconception that symptoms of allergic rhinitis are trivial and can be easily alleviated with the use of oral antihistamines and/or intranasal corticosteroids (2) an underestimation of the effect of allergic rhinitis on the quality of life, and (3) a lack of controlled trials of education in allergic rhinitis. 

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