Question

A 22 year-old woman presents with sneezing, runny nose, postnasal drip, and nasal congestion for the last week. She says this happens every spring. She is not allergic to any medications. Which of the following is the most appropriate pharmacologic treatment for this patient?

A. Azithromycin (Zithromax)
B. Phenylephrine (Neo-synephrine)
C. Nedocromil
D. Pseudoephedrine

Answer 1

The most appropriate treatment for the symptoms of seasonal allergic rhinitis is Pseudoephedrine, while the antibiotic azithromycin and nedocromil are not recommended for such symptoms. Phenylephrine, a less effective decongestant, could be considered as a secondary option.

Step-by-step explanation:

The most appropriate pharmacologic treatment for a 22-year-old woman experiencing seasonal allergic rhinitis symptoms, which include sneezing, runny nose, postnasal drip, and nasal congestion, is D. Pseudoephedrine. Pseudoephedrine is a nasal/sinus decongestant that works by reducing swollen blood vessels in the nasal passages. As the patient's symptoms recur every spring, they are likely related to seasonal allergies rather than an infection, making antibiotics such as azithromycin an inappropriate choice.

Phenylephrine is another option as a decongestant, but it is generally considered less effective than pseudoephedrine due to its poor oral bioavailability and short duration of action. Nedocromil is an anti-inflammatory medication typically used for asthma, and it would not be the first-line treatment for nasal congestion and rhinitis symptoms.