Medication for allergic rhinitis

  Allergic rhinitis has a high prevalence, and treatment includes avoidance of allergens, medication, surgery, immunotherapy, etc. Medication is the preferred treatment for most patients with allergic rhinitis, and some patients buy medication from pharmacies on their own, increase or decrease the amount of medication during medication, change medication frequently or even stop medication on their own, causing unnecessary pain and waste. We would like to introduce the standardized medication for allergic rhinitis.  The allergic rhinitis drug treatment involves few drugs, among which, nasal steroids and antihistamines occupy the core position.  1, antihistamine drugs, 1 to 2 hours onset of action, the effect can be maintained for 12 to 24 hours, the first generation of antihistamine drugs, central sedative effect is obvious, the representative drugs are paracetamol, terfenadine, benadryl, chlorpheniramine, etc., antihistamine effect is better, but about 50% of patients will appear central sedative effect, such as drowsiness, fatigue, sleepiness, etc.. The second generation of antihistamines, the central sedative effect is significantly weakened, about 7% of patients will have central sedative effect, the representative drugs are cetirizine hydrochloride, loratadine, etc. The third generation of antihistamines, theoretically no central sedative effect, the representative drugs are desloratadine, levocetirizine, levocabastine, norethindrone, etc. In addition to the above oral antihistamines, there are also nasal antihistamines, which take effect in 15 to 30 minutes and are slightly more effective than the oral form, and are represented by drugs such as eserpine and lisdexamfetamine.  2, nasal corticosteroids, is currently one of the most effective drugs for the treatment of allergic rhinitis, the onset of action is slower, generally 4 to 12 hours to take effect, 4 to 5 days to achieve a better therapeutic effect, the representative drugs are endosulfan, co-sulfan, Burkner, Renocort and other second-generation drugs, systemic absorption rate is low, but the inhibitory effect on the hypothalamus-pituitary-adrenal axis and the impact on the growth and development of children should be paid attention to However, the effects on the suppression of the thalamic-pituitary-adrenal axis and on the growth and development of children should be taken seriously. It is recommended that patients with allergic rhinitis should pay attention to the dose and method of use of such drugs, control the dose to the lowest level under the premise of symptom control, pay attention to the superimposed dose of drugs when combining drugs, communicate with the doctor in a timely manner, evaluate the efficacy in a timely manner, and detect possible local or systemic complications at an early stage.  3, oral or nasal decongestants, can make the nasal turbinate contraction, relieve nasal congestion symptoms, nasal representative drugs such as hydroxyzoline, furosemide nasal drops, etc., oral dosage forms such as Neocontek, Bacitracin, etc., it is recommended to apply 3 to 7 days, oral dosage forms are not suitable for people suffering from hypertension, ischemic heart disease, nasal dosage forms can not be used too often (less than 3 hours interval), too long (more than 3 weeks), will cause drug-related rhinitis.  4.Anti-cholinergic drugs, such as ipratropium bromide, are not available in the domestic nasal form, but only inhalation form.  5, mast cell stabilizers, the representative drugs are nasal cromoglycate sodium, trinostat, zallust, etc.  Suggestions for children: nasal steroids can be used, try to reduce the dose, the course of treatment is controlled within 2 to 6 weeks; oral second-generation antihistamines, consider using nasal antihistamines such as Acesipine over 6 years old; consider applying nasal decongestants to relieve nasal congestion symptoms, the course of treatment is 3 to 7 days, avoid using oral corticosteroids, corticosteroids extended-release dosage form, oral decongestants.  Mast cell stabilizers or saline rinses are preferred for allergic rhinitis in pregnant women, oral antihistamines should be avoided for the first 3 months, nasal corticosteroids should be used under medical supervision, and oral or nasal decongestants are not recommended without safety data provided.  Nasal corticosteroids, oral second-generation antihistamines, nasal ipratropium bromide, and nasal chromogranin are recommended for elderly patients with allergic rhinitis. Care should be taken to avoid oral first-generation antihistamines and oral decongestants. Anticholinergic drugs should not be used in patients with glaucoma and urinary retention. Specific allergen immunotherapy is not recommended for elderly patients.