Symptomatische Therapie der allergischen Rhinitis

Abstract

For the symptomatic treatment of allergic rhinitis the following groups of drugs are available: decongestants (sympathicomimetics), stabilizers of the mast cell membrane (DNCG, nedocromil), corticosteroids (aerosols), antihistamines, ketotifen, anticholinergics. The world wide use (and abuse) of decongestants (sympathicomimetics) is limited by the so-called rhinopathia medicamentosa, when the necessary treatment exceeds 3 or 4 weeks. The antiallergic preparations like sodiumcromoglycat and nedocromil prevent sneezing, rhinorrhea and eye irritations. Their reported effect is "stabilisation" of the mast cell membrane. They have practical no side effects, but the patients compliance is limited by the short, prophylactic effect, necessitating frequent topical applications up to 6 times daily. As the overall symptom scores are only reduced between 30% to 50%, they are not suited for severe cases of allergic rhinitis. Nedocromil should have a significantly better efficiency than DNCG. The development of efficient topical glucocorticosteroid aerosols was a great progress in the treatment of allergic rhinitis. With daily doses of 100 micrograms to 800 micrograms they are very effective against hypersecretion, sneezing, itching and also blocking of the nose. Because of the so-called "first pass" effect after resorption through the nasal mucosa they have minimal general side effects, especially on the balance of the endocrine system. Their rate local side effects on the nasal respiratory mucosa include local irritations, crusting, dryness and seldom nose bleeding.(ABSTRACT TRUNCATED AT 250 WORDS)