Allergic Rhinitis

[Ozymandias]

Before I give my advice may I know sir/madam kung under a certain medication po ba kayo at kung anu-ano ang mga ito?

Sir Charliehouse, ano po ang inyong profession at napansin ko na isa kayo sa mga members na malawak ang kaalaman sa science, at pati rin pala sa medicine, or sadyang masipag ka magbasa at magresearch ng mga articles?

[damage14]

cetirizine, montelucast,
ganyan din kasi problem q.
wla n nga yata gamot sa allergic rhinitis...
sakit sa ulo kpag sinumpong,

[damage14]

mabisa po ba talaga ung accupunture? 
grabe kasi kapag sinumpong aq.. bahing aq ng bahing, tpos 3x or 4x n sunod sunod.... sakit tlaga sa ulo at sa dibdib...

[charliehouse]

Sir Charliehouse, ano po ang inyong profession at napansin ko na isa kayo sa mga members na malawak ang kaalaman sa science, at pati rin pala sa medicine, or sadyang masipag ka magbasa at magresearch ng mga articles?

Thanks for the compliment sir, I am a management graduate and a frustrated science enthusiast hahaha

[charliehouse]

@TS
Tanong ko lang TS, nagdrydry ba ang bibig mo when you are under OTC antihistamines?

[shane]

@TS
Tanong ko lang TS, nagdrydry ba ang bibig mo when you are under OTC antihistamines?

opo, tama nagda- dry nga siya, gusto ko nga sana pa- inject na lang, meron daw kasing injection for allergy pero gusto kong makatiyak muna

[shane]

Before I give my advice may I know sir/madam kung under a certain medication po ba kayo at kung anu-ano ang mga ito?

opo may mgamot akong iniinom everyday kasi kapag itinigil ko babanat ang allergy. clarinase, desloratadine at lorin. mas effective nga lang sa akin yong clarinase pero kapag grabe at hindi kaya yong lorin kasi 10mg siya mas malakas.

[ladyvirus01]

ALLERGIC RHINITIS TREATMENT

The treatment of allergic rhinitis includes reducing exposure to allergens and other triggers in combination with medication therapy. In most people, these measures effectively control the symptoms.

Reduce exposure to triggers — Some simple measures can reduce a person's exposure to allergens and triggers that provoke allergic rhinitis. These measures are discussed in detail in a separate topic review. (See "Patient information: Trigger avoidance in allergic rhinitis (Beyond the Basics)".)

Several different classes of drugs counter the inflammation that causes symptoms of allergic rhinitis. The severity of symptoms and personal preferences usually guide the selection of specific drugs.

Nasal irrigation and saline sprays — Rinsing the nose with a salt water (saline) solution is called nasal irrigation or nasal lavage. Saline is also available in a standard nasal spray, although this is not as effective as using larger amounts of water in an irrigation.

Nasal irrigation is particularly useful for treating drainage down the back of the throat, sneezing, nasal dryness, and congestion. The treatment helps by rinsing out allergens and irritants from the nose. Saline rinses also clean the nasal lining and can be used before applying sprays containing medications to get a better effect from the medication.

Nasal lavage with warmed saline can be performed as needed, once per day, or twice daily for increased symptoms. Nasal lavage carries few risks when performed correctly and with sterilized water. Saline nasal sprays and irrigation kits can be purchased over-the-counter. Saline mixes can also be purchased or patients can make their own solution.

A variety of devices, including bulb syringes, Neti pots, and bottle sprayers, may be used to perform nasal lavage; instructions for nasal lavage are provided in the table . At least 200 mL (about three-quarters cup) of fluid (salt solution made with distilled or boiled water or sterile saline, not tap water) is recommended for each nostril.

Nasal glucocorticoids — Nasal glucocorticoids (steroids) delivered by a nasal spray are the first-line treatment for the symptoms of allergic rhinitis. These drugs have few side effects and dramatically relieve symptoms in most people. Studies have shown that nasal glucocorticoids are more effective than oral antihistamines for symptom relief .

There are a number of nasal glucocorticoids available by prescription. Specific medications include fluticasone, mometasone, budesonide, flunisolide, triamcinolone, beclomethasone, fluticasone furoate, and ciclesonide. These drugs differ with regard to the frequency of doses, the spray device, and cost, but all are similarly effective for treating all the symptoms of allergic rhinitis. In the United States, triamcinolone nasal spray (Nasacort Allergy 24HR) is available without a prescription. Various agents are available without a prescription in other countries.

People with severe rhinitis may need to use a nasal decongestant for a few days before starting a nasal glucocorticoid to reduce nasal swelling, which will allow the nasal spray to reach more areas of the nasal passages.

Some symptom relief may occur on the first day of therapy with nasal glucocorticoids, although their maximal effectiveness may not be noticeable for days to weeks. For this reason, nasal glucocorticoids are most effective when used regularly. Some people are able to use lower doses when symptoms are less severe.

How to use a nasal spray — Nasal sprays work best when they are used properly and the medication remains in the nose rather than draining down the back of the throat. If the nose is crusted or contains mucus, it should be cleaned with a saline nasal spray before a nasal spray that contains medication.

The head should be positioned normally or with the chin slightly tucked. The spray should be directed away from the nasal septum (the cartilage that divides the two sides of the nose). The spray is dispensed and then sniffed in slightly to pull it into the higher parts of the nose. Sniffing too hard will result in the medicine draining down the throat, and should be avoided.

Some people find that holding one nostril closed with a finger improves their ability to draw the spray into the upper nose. Medicine that drains into the throat should be spit out, since it is not effective unless it remains in the nose.

Side effects — The side effects of nasal steroids are mild and may include a mildly unpleasant smell or taste or drying of the nasal lining. In some people, nasal steroids cause irritation, crusting, and bleeding of the nasal septum, especially during the winter. These problems can be minimized by reducing the dose of the nasal steroid, applying a moisturizing nasal gel or spray to the septum before using the spray, or switching to a water-based (rather than an alcohol-based) spray.

Studies suggest that nasal steroids are generally safe when used for many years. However, people who use these drugs for years should have periodic nasal examinations to check for rare side effects, such as nasal infection.

Steroids taken as a pill or inhaled into the lungs can have side effects, especially when taken for long periods of time. However, the doses used in nasal steroids are low and are NOT associated with these side effects. However, clinicians usually recommend using the lowest effective dose.

Use of steroid nasal sprays may slightly slow growth rate in some children if used for extended periods of time. If a child requires a nasal steroid spray for more than two months of the year, then a clinician should be consulted for advice.

Antihistamines — Antihistamines relieve the itching, sneezing, and runny nose of allergic rhinitis, but they do not relieve nasal congestion. Combined treatment with nasal steroids or decongestants may provide greater symptom relief than use of either alone.

Oral medications — Several antihistamines have been available for many years without a prescription, including brompheniramine (sample brand names Dimetapp allergy, Nasahist B), chlorpheniramine (sample brand name Chlor-Trimeton), diphenhydramine (sample brand name Benadryl), and clemastine (sample brand name Tavist). These drugs often cause sedation and should not be used before driving or operating machinery. Even if the person does not feel excessively drowsy, these drugs can have a sedating effect. Thus, patients should use caution.

Less-sedating oral antihistamines include loratadine (Claritin, Alavert), desloratadine (Clarinex), cetirizine (Zyrtec), levocetirizine (Xyzal), and fexofenadine (Allegra). Loratadine, cetirizine, and fexofenadine are available without a prescription. These drugs work as well as the sedating antihistamines for rhinitis, but they are less sedating and are available in long-acting formulas. However, they may be more expensive.

Nasal sprays — Azelastine (Astelin, Astepro) and olopatadine (Patanase) are prescription nasal antihistamine sprays that can be used daily or when needed to relieve symptoms of postnasal drip, congestion, and sneezing. These sprays start to work within minutes after use. The most common side effect with azelastine is a bad taste in the mouth immediately after use. This can be minimized by keeping the head tilted forward while spraying, to prevent the medicine from draining down the throat.
Combinations of nasal glucocorticoid and antihistamines — A prescription combination of the nasal steroid fluticasone and the nasal antihistamine azelastine (Dymista) appears to improve symptoms of allergic rhinitis better than either drug alone in three clinical trials. The combination drug has the side effects of both when used at the recommended dose of one spray in each side of the nose twice a day and is approved for use in patients over 12 years old. The most common side effects are a bad taste, nose bleed, and headache .

Decongestants — Decongestants (like pseudoephedrine or phenylephrine [sample brand names Sudafed, Actifed, Drixoral]) are often combined with antihistamines in oral, over-the-counter allergy drugs. In the United States, pseudoephedrine has been used to make illegal drugs, which caused many companies to substitute phenylephrine for pseudoephedrine. However, phenylephrine is not effective for treating allergic rhinitis.

Oral decongestants elevate blood pressure and are not appropriate for people with high blood pressure or certain cardiovascular conditions. Men with an enlarged prostate who have difficulty urinating may notice a worsening of this symptom when they take decongestants. (See "Patient information: Benign prostatic hyperplasia (BPH) (Beyond the Basics)".)

Decongestants in the form of nasal sprays are also available, including oxymetazoline (sample brand name Afrin) and phenylephrine (sample brand name Neo-synephrine). Nasal decongestant sprays should not be used for more than two to three days at a time because they may cause a type of rhinitis called rhinitis medicamentosa, which causes the nose to be congested constantly UNLESS the medication is used repeatedly. This condition can be difficult to treat. To avoid it, do not use decongestant sprays for more than three days. (See "Patient information: Nonallergic rhinitis (runny or stuffy nose) (Beyond the Basics)".)

Cromolyn sodium — Cromolyn sodium (Nasalcrom) prevents the symptoms of allergic rhinitis by interfering with the ability of allergy cells to release natural chemicals that cause inflammation. This drug is available as an over-the-counter nasal spray that must be used three to four times per day, preferably before symptoms have begun, to effectively prevent the symptoms of allergic rhinitis.

Allergy shots — Allergy shots, also known as allergen immunotherapy, are injections given to reduce a person's sensitivity to allergens. Allergy shots are only available for common allergens, such as pollens, cat and dog dander, dust mites, and molds. These shots contain solutions of the allergens to which a specific person is allergic, and are made up individually for each person. The process of immunotherapy changes the person's immune response to the allergens over time. As a result, being exposed to the allergen causes fewer or even no symptoms.

Immunotherapy can help many people with allergic rhinitis. In children, immunotherapy can help prevent developing allergic asthma later in life. However, immunotherapy is relatively time consuming and is often reserved for people who have a poor response to medication, or want to avoid taking medications long term. Immunotherapy can be expensive, but many insurance plans cover the therapy because long-term use of allergy medications is also costly.

Immunotherapy is usually started by an allergist. Treatment begins with several months of weekly injections of gradually increasing doses, followed by monthly maintenance injections.


Other treatments — Other drugs may be recommended for some people with allergic rhinitis.

●Ipratropium – Nasal atropine is effective for the treatment of severe runny nose. This drug, available as ipratropium bromide (sample brand name Atrovent), is not generally recommended for people with glaucoma or men with an enlarged prostate.

●Leukotriene modifiers – Release of substances called leukotrienes may contribute to the symptoms of allergic rhinitis. Drugs that block the actions of leukotrienes, called leukotriene modifiers, can be very useful in patients with asthma and allergic rhinitis. However, nasal steroids are more effective than leukotriene modifiers for treating allergic rhinitis; thus, leukotriene modifiers are generally reserved for patients who cannot tolerate nasal sprays (due to nose bleeds) or azelastine.


Immunotherapy is usually administered for a minimum of three to five years. If immunotherapy is discontinued, the benefits gradually diminish over time, although some patients have several more years of symptom relief [3].

Immunotherapy injections carry a small risk of a severe allergic reaction. These reactions occur with a frequency of 6 of every 10,000 injections. The symptoms usually begin within 30 minutes of the injection. For this reason, patients are required to remain in the office after routine injections so that such a reaction could be quickly treated. Because drugs called beta-blockers may interfere with the ability to treat these reactions, people who take beta-blockers are often advised to avoid immunotherapy.

credit to source:

[shane]

I tried the nasal irrigation using only mineral water and it works. Basta nilagay ko sa basin yong mineral water at sininghot ko  tapos buga then singhot uli hanggang maubos yong tubig. Masakit lang sa batok pero after nun ginhawa talaga.

Thanks dok...


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[cherdZ]

Huwaaa... singhot talaga?? Demn... sige nga try ko....

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[shane]

Huwaaa... singhot talaga?? Demn... sige nga try ko....

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As in singhot talaga. Minsan kahit sa gripo na, isinahod ko lang ang kamay ko tapos yun singhot at nagiginhawaan ako.


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[charliehouse]

opo, tama nagda- dry nga siya, gusto ko nga sana pa- inject na lang, meron daw kasing injection for allergy pero gusto kong makatiyak muna

opo may mgamot akong iniinom everyday kasi kapag itinigil ko babanat ang allergy. clarinase, desloratadine at lorin. mas effective nga lang sa akin yong clarinase pero kapag grabe at hindi kaya yong lorin kasi 10mg siya mas malakas.

Have you ever tried Montelukast already? Bukod ba jan wala na? yung tipong mga gamot na maintenance based like for hypertension, diabetes and etc?

I assume na di na kaya ng montelukast ang rhinitis mo pero you can always see your doctor for it. I recommend avamys nasal spray para sa rhinitis spray mo sa lining ng ilong mo twice then singhot twice a day or every night kaso nga lang adverse reaction nyan is magdrdry talaga ang mouth mo.

sakin ay recommendation lang, always seek proper medical advice.
Post Merge: April 25, 2014, 10:18:29 PM

I tried the nasal irrigation using only mineral water and it works. Basta nilagay ko sa basin yong mineral water at sininghot ko  tapos buga then singhot uli hanggang maubos yong tubig. Masakit lang sa batok pero after nun ginhawa talaga.

Thanks dok...


Sent from my shoes

You can also use saline for that pero hula ko di ito masyadong tumatalab sa iyo tama ba?

[shane]

Have you ever tried Montelukast already? Bukod ba jan wala na? yung tipong mga gamot na maintenance based like for hypertension, diabetes and etc?

I assume na di na kaya ng montelukast ang rhinitis mo pero you can always see your doctor for it. I recommend avamys nasal spray para sa rhinitis spray mo sa lining ng ilong mo twice then singhot twice a day or every night kaso nga lang adverse reaction nyan is magdrdry talaga ang mouth mo.

sakin ay recommendation lang, always seek proper medical advice.
Post Merge: April 25, 2014, 10:18:29 PMYou can also use saline for that pero hula ko di ito masyadong tumatalab sa iyo tama ba?

montelukast (for lungs i think) at yung saline ay hindi ko pa nasubukan pero susubukan ko pag- uwi ko ng pinas.

salamat po boss makakatulong po ito sa akin...

[charliehouse]

Maraming gamit ang montelukast, it is quite a useful drug... Always welcome sir..

[jheyare23]

problema ko din talaga yang rhinitis. haizt nakaka-inis masyado. nakakawalang gana magtrabaho. hehehehe.