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ComPbms.HEENT

Seasonal Allergies

QuestionAnswer
What Allergic Rhinitis is an IgE mediated hypersensitivity response to inhaled allergens causing sneezing, rhinorrhea, nasal pruritis, and congestion. 10-20% of the population suffer with seasonal allergies. Onset age is 8-12 years.
Physical Findings Pale nasal mucosa venous, engorgement of the turbinates, and nasal polyps may be present. Lymphoid hyperplasia of the oropharynx with a cobblestoned appearance . Erythema of the throat, conjunctival and scleral injection.
Physical Findings Sneezing, cough, post nasal drip, sensation of plugged ears are most common c/o.
Tx Maintain an allergen free environment as much as possible. Air purifies and dust filters are helpful. Maintain humidity <50% to discourage dust mites and mold. Air conditioners when possible. Remove pets when possible.
Tx; acute Rx Acute RX: First generation antihistamines cause drowsiness, it is recommended that the second generation antihistamines are used as first line, loratadine, cetirizine, and fexofenadine.
Tx Nasal corticosteroids. Montelukast (singulair) is effective if the pt doesn’t tolerate the antihistamines or added for better control. Astelin is an inhaled antihistamine.
Referral Refer for Immunotherapy is generally reserved for patients who do not respond to the previous treatments.
Viral rhinitis vs allergic rhinitis Viral rhinitis is distinguished from allergic rhinitis by erythema of the nasal mucosa, and can be accompanied by URI symptoms such as fever, malagias, clear to yellow nasal discharge and is self limiting over 1-2 weeks.
Created by: DianaB
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