environmental control (avoiding exposure to allergens)

Neti Pots

Not overly sanitizing infants is important: children need to build a healthy immune system and over - worry about cleanliness ends up causing more illness.

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Intranasal corticosteroids

Milder, intermittent symptoms can be treated with oral antihistamines.

first line for patients with mild - moderate disease

itching, sneezing, and rhinorrhea. They have little effect on nasal congestion

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second - generation agents have less side effect, including less sedation

alpha adrenergic agonists that cause nala vasoconstriction

[image][image][image][image]Wikipedia: agonist definition: one that is engaged in a struggle. →

Side effects include insomnia, loss of appetite, excessive nervousness, increased BP, paplitations

Caution in certain conditions: arrhytmias, angina pectoris, patients with HTN, CAD, hyperthroidism, glaucoma, diabetes, urinary dysfunction &c.

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(1) Pseudoephedrine (Sudafed) - 30 mg Q 12 hours

(2) Phenylephrine (Sudfed PE) - not as effective as pseudoephedrine 5 mg, 1-2 Q 4-6 hours, max 8/day

Naphazoline

Phenylephrine

Oxymetazoline

Tetrahydrozoline

Xylometazoline

For topical agents, limit use to < 5 days (ideally 2-3 days) to prevent rebound congestion, or rhinitis medicamentosa ---> usually occurs after 5 - 10 days of treatment.

Brand name for Intranasal cromolyn

Nasalcrom

(A) Takes 4-7 days to see symptom relief; up to 2 weeks for maximal effect

(B) Not as effective as other agents

(C) Due to its safety prfile, consider for young children and pregnany

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Effective in reducing rhinorrhea but no effect on other nasal symptoms (can cause nasal dryness)

Usually used in combination with other agents when rhinorrhea is the predominant symptom

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Not any more effective than antihistamines or pseudoephedrine

A neti pot looks like a small genie lamp or teapot. It is used to hold salt water (saline solution) that is poured into one nostril and allowed to drain out the other nostril. This technique may help with sinus symptoms. It can clear out your nasal passages, reduce swelling. Neti pots are safe for children and pregnant women. The most common side effects are burning or stinging in the nose.

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OTC cough and cold products should NOT be used in children under age 4.

recommend nasal bulbs for gentle suctioning, saline drops/sprays (Ocean and generics) and tell parents that the medications have not been shown to work in young children, they can be dangerous, and symptoms usually resolve in a few days or up to 2 weeks.

Children:

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When to prime your bottle of VERAMYST Nasal Spray?

You need to prime your bottle of VERAMYST Nasal Spray before using it for the first time, not every time.

You ONLY need to reprime your bottle of VERAMYST Nasal Spray if:

(1) Device has not been used for 30 days or more

(2) Cap has been lfet off the bottle for 5 days or longer

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See the flip for the "Don't"