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Allergic Rhinitis

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DJ CrissCross
DJ CrissCross

This document discusses classifications of allergic rhinitis proposed by various groups from 1985 to 2001. It describes classifications based on etiology (allergic vs non-allergic), chronicity (seasonal vs perennial), and severity (intermittent vs persistent). The ARIA classification from 2001 divides rhinitis into intermittent or persistent, and further by severity as mild or moderate-severe based on sleep disturbance and impairment. Topical corticosteroids are highlighted as the most potent and effective treatment for moderate-severe persistent allergic rhinitis.

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ALLERGIC RHINITIS
DEFINITIONS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification (CHRONIC RHINITIS) ,[object Object],[object Object],[object Object]
Classification (CHRONIC RHINITIS) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Classification (CHRONIC RHINITIS)
Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Why these classifications were not satisfactory ,[object Object],[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Classification ,[object Object],[object Object],[object Object],[object Object]
ARIA - New Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
New Trends ,[object Object],[object Object],[object Object]
Other New Trends ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Other New Trends ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Definition: Allergic Rhinitis ,[object Object],[object Object],[object Object],[object Object],[object Object]
History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
“ Sneezers and Runners” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
“ Blockers” ,[object Object],[object Object],[object Object],[object Object],[object Object]
Differential Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
History ,[object Object],[object Object],[object Object],[object Object],[object Object]
History ,[object Object],[object Object]
ENVIRONMENT CONTROL The Stepladder Approach to the Management of Allergic Rhinitis ,[object Object],[object Object]
History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
GOAL of Pharmacotherapy in AR ,[object Object]
ENVIRONMENT CONTROL The Stepladder Approach to the Management of Allergic Rhinitis ,[object Object],[object Object],Oral antihistamines (Aerius, Zyrtec, Telfast, Virlix, Xyzal )
Antihistamines - History ,[object Object],Daniel Phenbenzamine Chlorphenamine Terfenadine Astemizole Fexofenadine Bovet Cetirizine Loratadine Levocetirizine Desloratadine
[object Object],[object Object],[object Object],[object Object],[object Object],Antihistamines – History & Classification
[object Object],[object Object],[object Object],[object Object],[object Object],Antihistamines – History & Classification
[object Object],[object Object],[object Object],[object Object],[object Object],Antihistamines – History & Classification
Antihistamine – Mechanism of Action ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Antihistamine – Mechanism of Action ,[object Object],[object Object],[object Object],[object Object]
Antihistamine- Ideal Characteristics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ENVIRONMENT CONTROL Nasal steroid sprays (Nasonex, Flixotide, Budecort) The Stepladder Approach to the Management of Allergic Rhinitis ,[object Object],[object Object],Oral antihistamines (Aerius, Zyrtec, Telfast, Virlix, Xyzal )
Topical Corticosteroids ,[object Object],[object Object],[object Object],[object Object],[object Object]
Action of topical corticosteroids ,[object Object],[object Object],[object Object]
Safety of Topical CS ,[object Object],[object Object],[object Object],[object Object],[object Object]
Safety of Topical CS ,[object Object],[object Object],[object Object],*Meltzer et al; J Allergy Clin Immunol 1999;204: 107-114 **Minshall et al; Otolaryn Head Neck Surg 1998; 118:648-54
Use of Inhaled Steroids in Pregnancy ,[object Object],[object Object]
Use of Inhaled Steroids in Pregnancy ,[object Object],[object Object],[object Object],[object Object]
Use of Inhaled Steroids in Pregnancy ,[object Object],[object Object],[object Object],[object Object]
Relationships between ICS and SGA infants and mean birth weight 3452 + 120.3 8.0 347 flunisolide 3393 + 69.0 9.3 393 Budesonide 3508 + 60.1 4.9 193 Triamcinolone 3428 + 51.7 7.6 720 Fluticasone 3421 + 37.5 6.0 277 Beclomethasone Birth wt (g) Mean + SEM SGA percent μ g Drug
Use of Inhaled Steroids in Pregnancy ,[object Object],[object Object],JACI 2004; 113:427-32
ENVIRONMENT CONTROL Nasal steroid sprays (Nasonex, Flixotide, Budecort) Nasal antihistamine sprays (Azep) The Stepladder Approach to the Management of Allergic Rhinitis ,[object Object],[object Object],Oral antihistamines (Aerius, Zyrtec, Telfast, Virlix, Xyzal )
Decongestants ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Decongestants ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Rhinitis medicamentosa ,[object Object],[object Object]
Rhinitis medicamentosa ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Rhinitis medicamentosa ,[object Object],[object Object],[object Object]
ENVIRONMENT CONTROL Nasal steroid sprays (Nasonex, Flixotide, Budecort) Nasal antihistamine sprays (Azep) Oral steroids (Prednisone) The Stepladder Approach to the Management of Allergic Rhinitis ,[object Object],[object Object],Oral antihistamines (Aerius, Zyrtec, Telfast, Virlix, Xyzal )
ENVIRONMENT CONTROL Nasal steroid sprays (Nasonex, Flixotide, Budecort) Nasal antihistamine sprays (Azep) Oral steroids (Prednisone) Immunotherapy The Stepladder Approach to the Management of Allergic Rhinitis ,[object Object],[object Object],Oral antihistamines (Aerius, Zyrtec, Telfast, Virlix, Xyzal )
ENVIRONMENT CONTROL Nasal steroid sprays (Nasonex, Flixotide, Budecort) Nasal antihistamine sprays (Azep) Oral steroids (Prednisone) Immunotherapy The Stepladder Approach to the Management of Allergic Rhinitis ,[object Object],[object Object],Oral antihistamines (Aerius, Zyrtec, Telfast, Virlix, Xyzal ) 1 2 3
Highlights ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Highlights ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Highlights ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Highlights ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]

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Allergic Rhinitis

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  • 60. Relationships between ICS and SGA infants and mean birth weight 3452 + 120.3 8.0 347 flunisolide 3393 + 69.0 9.3 393 Budesonide 3508 + 60.1 4.9 193 Triamcinolone 3428 + 51.7 7.6 720 Fluticasone 3421 + 37.5 6.0 277 Beclomethasone Birth wt (g) Mean + SEM SGA percent μ g Drug
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