Only after the initial examination, the patient is referred to an allergist. How to treat an allergic rhinitis? Treatment includes both local and systemic drugs.
The appearance of mucous secretions, nasal congestion and shortness of breath are all signs of an inadequate response of the immune system to the action of an allergen. Frequent provoking factors include:
- pollen. Clinical signs occur during the flowering period of plants (hay fever);
- harsh chemical aromas;
- cosmetical tools;
- fluff;
- wool;
- food products (citrus fruits, seafood, products with dyes);
- insect bites;
- medicines;
- dust mites.
Symptoms
Allergic rhinitis in adults can be suspected by the following:
- transparent watery discharge;
- itchy sensation in the nose;
- sneezing;
- severe nasal congestion, which is caused by swelling of the mucous membrane;
- decreased sense of smell;
- peeling of the skin of the wings of the nose as a result of frequent friction. Microcracks can act as gateways for infection.
An increase in clinical signs is observed after contact with an allergen, which helps in finding it.
In addition to local manifestations of allergies, in most cases, other signs are noted:
- lacrimation, itching sensations in the eyes, blurred vision, conjunctival hyperemia;
- skin rashes;
- tissue edema of the face, neck;
- dyspeptic disorders;
- itchy skin.
Therapeutic tactics
With an allergic rhinitis in an adult, certain recommendations are required. They relate to the general regimen and drug therapy.
For treatment it is necessary:
- exclude possible allergens from the diet;
- regularly clean the room, due to which the concentration of provoking factors in the air decreases;
- ventilate the room twice a day (in the morning, in the evening), preferably in calm weather, otherwise a large amount of pollen can enter the room. This is important for hay fever;
- reduce the air temperature to 19 degrees;
- maintain air humidity at 55%, which will greatly facilitate nasal breathing;
- use hypoallergenic cosmetics, household chemicals;
- walk regularly in the fresh air (best after rain). This is necessary to saturate the internal organs with oxygen and naturally cleanse the nasal passages;
- remove from the room "dust collectors" (decorative pillows, carpets, soft toys).
Desensitization
To cure allergies, sometimes drugs alone are not enough. The main task of therapy is to stop contact with the allergen and eliminate unpleasant symptoms.
The question of conducting desensitization is resolved when drug therapy is ineffective. It is based on the fractional administration of the allergen by the subcutaneous method at a minimum dose. Doses are gradually increased, thereby developing the resistance of the immune system to the action of a provoking factor.
Therapy is carried out during the period of remission, when there are no allergy symptoms.
Medications
To properly treat allergic rhinitis, it is necessary to use drugs of local and systemic action. For intranasal administration, the following drugs are used:
- with an antihistamine effect (Allergodil, Tizin Allergy);
- salt solutions (Aqua Maris, Humer). Despite their safety, their uncontrolled use leads to serious complications. The fact is that the nasopharyngeal mucosa has a certain composition of microflora, which maintains local protection at a sufficient level. The flora contains both beneficial and opportunistic microorganisms that normally do not cause disease. With frequent use of the saline solution, their quantitative composition changes, due to which the protection of the mucous membrane decreases, and the risk of infection increases;
- mast cell stabilizers (Cromohexal). They are often prescribed to patients from two years old to reduce the severity of local manifestations of rhinitis;
- combination medications for allergic rhinitis. They include a vasoconstrictor and antihistamine component. This group of drugs includes Vibrocil, Sanorin Anallergin;
- vasoconstrictor drugs. Their action is based on local vasospasm, due to which tissue swelling, the severity of rhinorrhea decreases, and nasal breathing is facilitated. The prominent representatives of the group are Nazol, Otrivin, Ksilo Mefa, Sanorin. They differ in composition, method of administration and duration of the vasoconstrictor effect;
- hormonal remedies for allergic rhinitis (Nasonex, Avamis, Fliksonase, Nasobek). They are used in severe cases of the disease, when monotherapy with antihistamines is not able to get rid of the signs of allergy.
Hormonal and vasoconstrictor drugs can be addictive after 7 days, which is why the therapeutic effect is sharply reduced.
Here is a list of systemic medicines that are used to treat allergic rhinitis:
- antihistamines (Centrin, Loratadin, Erius, Zodak);
- mast cell stabilizers (Intal). Medicines provide therapeutic assistance some time after taking. In this regard, it is recommended to use them in combination with fast-acting medicines;
- corticosteroids (Prednisolone, Dexamethasone). Depending on the composition of the drug, the therapeutic effect may develop in the first hour after taking the medication or after a couple of days.
Antihistamines
Antihistamines are the most commonly prescribed group of drugs for allergic rhinitis. Tablet forms are divided into three generations, which differ in composition, mechanism of action and the number of side effects:
- first generation. This group includes Suprastin, Tavegil, and Diazolin. Their advantage lies in the rapid relief of the general condition by relieving tissue edema, reducing itching sensations, sneezing frequency and facilitating breathing. They are considered ambulance drugs. Despite this, pills are used quite rarely in comparison with medicines of other generations. The fact is that they have a strong sedative effect, which is why they are limited in use by people whose profession requires concentration of attention. The disadvantages also include a short-term therapeutic effect (no more than 5 hours). The risk of changes in the psychoemotional state, the emergence of aggression, agitation, hysteria is not excluded. Due to the high likelihood of developing addiction, it is recommended to select a different treatment regimen every three weeks;
- second generation (Loratadin, Claritin, Tsetrin). The clear benefits include the absence of drowsiness after taking the drug. Tablets for allergic rhinitis have a prolonged effect, due to which, after a single dose, the effect lasts for a day. Over the next few days, the person continues to be under drug protection from allergens. Restrictions on use apply to people with severe cardiac pathology.
Claritin has the minimum number of side effects, so it is often prescribed even to infants.
- third generation (Telfast, Zirtek, Tsetrilev). These drugs for allergic rhinitis are the best in the fight against the disease. They do not have a negative effect on the nervous system, and also do not affect the myocardium. Some representatives of this group are capable of accumulating in the body, which must be taken into account when drawing up a treatment regimen. The drugs can be used for several months.
Cetrin
The active ingredient of the drug is cetirizine. It reduces the severity of symptoms and prevents their recurrence with hay fever. Thanks to regular intake, a decongestant, antipruritic effect is provided, the action of histamine is blocked, and vascular permeability is also reduced.
Tsetrin is prescribed as a tablet once a day. Children from six years old are recommended half a tablet twice a day. The drug should be taken with a small amount of water. The duration of the course can be 1-4 weeks, however, if necessary, it can be extended up to six months.
The medicine has some side reactions, among which it is worth highlighting:
- tremor, dizziness, insomnia, migraine, headache, agitation;
- change in taste;
- dry mouth, discoloration of the tongue, hepatic dysfunction;
- stomatitis;
- heart palpitations, increased blood pressure;
- joint, muscle pain; inflammation of the throat.
Contraindications include pregnancy, lactation, hypersensitivity to cetirizine.
Kromoglin
Spray for allergic rhinitis blocks the release of biologically active substances that stimulate the development of allergies. The drug is prescribed for therapeutic and prophylactic purposes.
Among the contraindications, we highlight:
- individual intolerance;
- polyposis formations in the nasal passages;
- severe renal, liver failure;
- pregnancy (first trimester);
- age up to five years.
The remedy for allergic rhinitis must be used daily, otherwise the therapeutic effect will be incomplete. The recommended dosage is one spray up to four times a day. If necessary, the frequency of administration can be increased to six.
The drug is prescribed for a long course. Even after the symptomatology has decreased, its administration should be continued, reducing the frequency of administration. The drug is mainly prescribed in combination with a vasoconstrictor for a quick effect.
Adverse reactions include:
- lacrimation;
- increased tissue swelling;
- unpleasant taste sensations;
- nausea, vomiting;
- irritation, dryness of the mucous membrane in the nasopharynx.
Hormonal medications
Steroid drugs for allergic rhinitis can be used in tablet form or as a spray. Note that systemic corticosteroids have many adverse reactions. They are prescribed as a last resort, to obtain a quick healing effect.
Now we will consider hormonal preparations for allergic rhinitis for intranasal administration. Here is a list of commonly prescribed medications:
- Fliksonase;
- Beconase;
- Nazonex;
- Avamis;
- Nasobek;
- Nazarel.
Fliksonase has a powerful anti-inflammatory, anti-allergic effect at the injection site. The drug has no systemic effect. After opening the bottle, the medicinal properties of the solution remain for two months.
Contraindications include individual intolerance. The maximum course duration is 3 months. Before using Fliksonase, you should pay attention to the contraindications:
- concomitant use of systemic corticosteroids;
- the presence of infection in the paranasal cavities;
- the presence of hyperthermia;
- ulcerative lesion of the nasal mucosa;
- recent injuries, surgical interventions in the nasopharyngeal area.
Fliksonase is prescribed from the age of 18, two sprays once a day (preferably in the morning). In severe cases of the common cold, you can use two doses twice a day. After a decrease in the severity of symptoms, you should return to the maintenance dose.
Adverse reactions include:
- headache;
- bad breath;
- change in taste;
- nasal bleeding;
- dryness, irritation of the nasopharyngeal mucosa.
With prolonged use of a steroid spray, the risk of ulceration, septal perforation, and the development of addiction increases.
Vasoconstrictor drugs
Vasoconstrictor medications are often used to quickly relieve nasal breathing. Here is a list of effective medications:
- Xymelin;
- Meralis;
- Nazivin;
- Knoxprey;
- Sanorin;
- Rinostop;
- For the nose;
- Pharmazoline;
- Galazolin.
All drugs with vasoconstrictor properties are divided according to the active substance, which determines the duration of the therapeutic effect, contraindications, and adverse reactions.
Let's select groups of drugs with:
- short-acting (up to 4 hours) - with naphazoline;
- medium duration (up to 8 hours) - based on ximetazoline;
- long-term effect (up to 12 hours) - with oxymetazoline.
Among the contraindications, it is worth highlighting:
- pheochromocytoma;
- uncontrolled arterial hypertension;
- glaucoma;
- violation of the cardiac rhythm;
- taking antidepressants;
- an increase in the volume of the prostate;
- diabetes;
- renal insufficiency;
- epilepsy;
- increased production of thyroid hormones;
- severe atherosclerotic vascular disease.
Medicinal solutions are produced with different concentrations of the active substance, which makes it possible to prescribe drugs in childhood.
Side effects include:
- increased blood pressure;
- failure of the cardiac rhythm;
- tremor;
- retention of urine;
- dryness, irritation of the nasal mucosa;
- frequent sneezing;
- excitation.
Failure to comply with the recommended doses and duration of the treatment course may decrease the sensitivity of the vessels to the action of vasoconstrictor substances. As a result, the vessels remain in a dilated state both under the influence of endogenous hormones (adrenaline) and after instillation of the nose with vasoconstrictor agents. Thus, addiction develops.
To avoid complications, read the instructions before using any drug.
