Home' Australian Pharmacist : June 2011 Contents Vol.30–June#06
The articles in this series are independently researched and compiled by PSA commissioned authors and peer reviewed.
• the patient has severe allergic
co-morbidities, e.g . asthma, eczema
or food allergies;
• the patient has atypical symptoms
(e.g . persistent unilateral nasal
congestion or bleeding);
• the patient’s quality of life is being
seriously affected; or
• there are complications such as pain,
anosmia (impaired sense of smell),
sinusitis or hearing loss.
Where can I find more
information on allergic rhinitis?
The following websites contain useful
information about allergic rhinitis:
• Allergic Rhinitis and its Impact on
Asthma (ARIA). At: www.whiar.org
• Australasian Society of Clinical
Immunology and Allergy (ASCIA).
• Australian Family Physician.
• American Academy of Allergy
Asthma & Immunology.
Case study continued
To confirm that the customer most
likely has allergic rhinitis, she should
be asked questions such as:
• Have you previously had allergic
rhinitis or a family or personal history
of atopy (e.g . asthma, eczema)?
• What is the duration, pattern and
exact nature of your symptoms?
• What are your occupation and
• Are there any trigger factors you
may be aware of?
• Are you taking any other medicines
or do you have any other medical
Table 3. Correct technique for
using a nasal spray3,7,12
• Clear nasal passages by blowing gently
(saline nasal spray/drops may be used
• Shake the bottle before use and follow
the manufacturer’s advice about priming
• Bend head for ward.
• Use the right hand for the left nostril;
place the nozzle just inside the nose
and aim to the side of the nostril, not
towards the septum.
• Squirt once or twice as directed, block
other nostril and sniff gently.
• Change hands and repeat for the other
Table 4. Allergen avoidance measures7, 1 5
• Wash bedding weekly in hot (>55oC) water.
• Wash blankets and washable doonas in hot water every three months.
• Cover pillows and mattresses with impermeable covers; covers should be
washed every two months.
• Remove sheepskin or woollen underlays from beds.
• Vacuum weekly using a high efficiency particulate air (HEPA) filter vacuum
cleaner (however, vacuuming, even with a HEPA filter, increases the amount
of house dust mite allergen in the air for up to 20 minutes).
• Replace soft toys with washable wooden or plastic toys. If a soft toy is
allowed it should be washed weekly in hot water. Freezing soft toys overnight
kills mites but does not remove allergen.
• Consider replacing carpets with hard floors such as tiles, timber or linoleum.
• Remain indoors, especially in the early morning when pollen counts are
highest, on windy days and after thunderstorms.
• Avoid activities which increase the risk of exposure (e.g . lawn mowing).
• Shower after outdoor activities.
• Use re-circulated air in the car and keep house and car windows closed.
• Keep pets (especially cats) out of bedrooms and living areas.
• If symptoms are severe the pet may have to be removed from the house (cat
allergen can remain in the house for months after the cat is removed).
• Frequent washing of pets is ineffective and may be harmful to pets.
• Clean away visible mould with bleach or other anti-mould cleaners.
• Keep house well-ventilated.
• Use an air conditioner to reduce humidity indoors during the warmer months.
• Seal roof and bathroom leaks.
• Avoid garden compost or mulch.
counselling in practice
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medicines for upper respiratory tract infections.
Specifically clinically proven for acute and chronic sinusitis1,2 and
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recommendation you can confidently make.
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you can safely recommend
1. Neubauer N et al Phytomedicine 1994; 1: 177–181
2. Richstein A & Mann W Schweiz Zschr Ganzheits Medizin 1999; 11(6): 280–283
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