By vgreene, 26 April, 2021 Avoidance of animals effective for animal allergy 1 highly pollen allergic pts should stay indoors during high pollen counts benefit of other environmental measures uncertain1 7
By vgreene, 26 April, 2021 Complementary BSACI advises against acupuncture 1 while AAO HNS says it may be offered 4 No evidence for against homeopathy herbs phototherapy or other complementary tx per AAAAI AAO HNS BSACI
By vgreene, 26 April, 2021 If ocular sx allergic conjunctivitis sx improve w OAH INCS INAH but may require ophthalmic med mast cell stabilizer antihistamine or dual action drug3 6
By vgreene, 26 April, 2021 If pregnant 1 2 nasal saline INCS except triamcinolone OAH nedocromil cromolyn considered safe avoid decongestants esp in 1st trimester per AAAAI
By vgreene, 26 April, 2021 Don t use montelukast d t darr efficacy serious neuropsych side effects suicidality don t use LTRAs in combo w OAH use only in pts not successfully treated w other options2
By vgreene, 26 April, 2021 Consider structural or infectious problem in setting of repeated tx failure1 or after initial failure w congestion as dominant sx4
By vgreene, 26 April, 2021 If rhinorrhea is dominant Consider switching to or adding intranasal ipratropium1 2
By vgreene, 26 April, 2021 Nasal saline may reduce pt reported dz severity 1 2 amount of pharmaco tx needed 1 is well tolerated1 2
By vgreene, 26 April, 2021 Consider oral steroids not depot injection 1 2 x5 7 days for very severe sx 2 or if inflammatory rhinitis is suspected after other tx failures1
