Rhinitis

18/05/2013 by admin | Respiratory

Rhinitis

Definition

Present if sneezing attacks, nasal discharge or blockage occur for more than an hour on most days for:

  1. A limited period of the year = Seasonal rhinitis (‘Hayfever’): allergic, 2-20% incidence, most common in teens, p/c: nasal irritation, sneezing, rhinorrhoea, itching eyes/soft palate.
  2. Throughout the whole year = Perennial rhinitis: rarely affects eyes/throat, 50% have sneezing and watery rhinorrhoea, other half nasal blockage.

 

Aetiology – cause, risk factors

Major cause is allergy to the faecal particles of the house dust mite.

Pathophysiology

Mediated by efferent nerve fibres and by released mediators.

Mucus production (parasympathetic stimulation).

Treatment/management

  1. Allergen avoidance
  2. Antihistamines
  3. Decongestants (adrenomimetic agents: agonists of alpha 1 and 2 receptors).
    1. o Xylometazoline
    2. o Oxymetazoline
  4. Anti-inflammatory drugs
    1. o Sodium cromoglicate (mast cell stabaliser): reduce histamine release.
    2. Being replaced by Monteleukast (leukotriene receptor antagonist).
    3. o Nedocromil sodium
  5. Corticosteroids
    1. o Beclometasone   
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