allergic rhinitis pathogenesis and managment

1. Rhinitis
Pharmacotherapeutics

2. Introduction
• Rhinitis is inflammation of nasal mucosa.
• It is group of disorder characterized by inflammation and irritation of
mucosal membrane of the nose.
• It is often co exist with other respiratory disorder such as asthma.

3. Etiology
• Rhino virus
• Allergens: dust, mold, pollen, dog dander
• Dairy products: milk, cheese
• Chemical: Household spray
• Medicines: aspirin, penicillin, enalapril
• Change in temperature, humidity
• Mode of transmission: Droplet (from sneezing), Close contact

4. Types
• Acute rhinitis
• Chronic rhinitis

5. Acute rhinitis
A. Non Allergic
B. Allergic rhinitis/hay fever

6. Allergic rhinitis

7. Chronic rhinitis

8. Clinical features

9. PATHOGENESIS

10. Diagnosis

11. Differential diagnosis
• Immotile cilia syndrome (ciliary dyskinesis)
• Cerebrospinal fluid leak
• Nasal polyps
• Sinusitis

12. Non Pharmacological Management
• Bed rest,
• Intake fluids
• Semisolid

13. Pharmacological
• NSAID: Paracetamol (500mg TDS/QID), Ibuprofen (400mg TDS)
• Anti histamine:
• Second generation: Levocetrizine 5mg, loratidine 10 mg H.S
• First generation: Pheniramine, chloropheniramine
• Nasal drop/spray: nasal decongestant drop (xylometazoline (0.5-1%), oxymetazoline),
corticosteroid drop/spray (Beclomethasone, fluticasone), antihistamine spray.
• Decongestant tablet: Pseudoephedrine tablet
• Mast cell stabilizer: Cromolyn sodium,
• Leukotriene antagonist: Montelukast 10 mg OD
• Immunotherapy.
• Normally combination of paracetamol, chloropheniramine and pseudoephedrine table(anti
cold tablet) is use.
• Vitamin C supplement.

14. Complication
• Acute or chronic sinusitis
• Otitis media
• Sleep disturbance or apnea
• Dental problems (overbite): Caused by excessive breathing through
the mouth
• Eustachian tube dysfunction

15. Prevention
• Vaccination
• Reduce exposure to allergen
• Avoid smoking