TREATMENT OF ALLERGIC RHINITIS

An increased understanding of the pathophysiology of allergic rhinitis can provide a logical basis for improved therapeutic strategies tailo red individually to each patient. The first recommendation is the avoi dance of possible or verified allergens, If this does not provide sign ificant relief or is impractical, then immunotherapy plays a preventat ive role in some patients and it has been shown to be effective in cer tain cases, Initially, most patients try new nonsedating antihistamine s, sometimes combined with a short course of topical vasoconstrictors. When nasal obstruction is a problem, a steroid spray is preferred, It is often necessary to add topical treatment for eye symptoms, e.,g., antihistamine or cromoglycate eyedrops, In severe cases simultaneous a dministration of nasal corticosteroids and nonsedating antihistamines may achieve optimal control of symptoms, Cromolyn derivates are also e ffective in mild or moderate rhinoconjunctivitis and are especially re commended in the treatment of children. Systemic corticosteroid therap y should be reserved for the rare patient with extreme symptoms, and l imited to short courses. Recent studies have shown that if patients ar e provided with appropiate medication, education and instruction, symp toms of allergic rhinitis can be well controlled with minimum impairme nt of quality of life.