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Runny nose

• Definition
· Runny nose (“allergies”) is an allergy-induced irritation of the nose and sinuses.

• Overview
· Runny nose (“allergies”) is an inappropriate immune reaction resulting from the migration of inflammatory cells to the lining of the nose causing nose and sinus congestion.

· Runny nose (“allergies”) may occur during specific season depending on the allergen (protein or substance you are allergic to).
Allergies to pollen are more prevalent in the spring when flowers bloom and after a windy day.
Mold allergies are exacerbated after heavy rains and damp environments.

• Common allergens:
· pollens
· animal danders
· house dust
· dust mites
· mold

• Symptoms
· Runny nose “allergies” symptoms include:
· nasal itching
· sinus congestion
· sneezing
· runny nose
· nasal discharge which is usually a clear liquid
· eye irritation, tearing and redness.

• Treatment
· Avoidance is the most effective treatment for allergic conditions including Allergic rhinitis.
· Avoidance may cure the clinical manifestations but does not reduce the sensitivity to the allergen.
· Nasal steroids inhibit the migration of inflammatory cells into the nasal passages
· Antihistamine are drugs that inhibit the histamine receptors and are useful for the treatment allergic rhinitis.
· Oral decongestants (pseudoephedrine/sudafed, phenylephrine) are stimulant type drugs used for both vasoconstricting and bronchodilating properties.

The main side effects of oral decongestants are:
· insomnia
· tremor
· tachycardia

· Corticosteroids are steroidal anti-inflammatory medications that inhibit the inappropriate allergic mechanisms.

· Leukotriene antagonists: have some of the same functions as corticosteroids but are felt to be safer.

· Allergen immunotherapy. (allergy shots): Injections of allergens under the direction of a physician.

References
Abramson MJ et al: Allergen immunotherapy for asthma. Cochrane Database Syst Rev 2000; CD001186.
Norman PS: Immunotherapy: 1999-2004. J Allergy Clin Immunol 2004;113:1013.

Posted on March 22, 2009