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Drugs Used in Upper Respiratory Disorders: Overview01:16

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Upper respiratory tract disorders, including viral infections and allergic rhinitis, cause significant discomfort and disrupt daily life. Managing these conditions involves a variety of drugs, such as antihistamines, intranasal steroids, decongestants, antitussives, expectorants, and mucolytics. Specific examples of drugs in each category are provided.
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Asthma is a chronic respiratory condition for which new therapeutic avenues, including anti-inflammatory drugs like mast cell stabilizers and anti-IgE treatments, continue to be developed.
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Drugs Used in Lower Respiratory Disorders: Overview01:17

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Lower respiratory tract disorders present challenges that often require skilled and nuanced approaches for effective management. Common ailments, such as asthma and chronic obstructive pulmonary disease (COPD), have prompted the development of intricate treatment strategies involving bronchodilators and anti-inflammatory drugs, each tailored to ease breathing and revitalize the lungs.
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Symptom Assessment of Patients with Allergic Rhinitis Using an Allergen Exposure Chamber
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Focused allergic rhinitis practice parameter for Canada.

Anne K Ellis1, Victoria Cook2, Paul K Keith3

  • 1Division of Allergy & Immunology, Department of Medicine, Queen's University, Kingston, ON, Canada. anne.ellis@kingstonhsc.ca.

Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology
|August 8, 2024
PubMed
Summary
This summary is machine-generated.

This Canadian practice parameter for allergic rhinitis (AR) treatment confirms serum-specific IgE or skin prick tests are acceptable for immunotherapy candidates. It also clarifies first-line therapy choices and immunotherapy options for AR management.

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Area of Science:

  • Allergy and Immunology
  • Pharmacotherapy
  • Clinical Practice Guidelines

Background:

  • Allergic rhinitis (AR) is a common condition in Canada affecting all age groups.
  • Existing AR management guidelines show regional variations and differing pharmacotherapy approvals.
  • This focused practice parameter addresses six key research questions specific to Canadian AR treatment.

Purpose of the Study:

  • To provide evidence-based recommendations for the clinical management of allergic rhinitis in Canada.
  • To address specific research questions regarding AR diagnosis, pharmacotherapy, and immunotherapy.
  • To guide healthcare professionals in optimizing AR treatment strategies.

Main Methods:

  • Literature reviews were conducted for studies published since 2016.
  • Evidence was gathered to support responses to six defined research questions on AR treatment.
  • Recommendations were formulated by a Work Group based on synthesized evidence.

Main Results:

  • Serum-specific IgE and skin prick tests are both acceptable for diagnosing AR and guiding immunotherapy.
  • Intranasal corticosteroids (INCS) are generally first-line, but patient/provider preference may favor second-generation oral antihistamines (OAH).
  • Combination intranasal antihistamine/INCS formulations are superior to INCS plus OAH; LTRAs offer limited benefit over OAH for most symptoms but may help with nighttime symptoms and in patients with asthma.
  • Sublingual immunotherapy (SLIT) and subcutaneous immunotherapy (SCIT) choices depend on multiple factors beyond efficacy, though efficacy data supports broad use of both.

Conclusions:

  • Diagnostic testing for AR and immunotherapy candidacy can utilize either serum-specific IgE or skin prick tests.
  • Treatment decisions for AR should consider patient and prescriber preferences, with INCS and OAH as viable first-line options.
  • Combination INAH/INCS therapy is more effective than INCS plus OAH; immunotherapy options like SLIT and SCIT should be considered broadly for AR patients.