LYCOS RETRIEVER 
Rhinitis: Patients
built 621 days ago
In 1 study, more than 38% of patients treated with Ribomunyl were free of infectious rhinitis compared with 29.6% of those receiving placebo. In addition, significantly more patients assigned to the placebo group than those assigned to the treatment group required antibiotics. Patients receiving antibiotics in the placebo group required prolonged treatment with antibiotics. Ribomunyl continued protection from infectious rhinitis throughout the peak season (ie, autumn to winter). Although adverse reactions occurred in some patients, they were not specifically reported. Patients were initially given 1 tablet (strength and quantity of individual components not stated) 4 times per week for 3 weeks; this dosage then was reduced to 4 consecutive days per month for a total of 5 months.
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With the exception of systemic steroids, intranasal corticosteroids are the most effective single agents for controlling the spectrum of allergic rhinitis symptoms and should be considered as first line therapy in patients with moderate to severe symptoms. Oral antihistamines are an effective alternative in patients who cannot use or prefer not to use intranasal corticosteroids. They can ... be added to intranasal corticosteroids as an adjunctive agent. Some patients and physicians prefer to use antihistamines or antihistamine/decongestant combinations to treat mild or episodic disease, particularly when rapid onset of symptom relief is desired. Second generation antihistamines are less sedating and cause less central nervous system impairment because they do not cross the blood brain barrier well. Topical cromolyn is less effective than intranasal corticosteroids.
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Infectious rhinitis is usually caused by an upper respiratory tract infection, usually of viral origin. The most common causes are infections due to rhinovirus, coronavirus, adenovirus, parainfluenza virus, respiratory syncytial virus, or enterovirus. Viral infections are generally self-limited and resolve within 7-10 days. Patients with infectious rhinitis typically present with clear-to-mucopurulent nasal discharge rather than watery rhinorrhea; this discharge is accompanied by facial pain and pressure, an altered sense of smell, and postnasal drainage with cough. Persistent facial pain and edema, purulent drainage, and fevers suggest a secondary bacterial infection.
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Once a working diagnosis of vasomotor rhinitis has been made, the patient can be empowered to avoid known environmental triggers as much as possible. These may include odors (e.g., cigarette smoke, perfumes, bleach, formaldehyde, newspaper or other inks); auto emission fumes; light stimuli; temperature changes; and hot or spicy foods. A stepwise pharmacologic approach may then be employed, choosing the initial intervention based on the patient's predominant symptoms. If the presenting symptom is solely rhinorrhea, a topical anticholinergic is the logical first step.
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Autonomic stimuli have a greater effect on patients with nonallergic rhinitis than on those with allergic rhinitis. Autonomic imbalance favoring the parasympathetic system increases nasal blood flow, edema, and secretions, creating an overall presentation of rhinorrhea and nasal obstruction. Patients can reduce nasal airway resistance up to 50% with isotonic exercise, which increases in sympathetic tone mediate. Changes in body posture from erect to supine can increase nasal airway resistance. In the supine position, pressure is lower in the right nostril than in the left nostril when the patient lies on the right side. Temperature can ... affect nasal blood flow and compliance, both of which decrease in cold environments.
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Symptoms of up to 20 percent of people with allergic rhinitis may be due to exposure to house plants, according to Dr. Olivier Michel of the Free University of Brussels in Belgium. The weeping fig tree, a type of ficus tree that exudes latex, could be a source of inhaled allergens. Michel and his team tested 59 allergic rhinitis sufferers and a control group of 15 healthy individuals for sensitization to ficus, yucca, ivy, palm tree and other common ornamental plants using a skin prick test. Seventy-eight percent of the allergic rhinitis patients were sensitized to at least one of the plants. No one in the control group was sensitized to the test plants. Sensitization doesn't necessarily mean a person's allergic symptoms are due to a particular substance.
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