Page 123 - Community pharmcy practice E-book 2025

02/11/2025, 00:29

Non-Pharmacological Treatment
• Allergen avoidance: keep windows closed during high pollen counts, use air conditioning,
isolate pets or remove them, reduce dust mites via bedding covers C washing in hot water, use
HEPA filters.
• Nasal saline irrigation or sprays to wash away allergens + thin mucus.
• Maintain good indoor air quality (avoid smoking indoors, mould, humidity).
• Elevate head of bed to reduce nasal congestion at night; ensure adequate sleep; stress
reduction.
• Pharmacist role: educate patient on realistic expectations (e.g., exposure cannot always
be fully eliminated), demonstrate proper use of nasal devices, encourage adherence.

Pharmacological Treatment
• First-line: Intranasal corticosteroids (e.g., fluticasone, mometasone) — most effective for
nasal inflammation.
• Oral or intranasal antihistamines (second generation preferred: cetirizine, loratadine etc)
for sneezing/itching/rhinorrhea.
• Oral decongestants or intranasal decongestants for short-term relief of nasal congestion
(careful with rebound risk).
• Leukotriene receptor antagonists in some cases (though less effective than intranasal
steroids) and immunotherapy for refractory or severe cases.
• Pharmacist role: help choose OTC products (check age, comorbidities, sedation
potential), counsel on proper administration technique of nasal sprays (pointing away from
septum, consistent use, allow 1-2 weeks for full effect).

Patient Counselling Tips
• Explain difference between cold vs allergy: “If you have clear watery runny nose and
itching/sneezing seasonal or perennial, think of allergy rather than infection.”
• Show correct use of nasal sprays: tip of nozzle inside nostril, aim toward outer wall, prime
the pump, use daily rather than only when symptoms bad, wash nozzle after use.

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