Caring for patients with allergic rhinitis.
OBJECTIVE
Allergic rhinitis (AR) affects up to 40 million Americans, with an estimated cost of $2.7 billion per annum. This review discusses several therapeutic options that reduce the symptoms of AR, including allergen avoidance, antihistamines, intranasal corticosteroids (INS), leukotriene receptor antagonists, and immunotherapy.


METHODS
The articles included in this review were retrieved by a search of Medline literature on the subjects of AR, antihistamines, INS, leukotriene antagonists, and immunotherapy, as well as current published guidelines for the treatment of AR.


CONCLUSIONS
Allergen avoidance is recommended for all patients prior to pharmacologic therapy. Oral and nasal H(1)-antihistamines are recommended to alleviate the mild and intermittent symptoms of AR, and INS are recommended as the first-line treatment choice for mild persistent and more moderate-to-severe persistent AR.


CONCLUSIONS
There are a number of different types of therapy for the management of AR; with so many options available, successful tailoring of treatment to suit individual requirements is realistically achievable.
Hayden
Mary Lou
ML
Virginia Adult/Pediatric Allergy and Asthma, Virginia, USA. mlhayden@vaallergy.com
Womack
Catherine R
CR
D000281:Administration, Intranasal; D000328:Adult; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D002648:Child; D005938:Glucocorticoids / Q000627:therapeutic use; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D007167:Immunotherapy; D020024:Leukotriene Antagonists / Q000627:therapeutic use; D017410:Practice Guidelines as Topic; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis / Q000188:drug therapy* / Q000451:nursing; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis / Q000188:drug therapy* / Q000451:nursing
D018926:Anti-Allergic Agents; D005938:Glucocorticoids; D006634:Histamine H1 Antagonists; D020024:Leukotriene Antagonists