Allergic Rhinitis

DEFINITIONS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Classification ,[object Object],[object Object],[object Object],[object Object]

Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Classification (CHRONIC RHINITIS) ,[object Object],[object Object],[object Object]

Classification (CHRONIC RHINITIS) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Classification (CHRONIC RHINITIS)

Classification ,[object Object],[object Object],[object Object],[object Object],[object Object]

Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Why these classifications were not satisfactory ,[object Object],[object Object],[object Object],[object Object],[object Object]

ARIA - New Classification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

New Trends ,[object Object],[object Object],[object Object]

Other New Trends ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Other New Trends ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Definition: Allergic Rhinitis ,[object Object],[object Object],[object Object],[object Object],[object Object]

History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

“ Sneezers and Runners” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

“ Blockers” ,[object Object],[object Object],[object Object],[object Object],[object Object]

Differential Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

History ,[object Object],[object Object],[object Object],[object Object],[object Object]

History ,[object Object],[object Object]

ENVIRONMENT CONTROL The Stepladder Approach to the Management of Allergic Rhinitis ,[object Object],[object Object]

History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

History ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

GOAL of Pharmacotherapy in AR ,[object Object]

ENVIRONMENT CONTROL The Stepladder Approach to the Management of Allergic Rhinitis ,[object Object],[object Object],Oral antihistamines (Aerius, Zyrtec, Telfast, Virlix, Xyzal )

Antihistamines - History ,[object Object],Daniel Phenbenzamine Chlorphenamine Terfenadine Astemizole Fexofenadine Bovet Cetirizine Loratadine Levocetirizine Desloratadine

[object Object],[object Object],[object Object],[object Object],[object Object],Antihistamines – History & Classification

Antihistamine – Mechanism of Action ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Antihistamine – Mechanism of Action ,[object Object],[object Object],[object Object],[object Object]

Antihistamine- Ideal Characteristics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ENVIRONMENT CONTROL Nasal steroid sprays (Nasonex, Flixotide, Budecort) The Stepladder Approach to the Management of Allergic Rhinitis ,[object Object],[object Object],Oral antihistamines (Aerius, Zyrtec, Telfast, Virlix, Xyzal )

Topical Corticosteroids ,[object Object],[object Object],[object Object],[object Object],[object Object]

Action of topical corticosteroids ,[object Object],[object Object],[object Object]

Safety of Topical CS ,[object Object],[object Object],[object Object],[object Object],[object Object]

Safety of Topical CS ,[object Object],[object Object],[object Object],*Meltzer et al; J Allergy Clin Immunol 1999;204: 107-114 **Minshall et al; Otolaryn Head Neck Surg 1998; 118:648-54

Use of Inhaled Steroids in Pregnancy ,[object Object],[object Object]

Use of Inhaled Steroids in Pregnancy ,[object Object],[object Object],[object Object],[object Object]

Relationships between ICS and SGA infants and mean birth weight 3452 + 120.3 8.0 347 flunisolide 3393 + 69.0 9.3 393 Budesonide 3508 + 60.1 4.9 193 Triamcinolone 3428 + 51.7 7.6 720 Fluticasone 3421 + 37.5 6.0 277 Beclomethasone Birth wt (g) Mean + SEM SGA percent μ g Drug

Use of Inhaled Steroids in Pregnancy ,[object Object],[object Object],JACI 2004; 113:427-32

ENVIRONMENT CONTROL Nasal steroid sprays (Nasonex, Flixotide, Budecort) Nasal antihistamine sprays (Azep) The Stepladder Approach to the Management of Allergic Rhinitis ,[object Object],[object Object],Oral antihistamines (Aerius, Zyrtec, Telfast, Virlix, Xyzal )

Decongestants ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Decongestants ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Rhinitis medicamentosa ,[object Object],[object Object]

Rhinitis medicamentosa ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Rhinitis medicamentosa ,[object Object],[object Object],[object Object]

ENVIRONMENT CONTROL Nasal steroid sprays (Nasonex, Flixotide, Budecort) Nasal antihistamine sprays (Azep) Oral steroids (Prednisone) The Stepladder Approach to the Management of Allergic Rhinitis ,[object Object],[object Object],Oral antihistamines (Aerius, Zyrtec, Telfast, Virlix, Xyzal )

ENVIRONMENT CONTROL Nasal steroid sprays (Nasonex, Flixotide, Budecort) Nasal antihistamine sprays (Azep) Oral steroids (Prednisone) Immunotherapy The Stepladder Approach to the Management of Allergic Rhinitis ,[object Object],[object Object],Oral antihistamines (Aerius, Zyrtec, Telfast, Virlix, Xyzal )

ENVIRONMENT CONTROL Nasal steroid sprays (Nasonex, Flixotide, Budecort) Nasal antihistamine sprays (Azep) Oral steroids (Prednisone) Immunotherapy The Stepladder Approach to the Management of Allergic Rhinitis ,[object Object],[object Object],Oral antihistamines (Aerius, Zyrtec, Telfast, Virlix, Xyzal ) 1 2 3

Highlights ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Highlights ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Highlights ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Highlights ,[object Object],[object Object],[object Object],[object Object],[object Object]

Allergic Rhinitis

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Allergic Rhinitis