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Rhinitis%20-%20nonallergic%20(pediatric) Treatment
Principles of Therapy
- If possible, treatment should be aimed at the underlying causative physiology of nonallergic rhinitis
- Treatment response may be less effective than in allergic rhinitis
- Predominantly aimed at symptomatic treatment
- Medications may be administered on an “as-required” basis or as a long-term therapy
Pharmacotherapy
Anticholinergics
- Action: Inhibit the parasympathetic nervous system that innervates the serous & seromucous glands
- Ideal for patients who present only with rhinorrhea, especially in gustatory rhinitis
- Have no activity against sneezing, itching or nasal congestion
- Less effective in nasal congestion but some have anti-inflammatory properties
- Effect: Have been shown to control rhinorrhea
- Effective for vasomotor rhinitis
- 1st generation antihistamines may be useful in controlling rhinorrhea
- Generally less effective for nonallergic rhinitis but may be used as an adjuvant to nasal corticosteroids in the treatment of NARES
- Effect: Decrease nasal obstruction
- Onset of action is relatively slow (up to 4 weeks) with maximum efficacy after a few days, thus more recommended for patients with chronic symptoms
- Patient should be maintained on the lowest effective dose
- Caution is needed due to the possible effect on growth
- Regular height measurements are advised
- Preparations containing Ephedrine, Oxymetazoline & Xylometazoline should not be used in patients <2 years of age
- Relieves nasal obstruction & postnasal drainage
- Effects: Relieve nasal obstruction & postnasal drainage
- Ideal for long-term use & for patients with sporadic symptoms
- Do not cause rebound nasal congestion
- May be used in combination with nasal corticosteroids
- May cause CNS stimulation, hypertension & cardiac arrhythmias
