Question

A 9-year-old girl is brought in by her mother for evaluation of allergies. Each year in the spring the child develops a runny nose; itchy, watery eyes; and sneezing. She has been treated in the past with diphenhydramine, but the child’s teacher says that she is very drowsy during school. She has no other medical problems and is on no chronic medications. Her examination is unremarkable today. You diagnose her with seasonal allergic rhinitis.

1. What modifications would you recommended for this patient?
2. What are the advantages and disadvantages of your choice for treatment?

Answer 1

For a patient with seasonal allergic rhinitis, modifications may include avoidance of allergens, using non-sedating antihistamines, and considering nasal corticosteroids. These modifications can improve symptom control and quality of life while reducing drowsiness. However, they may require adherence to a treatment plan and incur additional costs.

Step-by-step explanation:

For this patient with seasonal allergic rhinitis, there are a few modifications that can be recommended:

1. Avoidance of allergens: Encourage the patient to stay indoors when pollen counts are high, use air purifiers at home, and keep windows closed to minimize exposure to allergens.
2. Prescription medications: Instead of diphenhydramine, which can cause drowsiness, recommend non-sedating antihistamines such as cetirizine or loratadine to relieve symptoms.
3. Nasal corticosteroids: Consider prescribing intranasal corticosteroids like fluticasone or mometasone, which can effectively reduce nasal inflammation and congestion.

The advantages of these modifications include improved symptom control, reduced drowsiness, and better quality of life. The disadvantages may include the cost of prescription medications and the need for consistent adherence to the treatment plan.