- Avoid exposure to allergen
- In excessive nasal secretions (Rinorrhea,sneezing,itching):
- Rina 2.5mg/5ml syrup 2.5 ml (1/2 of a 5 ml spoonful) once a day
- In nasal obstruction:
- Decozal 0.05% spray /drop 1drops in each nostrils up to 3 times daily(>2y)
- Sinocort05% nasal spray : >3year one spray into each nostril once daily.
- Montelukast 4mg once daily at bed time(>2y)
Desloratadine
Available forms:
- Aerius :5mg tab, 0.5mg/ml syrup
- Lorius Dora, Noura :5mg tab
- Aeriallerg, Histcare, Iris : 5mg tab, 0.5mg/ml syrup
- Rina, Dislara :5mg tab, 2.5mg/5ml syrup
Dose :
Children 1 through 5 years of age:
- The recommended dose is 2.5 ml (1/2 of a 5 ml spoonful) of oral solution once a day.
Children 6 through 11 years of age:
- The recommended dose is 5 ml (one 5 ml spoonful) of oral solution once a day.
Adults and adolescents 12 years of age and over:
- The recommended dose is 10 ml (two 5 ml spoonfuls) of oral solution once a day.
- one tablet once a day.
Pregnancy, breast feeding
- Taking Desloratadine is not recommended in pregnancy or nursing a baby
Side effect:
- diarrhea
- fever
- insomnia
- fatigue
- dry mouth
- headache
Otrivine
Otrivine Nasal Spray contains the active ingredient xylometazoline hydrochloride which helps to open up and clear the nasal passages by reducing the excessive nasal secretions and returning the swollen blood vessels to their normal size.
Used in :
- nasal congestion (blocked nose, including colds)
- allergic rhinitis
- sinusitis.
- Not used>5 days Cause rebound congestion
Pregnancy : not recommended
Available forms:
- Otrivin 0.1% spray/drop , .05% spray /drop
- Decozal 0.1% spray/drop , .05% spray /drop
- Xylomet 0.1% spray
Dose:
Adult
- 0.1% Nasal drop 2-3 drops in each nostrils up to 3 times daily
Child>6y
- 0.05% Nasal drop 2-3 drops in each nostrils up to 3 times daily
Child 6months-6y
- 0.05% Nasal drop 1drops in each nostrils up to 3 times daily
Corticosteroids nasal spray (Mometasone)
- help to relieve inflammation(swelling and irritation of the nose), sneezing, itching and a blocked up or runny nose.
Available forms:
- Nasonex 0.05% nasal spray : one spray into each nostril once daily.
- Tabunex 0.05% nasal spray : one spray into each nostril once daily.
- Sinocort 0.05% nasal spray : one spray into each nostril once daily.
Indications:
- to treat the symptoms of seasonal allergic rhinitis (also called hayfever) and perennial (long lasting) rhinitis in adults and children aged 3 and older;
- to treat nasal polyps in adults aged 18 and over
Dose:
Adult:
- recommended dose is two sprays in each nostril once a day.
- Once symptoms are controlled, dose reduction to one spray in each nostril may be effective for maintenance.
- may increase to the dose; the maximum daily dose is four sprays into each nostril once a day.
Children aged 3 to 11 years :
- the usual dose is one spray into each nostril once daily.
- May used some days before the start of the allergy season, as this will help to prevent allergic rhinitis symptoms from occurring.
- Prophylaxis must be initiated up to 2-4 weeks prior to the anticipated start of the allergy season.
- Benefit of treatment may be achieved in the first two days.
- Maximum benefit is achieved within 1-2 weeks following initiation of treatment. Therefore, patients should continue regular use to achieve full therapeutic benefit.
For patients who use MOMEX® at regular intervals for treatment of allergic rhinitis,:
- recommended dose is a spray into each nostril once a day. For children between the ages of 2 and 11 years the usual recommended dose is one spray in each nostril once a day.
Montelukast
Available forms :
- Singulair
- Lukast
- Unicast
- Sincast
- Motrinex
- 4mg 5mg, 10mg Chewable tab
Action:
- Montelukast is in the leukotriene receptor antagonist family of medications. It works by blocking the action of leukotriene D4 in the lungs resulting in decreased inflammation and relaxation of smooth muscle
- Leukotrienes cause tightening of airway muscles and the production of excess mucus and fluid. These chemicals play a key role in allergies, allergic rhinitis, and asthma, also causing a tightening of your airways, making it difficult to breathe.
Indications
- Indicated in the treatment of asthma as add-on therapy in adults and adolescents from 15 years of age and older with mild to moderate persistent asthma who are inadequately controlled on inhaled corticosteroids and in whom “as-needed” short acting β-agonists provide inadequate clinical control of asthma.
- Montelukast Film-coated tablet can also provide symptomatic relief of seasonal allergic rhinitis.
- Indicated in the prophylaxis of asthma in which the predominant component is exercise-induced bronchoconstriction.
Pregnancy
- Montelukast may be used during pregnancy only if it is considered to be clearly essential.
Lactation
- Studies in rats have shown that montelukast is excreted in milk. It is not known if montelukast is excreted in human milk.
- May be used in breast-feeding only if it is considered to be clearly essential.
- Side effects:
- Headache
- Abdominal pain
- Upper respiratory infection
- Diarrhea, nausea, vomiting
- Elevated levels of serum transaminases (ALT, AST)
- Rash
- Pyrexia
Dose:
- Adult: 10mg once daily at bed time
- Children 6-14y: 5mg once daily at bed time
- 2-5 y: 4mg once daily at bed time
In Emergency room:
- Give Antihistamine In sneezing and rhinorrhea :
- Allerfin 10mg/ml IM injection :
Dose:
- 1-5 year : 25-5mg (½ ml )
- 6-12 year: 5-10mg (1ml )
- Adult : 10-20 mg (1-2 ml )
- Give Dexamethasone 4mg/1ml
Dose:
Pediatrics:
- 0.3 mg/kg/day IV / IM divided q6hr or q12hr
Adult:
- 4-8 mg IM /IV
Allergic rhinitis
Presentation :
- Rhinorrhea
- Repetitive sneezing
- nasal congestion, obstruction
- postnasal drainage
- Pruritus
- Itching of the palate, nose, ears, eye
- Snoring
- Frequent sore throats
- Cough
- Headache
- Itching redness watery eyes
Lines of management :
- Avoid exposure to allergens
- In excessive secretions and sneezing: oral antihistamine
- If nasal obstruction: Nasal decongestant
- For ocular symptoms: intranasal antihistamine
- If Symptoms persist and affect quality of life: Intranasal Corticosteroid
- Sever and persistent symptoms: Intranasal Corticosteroid + oral or intranasal antihistamine+ Oral leukotriene receptors antagonist