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Allergic Rhinitis: Hay Fever Treatments |
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Tuesday, 26 February 2008 |
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Page 15 of 16
Follow-Up Further Outpatient Care - Immunotherapy (desensitization) is a long-term process; noticeable improvement is often not observed for 6-12 months, and, if helpful, therapy should be continued for 3-5 years.
Deterrence/Prevention - Patients should avoid factors that may cause or exacerbate allergic rhinitis (see Medical Care).
Complications - Possible complications include otitis media, eustachian tube dysfunction, acute sinusitis, and chronic sinusitis.
Patient Education - Educate patients on environmental control measures, which involve both the avoidance of known allergens (substances to which the patient has IgE-mediated hypersensitivity) and the avoidance of nonspecific, or irritant, triggers (see Medical Care).
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- For excellent patient education resources visit eMedicine's Allergy Center. Also, see eMedicine's patient education articles Hay Fever, Indoor Allergens, and Allergy Shots.
Miscellaneous Medical/Legal Pitfalls While no major medicolegal pitfalls are associated with allergic rhinitis, 2 issues deserve mention. - While patients with allergic rhinitis may experience sedation and fatigue secondary to the disease process itself, sedation may occur due to medications. Most commonly, sedation is related to antihistamines, particularly the first-generation agents. In many states, driving while taking a first-generation, or sedating, antihistamine is illegal. Caution any patient who is taking a medication that has potential sedative effects about driving and operating heavy machinery.
- A potential area of medicolegal concern is the failure to diagnose a comorbid condition or complication. Allergic rhinitis can occur in conjunction with other atopic diseases, such as asthma. Because asthma can be severe and even fatal, failure to diagnose concomitant asthma can lead to serious adverse events. Failure to diagnose potentially serious medical conditions that should be considered in the differential diagnosis of allergic rhinitis (eg, intranasal malignancy) might lead to serious consequences. Also, complications of allergic rhinitis (eg, sinusitis) can be serious and must be recognized when present.
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