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It is a nasal hypersensitivity symptoms induced by an immunologically mediated inflammation after the exposure of the nasal mucous membranes to an offending allergen.
Allergic Rhinitis
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Any antigen that interacts with the body’s immune system to give rise to allergic response.
Allergen
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It is condition where the body recognizes a substance as non-self and is considered a threat thus stimulating the immune system to react and manufacture chemicals to “eradicate” the intruder.
Allergy
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Based on the 2008 National Nutrition and Health Survey, the prevalence of allergic rhinitis is
20%
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Asthma and allergic rhinitis occur in a continuous airway, two diseases frequently co-exist. Guidelines and studies estimate that about ___ of AR patients have asthma and __ of asthma patients have allergic rhinitis
40%, 80%
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A study by Nolte et al conducted to 726 participants showed that Rhinitis was undiagnosed in __% of patients and __% with moderate to severe rhinitis were undertreated.
32%, 83%
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It has been suggested that the association of allergic rhinitis with other inflammatory diseases may be the result of the commonly shared airways in all these disorders. What are the complications of AR?
sinusitis, otitis media, nasal polyps, heartburn and asthma
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People with allergic rhinitis (AR) rate their overall health significantly lower than individuals without nasal allergies. Compared with the general population, more people with AR complain with?
daytime fatigue, impaired learning and impaired cognitive functioning
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Cells initiating the allergic response.
Mast Cells
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Trademark of the allergic inflammation
Eosinophil
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The initial exposure of your body to the allergen
SENSITIZATION PERIOD
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Early phase of allergic process happens in:
within minutes
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Late phase of allergic process happens
4-6 hrs
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The cardinal symptoms of allergic rhinitis are the ff:
- Rhinorrhea or runny nose
- Sneezing
- Nasal pruritis or itching
- Nasal congestion or blocked nose
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It involves symptoms that are significantly worse during “pollen season”, usually during the summer months usually caused by common seasonal allergens or outdoor allergens such as grass and tree pollen and weeds.
SEASONAL ALLERGIC RHINITIS
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The allergic rhinitis with symptoms that are continuous or intermittent throughout the year
It is usually caused by indoor allergens such as dust mites, tobacco smoke and pet dander
PERENNIAL ALLERGIC RHINITIS
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4 days per week or < 4 weeks
INTERMITTENT
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> 4 days per week and > 4 weeks
PERSISTENT
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What is the primary treatment goal for patients with allergic rhinitis
to alleviate the severity of the patient’s symptoms and reduce the risk of developing associated disorders.
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The prevalence of Allergic Rhinitis in the Philippines
There are 18.5 Million Filipinos who have allergic rhinitis, AND only 50% of them consult their doctors.
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Other symptoms of AR
- Post Nasal Drip
- Ocular Symptoms
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What are the manifestation of a px with ocular symptoms?
- Watering/tears
- itching
- Red Eyes
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What is the most bothersome symptom of AR that was ranked by affected individuals?
Nasa Congestion
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Based on studies, % of px with AR suffer from ocular symptoms.
80%
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According to ARIA, a px experiencing normal sleep, no impairment of daily activities, normal work and no troublesome symptoms considered as
MILD
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According to ARIA, a px experiencing abnormal sleep, impairment of daily activities, abnormal work and troublesome symptoms considered as
Moderate-Severe
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What is the 1st line therapy in individuals with mild symptoms?
Identify and avoid known or suspected causative agents
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What is the most effective tx for AR?
Pharmacological therapy
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The H1 receptor antagonists
Antihistamines
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It is the most effective tx option for preventing and alleviating the symptoms of AR, may have variable efficacy in terms of relieving symptoms.
Intranasal Corticosteroids
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It is classed as mast cell stabilizers used in many countries as eye drops and show limited efficacy for the nasal symptoms of AR.
Chromones
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It induce vasoconstriction to reduce nasal congestion but show little effect against other nasal symptoms and show rapid onset of action.
Decongestants
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It bind to receptors on the glandular tissue to decrease the duration and severity of watery rhinorrhea.
Anti-Cholinergics
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An agent that block leukotriene receptors to inhibit the release of inflammatory cells and prevent nasal swelling.
Anti-Leukotrienes
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A controlled procedure that exposes the affected AR sufferer to known allergens to reduce symptom severity.
Immunotherapy
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Avamys is a nasal spray in white, uniform suspension contained in an amber glass bottle, fitted with a metering (___ microliters) atomising spray pump.
50 mcl
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Each spray of the suspension delivers approximately ___ micrograms of micronised Fluticasone furoate as an ex-device dose.
27.5 mcg
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What is the plasma protein binding of Avamys?
>99%
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The absolute bioavailability of Avamys administered as 880 mcg 3x per day is.
0.50%
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Elimination of Avamys was primarily via ____ route following oral and intravenous indicative of excretion of FF and its metabolites via the bile.
Faecal
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What is the dosing for adult and adolescence with SAR?
Once daily 110 mcg
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What is the dosing of children with SAR?
Once daily 55 mcg
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Tx of the nasal symptoms and ocular symptoms of SAR is indicated to.
Adults and Adolescents
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Tx of nasal symptoms of SAR and PAR is indicated to
Children (2-11 y/o)
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What is the on set of action of Avamys?
8 hrs after initial administration
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The recommended starting dosage in adults and adolescents
2 sprays, in each nostrils once daily
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The recommended daily dose for children
1 spray in each nostril, once daily
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Avamys is contra indicated in which type of px
Px with hyoersensitivity to any of the ingredients of FF.
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According to Meltzer, how many of adult patients want fast relief of symptoms
two-thirds
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6 out of 10 patients want relief of AR symptoms within an average of:
33 minutes
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How much percentage will be reduced on Nasal Symptoms given the Avamys 110mcg once daily in SAR vs placebo?
55%
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How much percentage will be reduced on ocular symptoms given the Avamys 110mcg daily in SAR vs placebo
33%
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Acccording to Salter, Avamys is safe and well-tolerated to use for how long?
1 year
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how much is the daily treatment cost of Avamys given with the coupons?
Php23.27
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