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Allergic Rhinitis 4

  • Diagnosis : history and physical findings, clear rhinorrhea, pale discoloration of nasal mucosa, and red and watery eyes) and one or more of the following symptoms: nasal congestion, runny nose, itchy nose, or sneezing.
  • associated conditions : asthma, atopic dermatitis, sleep-disordered breathing, conjunctivitis, rhinosinusitis, and otitis media.
  • Specific IgE testing (blood or skin) if necessary
  • Sinonasal imaging:  not routine 
  • Intranasal steroids: if symptoms affect quality of life.
  • Oral 2nd generation antihistamine
  • Intranasal antihistamines for seasonal, perennial, or episodic AR.
  • Oral leukotriene receptor antagonists:not  primary therapy for patients with AR.
  • Combination pharmacologic therapy:most effective combination therapy is an intranasal steroid and an intranasal antihistamine.
  • Immunotherapy :inadequate response to pharmacologic therapy.
  • Avoidance of known allergens or environmental control
  • Inferior turbinate reduction