Rhinitis
inflammation of the lining of the nose
Hx
Congestion
Rhinorrhoea
Sneezing
Itching
Classification
Acute (infectious)
- usually viral (rhinovirus (common cold)
- Rx 0.9%NaCl drops/spray can help clear congestion and ease breathing (FESS)
- IN decongestant: limit to 5 days to avoid weeks of rebound congestion
- oral decongestant
Allergic (Hayfever)
- type I hypersensitivity
- can be seasonal or perennial
Rx avoidance
IN corticosteroid (improves within 7 hours, max effect days) reduces inflammation and mucous for moderate
IN antihistamine for mild (can combined with decongestant but for 5 days only)
IN Cromoglycate (mast cell stabiliser) steroid sparing in children, prophylaxis Rynacrom
IN ipratropium (anticholinergic) for isolate rhinorrhoea Atrovent
oral antihistamine
oral steroids for severe or polyps
Refer to Allergist for desensitisation if avoidance and above have been trialled
Other rhinitis (drugs, irritant, occupational)
- environment (heat, cold, smoke, dust)
- hormones / emotional factors
- drugs (beta-blockers, oral contraceptives, aspirin, NSAIDs, ACE inhibitors)
- diet (eg alcohol, spicy foods)
Rx avoidance
PO decongestants, IN corticosteroids, or IN ipratropium if avoidance fails
antihistamines/mast cell stabilisers not likely to be effective
Hx
Congestion
Rhinorrhoea
Sneezing
Itching
Classification
Acute (infectious)
- usually viral (rhinovirus (common cold)
- Rx 0.9%NaCl drops/spray can help clear congestion and ease breathing (FESS)
- IN decongestant: limit to 5 days to avoid weeks of rebound congestion
- oral decongestant
Allergic (Hayfever)
- type I hypersensitivity
- can be seasonal or perennial
Rx avoidance
IN corticosteroid (improves within 7 hours, max effect days) reduces inflammation and mucous for moderate
IN antihistamine for mild (can combined with decongestant but for 5 days only)
IN Cromoglycate (mast cell stabiliser) steroid sparing in children, prophylaxis Rynacrom
IN ipratropium (anticholinergic) for isolate rhinorrhoea Atrovent
oral antihistamine
oral steroids for severe or polyps
Refer to Allergist for desensitisation if avoidance and above have been trialled
Other rhinitis (drugs, irritant, occupational)
- environment (heat, cold, smoke, dust)
- hormones / emotional factors
- drugs (beta-blockers, oral contraceptives, aspirin, NSAIDs, ACE inhibitors)
- diet (eg alcohol, spicy foods)
Rx avoidance
PO decongestants, IN corticosteroids, or IN ipratropium if avoidance fails
antihistamines/mast cell stabilisers not likely to be effective