Allergic Rhinitis, an IgE-mediated hypersensitivity disease of the nasal airway mucosa is characterized by sneezing, itching, watery nasal discharge, sensation of nasal obstruction and sometimes impairments of smell also.

Treatment of allergic rhinitis include 'Relievers' drugs which control symptoms and relieve acute attacks and 'Preventors' or anti-inflammatory, anti-allergic drugs which suppress the underlying disease process.

Antihistamines are very effective in control of sneezing, itching and watery rhinorrhoea but have very little effect on nasal congestion & blockage.

1. (i)  Chlorpheniramine:- Inexpensive but have sedative and anticholinergic side effects.
2. (ii)  Terfenadine and astemizole:- Non-sedative, less expensive, no interaction with alcohol.
3. (iii)   Loratidine & Desloratidine:- effective, non-sedative, once a day advantage, very rapid onset of action.
4. (iv)   Certrizine & Levocetrizine:- Occasional sedation.
5. (v)    Azelastine:- Only topical antihistamine. But the unpleasant taste reduces patient compliance.

Undoubtedly, oral & topical corticosteroids do this job along with mast cell stabilizers.

1. (A) Topical Corticosterids:- All nasal symptoms are effectively controlled including impaired smell.
2. (ii)        Aqueous Nasal sprays:- Advantages include less irritation, better toleration & local distribution. Example:- Rhinocort aqua.
3. (iii)       Fluticasone Propionate is a potent, very effective, safest once a day steroid spray although more expensive and should be reserved for refractory cases.
4. (iv)       Reasons for failure include irregular usage, faulty technique, ineffective penetration due to complete nasal block.
5. (v)        Severe Nasal block, nasal irritation, very active symptoms may be controlled initially by oral corticosteroids for few days.
6. (vi)       Steroid (Betamethasone) nasal drops is reserved for patients with ostiomeatal complex (middle meatal) disease, severe sinusitis and nasal polyps. But not for allergic rhinitis.
7. (B) Mast Cell Stabilizers:-(Sodium Chromoglycate)
8. (i)         Less effective prophylactic agent than steroids but very Safe & non-toxic.
9. (ii)        Poor Patient compliance due to QID dosage.