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Allergic rhinitis pp
- 1. SHRAVAN ENT HOSPITALSHRAVAN ENT HOSPITAL AMRELIAMRELI DR.HITESH SHAHDR.HITESH SHAH MSENTMSENT
- 4. RHINITISRHINITIS • ALLERGIC seasonal sporadic perenial • NONALLERGIC infectious occupational nares. • REFLUX INDUCED emotional gustatory • OTHER atrophic hormone pregnancy oc pills rhinitis medicamentosa
- 6. Vasomotor rhinitisVasomotor rhinitis Environmental and respiratory irritant Weather changes Spicy foods Alcohol Strong odours Bright lights “blockers” and “runners”
- 9. POLLEN :TREE POLLEN HIGH COUNTS DURING SPRING AND FALL POLLEN FROM GRASS IS A PREDOMINENT AEROALLERGEN OUTDOOR MOLDS: ASPERGILLUS, PENICILLIUM HOUSE DUST MITE: DERMATOPHAGOIDES FARINAE DERMATOPHAGOIDES PTERYNYSSINUS CARPETS, UPHOLSTERED FURNITURE, PILLOWSCOVERS, MATTRESSES, TOYS
- 10. PETS - CAT, DOG, FURY ANIMALS, BIRDS COCROACHES RODENTS OCCUPATIONAL –VETERINARIAN, LAB WORKERS LATEX, ACID, GLUE
- 11. • SYMPTOMS RHINNORHEA , REPETITIVE SNEEZING, ITCHING OF NOSE, PALATE AND EYE FREQ SORE THROAT, COUGH , HEADACHE SIGNS ALLERGIC CREASE (ALLERGIC SALUTE) ENLARGED TURBINATES PALE BLUISH NASAL MUCOSA POLYP ERYTHEMATOUS CONJUCTIVA BLUE TYMPANIC MEMBRANE
- 12. • Allergen avoidence • Pharmacotherapy • Immunotherapy
- 14. drugs M.A. Side effects comments oral H1 blockers 2nd generation Cetrizine Fexofenadine Loratidin Ebastine Azelastine Mizolastine 3rd generation Levocetrizine Desloratidine Rupatidie Acts via blocking H1 receptors; has some anti- allergic activity ;can be use as single drug therapy Usually non- sedative,no anti-collinergic effect or cardiotoxicity Azelastin may induce sedation and bitter taste Considerred as first line therapy
- 15. Drugs M.A. Side effects comments Local H1 antihistamines Azelastine Levocabastine Olopatidine Same Same Rapid onset and no systemic side effects MOMETASONE FLUTICASONE BECLOMETHA -SONE CICLOSONIDE BUDESONIDE Acts by reducing nasal inflammation Epistaxis Less systemic side effects Intra nasal steroids
- 16. Drugs M.A. Side efects comments Oral decongestants Ephedrine Phenylephrine Phenylpropanol amine Pseudoephedri ne Sympathomime tic Hypertension,p alpitation,restle ssness,tremors, insomnia,heada che,dry mucous membrane,urinr etention Heart diseases combinations Inranasal decongestants Oxymetazoline Xylometazoline Sympathomime tic Rhinitis medicamentosa Act more rapidly and effectively antileukotrines Montelukast Pranlukast Zafirlukast Blocking cysLT receptors Good tolerance Effective on rhinitis and aasthama
- 17. • Repeated controlled administration of increasing doses of allergen extract to an allergic subject to ameliorate the symptoms associated with the subsequent exposure to the causative allergen • M.A. : blunting of seasonal rise in IgE antibodies • increase in serum IgG • Down regulation of the cellular and inflammatory mediator • up regulation of counter regulatory cytokines
- 18. • Inadequate response to usual therapy • Persitent symptoms • Documented sensitivity • Future exposure of allergen is unavoidable • Coexisting sinusiis , asthama
- 19. • Autoimmune disease/malignancy • Severe pulmonary/cv disease • Pregnancy • Unstable ashama symptoms
- 20. Endoscopic sinus surgeryEndoscopic sinus surgery • Minimally invasive technique • Sinus air cells and ostia are opened under direct visualisation • AIM-maintaining ventilation and drainage of sinuses.
- 21. ESSESS • INDICATIONS Chronic/recurrent sinusitis Nasal polyposis Fungal sinusitis Headache Orbital decompression Csf leak Tumours of nasal cavity and sinuses