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Management of Allergic Rhinitis: Focus on Intranasal Agents
Author(s) -
Dushay Miriam E.,
Johnson Cary E.
Publication year - 1989
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/j.1875-9114.1989.tb04148.x
Subject(s) - medicine , nasal administration , mucous membrane of nose , cromolyn sodium , nedocromil sodium , rhinorrhea , pharmacology , histamine , ketotifen , nasal cavity , immunology , asthma , surgery , pathology , placebo , alternative medicine
The clinical manifestations of allergic rhinitis are the result of an immune‐mediated process after exposure of a sensitized individual to airborne allergens. The primary symptomatology includes nasal congestion, rhinorrhea, nasal and conjunctival pruritus, and sneezing. Principles of management include allergen avoidance, palliative therapy, immunotherapy, and pharmacotherapy. Oral decongestants stimulate α‐adrenergic receptors in the nasal cavity, resulting in vasoconstriction and decreased edema. Oral antihistamines block histamine 1 (H 1 ) receptors, and may relieve rhinorrhea, sneezing, and nasal and conjunctival pruritus. Topical decongestants have a local effect on adrenergic receptors in the nasal mucosa, resulting in rapid, marked vasoconstriction. Intranasal corticosteroids inhibit mediator release from mast cells and basophils, and reduce edema of the nasal mucosa. Dexamethasone sodium phosphate, beclomethasone dipropionate, and flunisolide are currently available for intranasal administration. Cromolyn sodium inhibits allergen‐induced degranulation and mediator release from sensitized cells, and is useful primarily as a prophylactic agent. Several agents, including the corticosteroids budesonide and flucortin butylester, the mast cell‐stabilizing agent nedocromil sodium, the antichololinergic agent ipratropium bromide, and the H 1 receptor antagonist levocabastine are being investigated for intranasal use in the management of allergic rhinitis.