By vgreene, 23 April, 2021 Start w combo intranasal antihistamine INAH intranasal steroid INCS which is more effective than INCS alone mono tx w INCS or INAH also a 1st line option individualize med mgmt in light of pt preference 1 avoid triggers step down stop tx if sx controlled
By vgreene, 23 April, 2021 Avoidance of animals effective for animal allergy 4 highly pollen allergic pts should stay indoors during high pollen counts benefit of other environmental measures uncertain4 8
By vgreene, 23 April, 2021 Complementary BSACI advises against acupuncture 4 while AAO HNS says it may be offered 3 No evidence for against homeopathy herbs phototherapy or other complementary tx per AAAAI AAO HNS BSACI
By vgreene, 23 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 drug6 7
By vgreene, 23 April, 2021 If pregnant 2 4 nasal saline INCS except triamcinolone OAH nedocromil cromolyn considered safe avoid decongestants esp in 1st trimester per AAAAI
By vgreene, 23 April, 2021 Don t use montelukast as 1st line d t darr efficacy serious neuropsych side effects suicidality other LTRAs also not recommended as 1st line option2
By vgreene, 23 April, 2021 Nasal saline may reduce pt reported dz severity 2 4 amount of pharmaco tx needed 4 is well tolerated2 4
