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ALLERGIC RHINITIS

ALLERGIC RHINITIS. Allergic Reactions. Allergy An inappropriate, often harmful response of the immune system to normally harmless substances Hypersensitive reaction to an allergen initiated by immunological mechanisms that is usually mediated by IgE antibodies

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ALLERGIC RHINITIS

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  1. ALLERGIC RHINITIS

  2. Allergic Reactions • Allergy • An inappropriate, often harmful response of the immune system to normally harmless substances • Hypersensitive reaction to an allergen initiated by immunological mechanisms that is usually mediated by IgE antibodies • Allergen: the substance that causes the allergic response

  3. Related Anatomic StructuresCompromised by Allergic Rhinitis

  4. Useful classification of allergic rhinitis • Intermittent. Occurs less than 4 days/week or for less than 4 weeks • Persistent. Occurs more than 4 days/week and for more than 4 weeks • Mild. One or more of the following – normal sleep; normal daily activities, sport, leisure; normal work and school; symptoms not troublesome • Moderate. One or more of the following – abnormal sleep; impairment of daily activities, sport, leisure; problems caused at work or school; troublesome symptoms

  5. ALLERGENS SEASONAL Occupational • Pollens Bakery,Dust • Fungi Washing powder • Grass Latex,Drugs Perennial Food • House dust mite Tartazine,Sulphate,Cheese • Cattle field Fish,Nuts,Eggs • Cockroaches Citrus fruits

  6. Allergic RhinitisFirst exposure – Phase of sensitizationOn re-exposure- Mast cell degranulation Exposure of genetically predisposed individuals to allergens (pollen, animal dander, fur) Activation of T-lymphocytes Stimulates IgE production by B-lymphocytes IgE coat mast cells [on re-exposure mast cell degranulation]

  7. Allergic Rhinitis: Inflammatory mediators Released by inflammatory cells (mast cells, eosinophils, lymphocytes) • Leukotrienes • hypersecretion of mucus • oedema (Increased vascular permeability) • Histamine • itching, rhinorrhea (Allergic rhinitis) • Cytokines • Interleukins (IL) • IL-4 (IgE production) • IL-3 and IL-5 (eosinophil, mast cell recruitment / activation)

  8. MUST KNOW: • Age - Baby, child, adult • Duration • Symptoms • Rhinorrhoea (runny nose) • Nasal congestion • Nasal itching • Watery eyes • Irritant eyes • Discharge from the eyes • Sneezing • Previous history • Associated conditions • Asthma • Medication

  9. Treatment Options: Allergic Rhinitis • Antihistamines • Oral: Most common form of Treatment. (Drowsiness / Dryness of mouth / Urinary retention / Blurred vision / appetite +).Cetrizine, • Nasal Spray : Azelastine. Potent H1 blocker with immediate effect • Decongestants/ Corticosteroids • Nasal Sprays: Most effective treatment of AR / certain types of perennial rhinitis (Beclomethasone / Budesonide / Fluticasone / Mometasone. • Reduce swelling & secretions in nasal mucosa (anti-inflammatory) • Oral Corticosteroids: Short term

  10. Further advice • 1 Car windows and air vents should be kept closed while driving. Otherwise a high pollen concentration inside the car can result. • 2 Where house dust mite is identified as a problem, regular cleaning of the house to maintain dust levels at a minimum can help.

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