Bridgeman Mary Barna
Department of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy, Rutgers, The State University of New Jersey, Piscataway, NJ, USA.
Department of Pharmacy, Robert Wood Johnson University Hospital, New Brunswick, NJ, USA.
Integr Pharm Res Pract. 2017 May 4;6:109-119. doi: 10.2147/IPRP.S129544. eCollection 2017.
Patients suffering from allergic rhinitis often attempt to self-manage their symptoms and may seek advice from pharmacists about nonprescription product choices. Several drug classes, both prescription and over-the-counter (OTC), are available, including intranasal corticosteroids (INCSs); oral, intranasal, and ocular antihistamines; leukotriene antagonists; and topical and systemic decongestants, as well as immunotherapies. Selection of the optimal treatment approach depends on the temporal pattern, frequency, and severity of symptoms as well as the patient's age. Nasal congestion is typically the most bothersome symptom, although rhinorrhea, postnasal drip, and ocular symptoms are also problematic. Together, these symptoms may adversely impact the quality of life, work productivity, sleep quality, and the ability to perform daily activities, particularly when uncontrolled. Practice guidelines recognize that INCSs are the most effective medications for controlling allergic rhinitis symptoms, including nasal congestion. Available INCS products have comparable safety and efficacy profiles, but they differ in formulation characteristics and sensory attributes. Several barriers can impede the use of INCSs, including concerns about safety, misperceptions regarding the loss of response from frequent use, and undesirable sensations associated with intranasal administration. Given the increasing number of INCSs available OTC, pharmacists can help allay these concerns by discussing treatment expectations, recommending INCS products with favorable formulation characteristics, and reviewing proper use and technique for the administration of the selected product. These steps can help to foster a collaborative relationship between the patient and the pharmacist in the treatment of allergic rhinitis.
患有过敏性鼻炎的患者常常试图自行管理其症状，可能会就非处方产品的选择向药剂师咨询。有多种药物类别可供使用，包括处方药和非处方药（OTC），如鼻用糖皮质激素（INCSs）；口服、鼻用和眼用抗组胺药；白三烯拮抗剂；局部和全身减充血剂，以及免疫疗法。选择最佳治疗方法取决于症状的时间模式、频率和严重程度以及患者的年龄。鼻塞通常是最困扰人的症状，不过鼻漏、鼻后滴漏和眼部症状也很成问题。这些症状加在一起可能会对生活质量、工作效率、睡眠质量以及进行日常活动的能力产生不利影响，尤其是在症状未得到控制时。实践指南认识到，INCSs是控制过敏性鼻炎症状（包括鼻塞）最有效的药物。现有的INCS产品具有可比的安全性和疗效，但它们在剂型特点和感官特性方面存在差异。有几个障碍可能会妨碍INCSs的使用，包括对安全性的担忧、对频繁使用会失去疗效的误解以及与鼻内给药相关的不良感觉。鉴于非处方INCSs的数量不断增加，药剂师可以通过讨论治疗期望、推荐具有良好剂型特点的INCS产品以及审查所选产品给药的正确用法和技巧来帮助减轻这些担忧。这些步骤有助于在过敏性鼻炎的治疗中促进患者与药剂师之间的合作关系。
