Your 20-year-old female patient presents with allergic rhinitis symptoms. She reports taking oral antihistamines intermittently but has found them ineffective. She complains of nasal congestion and rhinorrhea almost daily, stating her symptoms are worse in the Spring.

What do you recommend?

Question

TheoryPractice · Accepted Answer

Fluticasone nasal spray daily. The correct answer is C) Fluticasone nasal spray daily.

An intranasal corticosteroid (ICS), such as fluticasone, is the most effective treatment for allergic rhinitis and is the first-line treatment for patients with persistent symptoms (i.e., ≥4 days per week and ≥4 consecutive weeks per year).

Choice A is incorrect. Oral antihistamines, such as cetirizine, are recommended for patients with intermittent symptoms or persistent symptoms that are not controlled with an ICS.

Choice B is incorrect. Antihistamine nasal sprays, such as azelastine, are recommended for patients with intermittent symptoms or whose persistent symptoms are not controlled with an ICS.

Choice D is incorrect. Intranasal cromolyn may be recommended for use prior to known allergen exposure. For ongoing symptoms, it must be used 3-4 times per day for 1-2 weeks to achieve maximum effect. Cromolyn is not as effective as other medications.

Your 20-year-old female patient presents with allergic rhinitis symptoms. She reports taking oral antihistamines intermittently but has found them ineffective. She complains of nasal congestion and rhinorrhea almost daily, stating her symptoms are worse in the Spring.<br/><br/>What do you recommend?

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