Perennial allergic rhinitis

Allergic Seasonal or Perennial Rhinoconjunctivitis. Histamine can cause all pathologic features of allergic rhinitis (35—37), with the exception of late-phase inflammatory reactions. Pmritus is caused by stimulation of receptors on sensory nerve endings prostaglandins (qv) may also contribute. Sneering, like pmritus, is an H -mediated neural reflex and can also be mediated by eicosanoids. Mucosal edema, which manifests as nasal... 

Differentiate between seasonal and perennial allergic rhinitis. 

American Academy of Pediatrics allergen immunotherapy allergic rhinitis central nervous system histamine-1 receptor antagonist immunoglobulin E over the counter perennial allergic rhinitis seasonal allergic rhinitis... 

Ipratropium bromide (Atrovent) nasal spray is an anticholinergic agent useful in perennial allergic rhinitis. 

Greiff L, Andersson M, Svensson J, Wollmer P, Lundin S, Persson CGA (2002) Absorption across nasal airway mucosa in house dust mite perennial allergic rhinitis. Clin Physiol Funct Imaging 22 55-57. 

Respiratory disease In general, antihistamines are not recommended to treat lower respiratory tract symptoms, because their anticholinergic effects may cause thickening of secretions and impair expectoration. However, several reports indicate antihistamines can be safely used in asthmatic patients with severe perennial allergic rhinitis. 

Allergic rhinitis For the relief of symptoms of allergic rhinitis (seasonal allergic rhinitis in adults and children 2 years of age and older), and perennial allergic rhinitis in adults and children 6 months of age and older. 

Children 6 to 23 months of age with perennial allergic rhinitis One packet of 4 mg oral granules daily. 

Uses Asthma in pts requiring chronic st oid th apy relieve seasonal/perennial allergic rhinitis Action Topical steroid Dose Met-dose inhal 2 inhal bid... 

Bronchial asthma, perennial allergic rhinitis, seasonal allergic rhinitis PO One 10-mg tablet a day, taken in the evening. 

Cetirizine is indicated for the symptomatic treatment of perennial allergic rhinitis, seasonal allergic rhinitis, chronic idiopathic urticaria, conjunctivitis and pruritus in adults and children above two years of age. 

The newer antihistaminics agents e.g. Azelastme inhibits histamine release and also inflammatory reactions evoked by leukotrienes and plasma activating factor (PAF). It is used for seasonal and perennial allergic rhinitis in the form of nasal spray. Mizolastine, a non-sedating antihistaminic is used in allergic rhinitis and urticaria. Ebastine, another non-sedating antihistaminic is used in nasal and skin allergies. 

Perennial and seasonal allergic rhinitis Promethazine hydrochloride Phenergan Ascorbyl palmitate, silicon dioxide, white wax, and cocoa butter... 

Desloratadine (Clarinex) [Anrihistamine/Selecrive H1-Receptor Antagonist ] Uses Seasonal perennial allergic rhinitis chronic idiopathic urticaria Action Active metabolite of Claritin, H -an tihistamine, blocks inflammatory mediators Dose Adults Peds >12 y. 5 mg PO daily 5 mg PO qod... 

Uses Asthma in pts requiring chronic steroid therapy relieve seasonal/perennial allergic rhinitis Action Topical steroid Dose Adults. Met-dose inhal 2 inhal bid (max 8/d) Nasal 2 sprays/nostril bid (max 8/d) Peds >6y. Met-dose inhal 2 inhal bid (max 4/d) Nasal 1-2 sprays/nostril bid (max 4/d) Caution [C, ] w/ adrenal insuff Contra Status asdimaticus, viral, TB, fungal, bacterial Infxn Disp Inhaler SE Tach, bitter taste, local effects, oral candidiasis EMS Not for acute asthma, use inhaled [3-agonists OD Unlikely... 

Topical administration to the nose The safety of nasal glucocorticoids in the treatment of allergic rhinitis has been reviewed (434,435). The local application of glucocorticoids for seasonal or perennial rhinitis often results in systemic adverse effects. The use of nasal sprays containing a glucocorticoid that has specific topical activity (such as beclomethasone dipropionate or flunisolide) seems to reduce the systemic adverse effects, but they can nevertheless occur, even to the extent of suppression of basal adrenal function in children (436). Local adverse effects include Candida infection, nasal stinging, epistaxis, throat irritation (437), and, exceptionally, anosmia (438). 

Marcucci F, Sensi LG, Caffarelli C, Cavagni G, Bernardini R, Tiri A, Riva G, Novembre E Low-dose local nasal immunotherapy in children with perennial allergic rhinitis due to Dermatophagoides. Allergy 2002 57/l 23—28. 

Ohashi Y, Nakai Y, Tanaka A, Kakinoki Y, Ohno Y, Masamoto T, Sakamoto H, Kato A, Washio Y, Yamada K, Hayashi M Clinical role of soluble adhesion molecules during immunotherapy for perennial allergic rhinitis. Arch Otolaryngol Head Neck Surg 1998 124 41—45. 

Ohashi Y, Nakai Y, Sakamoto H, Ohno Y, Sugiura Y, Okamoto H, Tanaka A, Kakinoki Y, Kishimoto K, Hayashi M Serum levels of soluble interleukin-2 receptor in patients with perennial allergic rhinitis before and after immunotherapy. Ann Allergy Asthma Immunol 1996 77 203-208. Ohashi Y, Nakai Y, Tanaka A, Kakinoki Y, Washio Y, Kato A, Masamoto T, Sakamoto H, Yamada K Ten-year follow-up study of allergen-specific immunoglobulin E and immunoglobulin G4, soluble interleukin-2 receptor, interleukin-4, soluble intercellular adhesion molecule-1 and soluble vascular cell adhesion molecule-1 in serum of patients on immunotherapy for perennial allergic rhinitis. Scand J Immunol 1998 47 167-178. 

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. 

Antiinfective, cephalosporin antibiotic Antibacterial for bronchitis, cephalosporin antibiotic Antibiotic URTI, LRTI, UTI Cephalosporin Antibiotic Antibiotic Antibiotic NSAID Anti-HIV Oral contraceptive Antidepressant Veterinary drug Lipid-lowering Agent Seasonal rhinitis perennial allergic rhinitis pruritus... 

Budesonide nasal spray is available for the treatment of seasonal and perennial allergic rhinitis in adults and children. 

Schering-Plough has developed a once-daily nasal spray formulation of momethasone furoate for the treatment and prevention of seasonal and perennial allergic rhinitis. Inhalation formulations have also been developed. Schering-Plough has developed an inhaled powder formulation for asthma maintenance treatment. 

Q4 What category of drugs can be used for perennial allergic rhinitis ... 

Q2 Perennial and seasonal allergic rhinitis affects many individuals and can cause serious complications, such as otitis media and chronic sinusitis. The symptoms of allergic rhinitis can be caused by house dust mites, pollens, moulds and other allergens. 

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

Perennial and seasonal allergic rhinitis are type 1 hypersensitivity reactions to an allergen. 

Second-generation antihistamines have proved to be important therapeutic tools in the treatment of atopic disease, including both seasonal and perennial allergic rhinitis, urticaria, and atopic dermatitis (20). Several studies have shown that the use of second-generation antihistamines as adjunctive therapy can benefit patients whose allergic asthma co-exists with allergic rhinitis (21). 

The authors of a report of a comparison of the effectiveness of ebastine (10 and 20 mg) and loratadine (10 mg) for perennial allergic rhinitis claimed that ebastine provided greater symptomatic relief than loratadine, but with a similar low incidence of central effects and headache (60). 

Davies RJ. Efficacy and tolerability comparison of ebas-tine 10 and 20 mg with loratadine 10 mg. A double-blind, randomised study in patients with perennial allergic rhinitis. Clin Drug Invest 1998 16 413-20. 

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