Hay fever

Question 1

Referral

Answer 1

Acute asthma attack:
- Chest tightness
- Wheezing
- SOB

• Purulent conjunctivitis
• Painful ear/sinuses

Question 2

Treatment: non sedating antihistamines

Answer 2

• Acrivastine 12-65 TDS
• Cetirizine 6+ (2+ liquid) OD
• Loratidine 2+ OD

Question 3

Treatment: sedating antihistamines

Answer 3

• Chlorphenamine (piriton) 6+ (1+ liquid)
• Promethazine (phenergan) 5+ (2+ liquid)

Question 4

Antihistamine side effects

Answer 4

• Older antihistamines: more sedative + anticholinergic
• Caution: avoid in glaucoma, epilepsy + benign prostatic hyperplasia
• MAOI CI w sedating antihistamine + upto 14 days after stopping

Question 5

Treatment: other products

Answer 5

Steroid nasal spray 18+ 3 months
Red inflammation of nasal passage
- Fluticasone (pirinase)
- Beclometasone (beconase)

Eye drops
- Sodium cromoglycate (opticrom)
- Xylometazoline (otrivine antistin)

Question 6

Advise

Answer 6

Hayfever
- Close windows
- Sunglasses
- Avoid parks + fields

Perennial allergic rhinitis
- Exclude pets
- Strict cleaning regime