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Understanding Allergic Rhinitis: Prevalence, Symptoms, and Treatment Options

Allergic rhinitis affects 20-40 million Americans, with 10%-30% of adults and up to 40% of children impacted. Common signs include sneezing, nasal congestion, and itchy eyes. This condition arises from the immune system's hypersensitivity to allergens such as pollen, dust, and pet dander. Accurate diagnosis can differentiate it from a common cold through IgE tests. Treatment options include antihistamines, intranasal steroids, and immunotherapy, aiming to reduce symptoms and improve quality of life.

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Understanding Allergic Rhinitis: Prevalence, Symptoms, and Treatment Options

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  1. ALLERGIC RHNITIS - PREVALENCE • Affects 20-40 million Americans • 10% - 30% of adults • Up to 40% of children • More common young boys • but little sex difference after • adolescence • No impact of race or • socioeconomic status

  2. SIGNS and SYMPTOMS of ALLERGIC RHINITIS • Sneezing • Itchy nose, eyes, throat, • and/or ears • Nasal congestion • Clear rhinorrhea • Conjunctival edema, itching, • tearing, hyperemia • Subocular edema and • darkening “shiners” • Loss of taste and smell • sensations

  3. CASUSE OF ALLERGIC RHINITIS • Hypersensitivity of the immune • system • Exposure to an allergen • Triggers antibody production • Antibodies bind to cells that • contain histamine • Histamine released from cells

  4. DISTINGUISHING ALLERGIC RHINITIS FROM THE COMMON COLD

  5. Skin tests for specific IgE antibodies •Identify allergens •Antihistamine use can suppress results Serum specific IgE tests •RAST (radioallergosorbent) blood test DIAGNOSTIC TESTING

  6. COMMON ALLERGENS • Pollen • Mold • Animal dander • Dust • Dust mite • Food allergies • Insect bites • Drug allergies • Latex • Chemicals

  7. OTHER ALLERGIC REACTIONS • Cough • Asthma • Urticaria • Hives • Eczema • Atopic dermatitis • Contact dermatitis • Anaphylaxis

  8. ASTHMA and ALLERGIES • Definition: Airway hyperresponsive, exacerbated by inflammation • Symptoms • Reversible airway • obstruction • Wheezing • Cough • Dyspnea • Decreased exercise • tolerance

  9. URTICARIA • Affects 15% to 20% of the • population at some time • Most cases are acute • Duration <6 weeks • Chronic idiopathic more • frequent in elderly women • Less than 5% are chronic • Duration >6 weeks

  10. MECHANISMS FOR MAST CELL ACTIVATION IN THE SKIN • IgE immediate • hypersensitivity • Activation of complement • pathway • Drugs or chemical agents • Aggravating factors • •Heat • •Exercise • •Emotional stress

  11. DIAGNOSIS OF URTICARIA • Etiology known in <5% of • cases • Potential causes • •Foods • •Pharmaceuticals • •Sensitivity to animals, • plants, or latex • •Infections • Emotional stress often • an aggravating factor

  12. PRURITIS IN URTICARIA • Itch almost always present • varies in intensity • Pricking or burning nature • Usually worse in evening • or night • More often relieved by • rubbing than by scratching • Excoriation rare

  13. TYPE OF TREATMENT Antihistamines Intranasal steroids Cromolyn sodium Decongestants Antihistamine/decongestant combinations PRIMARY ACTION Block histamine (H1) receptor Exert local anti-inflammatory effects Stablize mast cell membrane Cause vasoconstriction Combine action of both antihistamines and decongestants PHARMACOLOGIC TREATMENT APPROACHES

  14. ANTIHISTAMINES ( H1 ANTAGONISTS) • Older Agents • Diphenhydramine (Benadryl) • Hydroxyzine (Atarax) • Clemastine (Travist) • Newer Agents • Loratadine (Claritin) • Fexofenadine (Allegra) • Cetirizine (Zyrtec) • Desloratadine (Clarinex)

  15. INTRANASAL STEROIDS • Used to control allergic • rhinitis • No systemic side effects • Common AGENTS • Fluticasone (Flonase) • Mometasone (Nasonex) • Triamcinolone (Nasacort • AQ) • Budesonide (Rhinocort)

  16. MAST CELL STABLIZERS • Adjuvant antiinflammatory • agents • Not for acute attacks • Inhibits release • •Histamines • •Leukotrienes • AGENTS • Cromolyn sodium (Intal) • Intranasal Cromolyn • (Nasalcrom) • Nedocromil (Tilade)

  17. DECONGESTANTS • Reduces nasal congestion • Avoid in patients with • hypertension • COMMON AGENT • Pseudoephedrine (Sudafed)

  18. ALLERGY IMMUNOTHERAPY • Increases IgG antibody • Decreased IgE • Decrease in histamine • release to specific allergen • Reduction in symptoms • Not indicated food allergies

  19. ALLERGIES Susan Hentz NURS 7724

  20. ReferencesReferences • American Academy of Allergy, Asthma, and Clinical Immunology (2002) Fast facts: allergies • 15 November 2002 http://www.aaaai.org/public/fastfacts/allergies.htm • Fireman P. (Ed.) (1998) Allergic rhinitis. In: Atlas of Allergies. Philadelphia: J.B. Lippincott Co. • Google Image Search 15 November 2002 http://images.google.com/images?=allergies • Patterson, R.(Ed.) (1993) Allergic Diseases Diagnosis and Management (4th ed.) • Philadelphia: J.B. Lippincott Co. • U.S. National Library of Medicine (2002) Medlineplus Medical Encyclopedia 15 November 2002 http://www.nlm.nih.gov/medlineplus/encyc/article/000812.htm

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