RESPIRATORY DISEASE

DEFINITION

Allergic rhinitis is an inflammation to the lining of the nose caused by inappropriate hypersensitivity reaction to an allergen.

Allergic rhinitis is an IgE-mediated immunological reaction.

Seasonal allergic rhinitis(Hay fever or Rose fever):This occurs during times of the year when allergens are in the air.

Perennial( Persistent) allergic

rhinitis: This condition is caused by allergens.

Atopy

Allergens : Seasonal :

Pollen , Fungus

Perenninal :

Dust mite, domestic pets, cockroaches

Occupational :

Flour, Animal , Wood, Latex , Paint

Hormonal

Food induced:Nuts,fish , prawns, legumes ,milk, chesse ,egg, meat, citrus fruits ,wines.

Drug induced: Aspirin, other NSAIDs , anti-hypertensives, oral

contraceptive pills.

Nasal (Nasal irritants) : Traffic fumes , tobacco smoke ,mosquito repellents, perfumes ,scented sticks, domestic sprays, bleaches

Anatomic defect

Immunodeficiency

disease

SYMPTOMSRhinorrheaItchy (nose , mouth , eyes ,throat ,skin or any area)Problems with smellSneezing Tearing eyes Stuffy nose (nasal congestion)Coughing Clogged earsSore throat Dark circles under the eyesPuffness under the eyesFatigue & irritabilityHeadacheMouth breathing

Physical exam( eyes, ears, nose ,oropharynx,lung)

CBC Test

Nasal smear examination for eosinophils: Mucus is examined for the presence of eosinophil cells, which

indicate an allergic reaction.

Skin prick test:A method for medical diagnosis of allergens that attempts to

provoke a small, controllled , allergic response.

Radio – allergo – sorbent test (R.A.S.T):A radioimmunoassay test to detect certain types of

immunoglobulin-bound allergens responsible for tissue hypersensitivity.

Diagnostic nasal endoscopy

C.T. scan

Lifestyle change & avoiding allergens:Avoid cigarette smoke & traffic fumes.Avoid cold drinks , ice cream, very cold air, cold bath.Avoid mosquito repellents, strong perfumes , scented sticks & cosmetics.Have a balanced diet & exercise regularly to improve body immunity.Adequate fluid intake to loosen nasal secretion.Control drugs to prevent attackAvoid sulfite-containing foods.Avoid occupational irritants.Visit doctor regularly & follow doctor’s advice.Allergy shots( immunotherapy)Medication

Leukotriene receptor antagonists:

Montelucast(Montene-sq.)

Anti-cholinergics:Ipratropium bromide

nasal spray(Rynaspray-sq.)H1-antihistamines:

Systemic:Cetirizine(Alatrol-sq.),

Fexofenadine(Fexo-sq.),

Loratidine(Loratin-sq.)

Levocetrizine(Curin-Beximco),

Desloratidine(Sedno-sq.)

Topical:Azelastine spray(Snizex-sq.)

Mast cell stabilizers:Sodium

cromoglycate(Nacromycin-sq.)

Ketotifen(Alarid-sq)

Systemic:Phenylephrine

Pseudoephedrine(Preecof-Incepta)

Topical:Xylometazoline(Antazol-sq.)

Oxymetazoline(Nocon-sq.)

Hypertonic saline

Nasal:Beclomethasone

(Decomit-Beximco)

Budesonide(Aeronoid-Beximco)

Fluticasone(Perinase-Beximco)

Mometasone

Injection:Methylprednisolone

Oral:Prednisolone

Nasal decongestants Corticosteroids

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