title: Role of leukotriene antagonists and antihistamines in the treatment of allergic rhinitis.
abstract: Allergic rhinitis is the most common atopic disorder seen in ENT clinics. It is diagnosed by history, physical exam and objective testing. Patient education, environmental control measures, pharmacotherapy, and allergen-specific immunotherapy are the cornerstones of allergic rhinitis treatment and can significantly reduce the burden of disease. Current treatment guidelines include antihistamines, intranasal corticosteroids, oral and intranasal decongestants, intranasal anticholinergics, intranasal cromolyn, and leukotriene receptor antagonists. In the mechanism of allergic rhinitis, histamine is responsible for major allergic rhinitis symptoms such as rhinorrhea, nasal itching and sneezing. Its effect on nasal congestion is less evident. In contrast, leukotrienes result in increase in nasal airway resistance and vascular permeability. Antihistamines and leukotriene receptor antagonists are commonly used in the treatment of allergic rhinitis. The published literature about combined antihistamines and leukotriene antagonists in mono- or combination therapy is reviewed and presented.
authors: Department of Otolaryngology-Head Neck Surgery, Trabzon Research and Training Hospital, Trabzon, Turkey. benguyc@gmail.com
authors: Bengü
authors: B
authors: Cobanoğlu
authors: Elina
authors: E
authors: Toskala
authors: Ahmet
authors: A
authors: Ural
authors: Cemal
authors: C
authors: Cingi
mesh_terms: D000085:Acetates / Q000627:therapeutic use; D003521:Cyclopropanes; D006633:Histamine Antagonists / Q000627:therapeutic use*; D006801:Humans; D020024:Leukotriene Antagonists / Q000627:therapeutic use*; D011804:Quinolines / Q000627:therapeutic use; D065631:Rhinitis, Allergic; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy*; D013440:Sulfides
chemical_list: D000085:Acetates; D003521:Cyclopropanes; D006633:Histamine Antagonists; D020024:Leukotriene Antagonists; D011804:Quinolines; D013440:Sulfides; C093875:montelukast
references: Ann Otol Rhinol Laryngol. 2004 Jul;113(7):552-7
references: 15274415
references: Curr Opin Allergy Clin Immunol. 2001 Feb;1(1):51-9
references: 11964670
references: Allergy. 2004 Mar;59(3):280-8
references: 14982509
references: J Allergy Clin Immunol. 2003 Jul;112(1):15-22
references: 12847474
references: Allergy. 2000;55 Suppl 64:17-27
references: 11291777
references: Clin Otolaryngol. 2006 Oct;31(5):360-7
references: 17014443
references: Annu Rev Immunol. 2000;18:767-811
references: 10837075
references: Allergy Asthma Immunol Res. 2010 Apr;2(2):65-76
references: 20358020
references: Allergy. 1993 Feb;48(2):87-93
references: 8457038
references: Ann Allergy Asthma Immunol. 2005 Jun;94(6):609-18; quiz 618-20, 669
references: 15984591
references: J Clin Invest. 1995 Jan;95(1):264-71
references: 7529260
references: Allergy Asthma Proc. 2009 May-Jun;30(3):270-6
references: 19549428
references: J Allergy Clin Immunol. 2002 Jun;109(6):949-55
references: 12063523
references: Br J Clin Pharmacol. 2004 Jun;57(6):714-9
references: 15151516
references: Clin Exp Allergy. 2006 Jun;36(6):689-703
references: 16776669
references: Chest. 2005 Apr;127(4):1312-26
references: 15821210
references: Ther Clin Risk Manag. 2007 Jun;3(2):327-32
references: 18360641
references: Int Immunopharmacol. 2011 Nov;11(11):1646-62
references: 21784174
references: Adv Ther. 2009 Jan;26(1):89-98
references: 19089321
references: Curr Med Res Opin. 2003;19(4):321-9
references: 12841925
references: Clin Rev Allergy Immunol. 1999 Spring-Summer;17(1-2):195-212
references: 10436866
references: Proc Natl Acad Sci U S A. 1979 Sep;76(9):4275-9
references: 41240
references: J Allergy Clin Immunol. 1990 Dec;86(6 Pt 1):924-35
references: 2262647
references: Allergy. 2008 Apr;63 Suppl 86:8-160
references: 18331513
references: Asian Pac J Allergy Immunol. 2008 Jun-Sep;26(2-3):89-95
references: 19054926
references: Rhinology. 2012 Mar;50(1):1-12
references: 22469599
references: Allergy. 2009 Dec;64 Suppl 91:1-59
references: 20041860
references: J Allergy Clin Immunol. 2007 Jan;119(1):213-8
references: 17208604
references: Drugs. 2007;67(6):887-901
references: 17428106
references: J Allergy Clin Immunol. 2000 May;105(5):917-22
references: 10808172
references: Expert Opin Pharmacother. 2007 Apr;8(5):701-9
references: 17376024
references: Curr Opin Allergy Clin Immunol. 2010 Aug;10(4):370-6
references: 20585242
references: Drugs. 2007;67(18):2717-26
references: 18062720
references: Ann Allergy Asthma Immunol. 2006 Jun;96(6):779-86
references: 16802764
references: Curr Opin Pharmacol. 2005 Jun;5(3):214-20
references: 15907905
references: Laryngoscope. 2010 Sep;120(9):1718-23
references: 20717951
references: Allergy Asthma Proc. 2009 Nov-Dec;30(6):634-42
references: 20031009
references: J Am Osteopath Assoc. 1999 Jul;99(7 Suppl):S1-6
references: 10478513
references: Pharmacol Ther. 2007 Jun;114(3):233-60
references: 17433446
references: Otolaryngol Head Neck Surg. 2003 Sep;129(3):274-9
references: 12958580
references: J Allergy Clin Immunol. 2010 Sep;126(3):466-76
references: 20816182
references: Clin Exp Allergy. 2004 Feb;34(2):259-67
references: 14987306
references: South Med J. 2003 Nov;96(11):1049-54
references: 14632350
references: J Pediatr (Rio J). 2006 Nov;82(5 Suppl):S173-80
references: 17136293
references: Inflamm Allergy Drug Targets. 2009 Jun;8(2):96-103
references: 19530991
references: J Investig Allergol Clin Immunol. 2008;18(5):343-9
references: 18973097