Management of seasonal allergic rhinitis: comparative efficacy of the newer-generation prescription antihistamines.
OBJECTIVE
To discuss the efficacy and safety of second-generation prescription antihistamines, cetirizine, desloratadine, and fexofenadine, and to inform nurse practitioners (NP) who are in a position to optimally manage patients presenting with seasonal allergic rhinitis (SAR).


METHODS
Selected published clinical trials.


CONCLUSIONS
NP, who are ideally placed to successfully manage the majority of patients with SAR, should be fully aware of the treatment options available. Although first-generation over-the-counter antihistamines are convenient to use and are readily accessible, patients run the risk of experiencing adverse effects, such as sedation. For this reason, second-generation antihistamines should be considered a better alternative; however, they need to be evaluated individually on the basis of their proven efficacy and safety. Both cetirizine and fexofenadine are equally effective at relieving the symptoms of SAR; however, cetirizine has been shown to be more likely to cause sedation and impairment.


CONCLUSIONS
If left untreated, SAR can have a substantial effect on patients' quality of life, resulting in fatigue, irritability, sleep disorders, and cognitive impairment.
Conboy-Ellis
Kathleen
K
University of Tampa, Tampa, FL 33606, USA. eellis4729@aol.com
D000293:Adolescent; D000328:Adult; D017332:Cetirizine / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D039563:Histamine H1 Antagonists, Non-Sedating / Q000627:therapeutic use*; D006801:Humans; D017336:Loratadine / Q000031:analogs & derivatives / Q000627:therapeutic use; D009722:Nurse Practitioners; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy*; D016593:Terfenadine / Q000031:analogs & derivatives / Q000627:therapeutic use; D016896:Treatment Outcome
D006634:Histamine H1 Antagonists; D039563:Histamine H1 Antagonists, Non-Sedating; D017336:Loratadine; D016593:Terfenadine; C093230:fexofenadine; C121345:desloratadine; D017332:Cetirizine