Fluticasone furoate nasal spray: A single treatment option for the symptoms of seasonal allergic rhinitis.JACI, Volume 119, Issue 6, Pages 1430-1437 (June 2007).
299 patients, aged 12 years and older, were included in a 2-week double-blind, parallel-group randomized study during the fall. Fluticasone nasal spray, 110 μg qd, was effective and well tolerated for treatment of fall-season allergic rhinitis (SAR). It also helped the eye symptoms of SAR.
Fluticasone was fast acting, with an 8-hour onset of action, and long-acting, with a 24-hour symptom control. Again, the duration of the study was only 2 weeks, so no major adverse effects were observed.
Mnemonic for symptoms of SAR: CS DIES
Congestion
Smell impairment
Discharge - watery nasal discharge
Itching
Eye symptoms
Sneeze
Mnemonic for stepwise approach to treatment of allergic rhinitis: OASIS
Omit (avoid) allergens
Antihistamines (oral and topical)
Steroids (topical)
Immunotherapy
Surgery
Patients should be instructed to angle the steroid spray towards the ear to direct it where the inflamed nasal mucosa is. Pumping it straight up will direct the medication to the nasal cartilage, leading to local side effects.
Related:
New tools help MDs treat allergies. National Review, 03/2008.
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Updated: 03/10/2008
Treatment Options for Allergic Rhinitis (click to enlarge the image).