Treatment The key to treatment is patient education. Teach patient to avoid triggers, have them change their environment, change their medication. If these are not feasible, then medical therapy is the next course of action. Immunologic therapy ahs no benefit to non-allergic rhinitis and therefore it is important to distinguish the disease before considering immunotherapy. Nasal lavage has been shown to have minor decongestion benefits and improves mucocilliary function. Topical nasal steroids have been used widely for use with NAR. Fluticasone, budesonide an beclomthasone are the only ones approved by FDA for use in NAR. However, efficacy is inconsistent and use must. | Non-Allergic Rhinitis Ky 3 Treatment The key to treatment is patient education. Teach patient to avoid triggers have them change their environment change their medication. If these are not feasible then medical therapy is the next course of action. Immunologic therapy ahs no benefit to non-allergic rhinitis and therefore it is important to distinguish the disease before considering immunotherapy. Nasal lavage has been shown to have minor decongestion benefits and improves mucocilliary function. Topical nasal steroids have been used widely for use with NAR. Fluticasone budesonide an beclomthasone are the only ones approved by FDA for use in NAR. However efficacy is inconsistent and use must be for a minimum of 6 wks. With the exception of NARES topical steroids do not provide the same relief as they do with allergic rhinitis. Antihistamines have given us inconsistent results. Histamine release is the main pathophysiology for allergic rhinitis and therefore not a good consideration for NAR. Azelastin intranasal have been proven efficacious for all forms of NAR including Idiopathic rhinitis. It is an H1 receptor antagonist that also inhibits synthesis of leukotrienes kinins cytokines and free radicals. The exact mechanism behind its relief is unknown. Anticholinergic drugs also have their place in treatment. Ipratropium bromide has been shown to be effective with rhinorrhea symptoms. The strength used is with 2 sprays TID initially. The dose is slowly lowered to one spray BID as maintenance. Mast cell stabilizers such as cromolyn have been shown to have no benefit with non-allergic rhinitis. There have been no studies that have looked at leukotriene modifies in the treatment of non-allergic rhinitis. Capsaicin has been shown to be of benefit to idiopathic rhinitis. This is the main chemical with in hot peppers. This substance is known to activate C-fiber in the nose which is responsible for pain. With repeated application of capsaicin a desensitization and .
