| Table 2: | |||
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Treatment
for Postnasal Drainage Syndromes
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|||
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Syndrome
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Treatment
|
Examples
|
Comment
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| Generic rhinitis | First-generation antihistamine/ decongestant combination | dexbrompheniramine maleate 6 mg/ pseudoephedrine 120 mg BID | Nasal CS useful for maintenance therapy; ipratropium nasal spray also effective |
| Allergic rhinitis | Second-generation antihistamine; nasal corticosteroid; allergen avoidance | loratidine 10 mg/d; beclomethasone nasal 42µg each nostril QID | Cromolyn azelastine also useful; consider allergy testing |
| Vasomotor rhinitis | Anticholinergic nasal spray | ipratropium 0.06% 2 puffs/nostril 4-6 times per day | Mediated by autonomic instability |
| Chronic sinusitis | First generation antihistamine/ decongestant (3 weeks), nasal decongestant (5 days), appropriate antibiotics (3+ weeks) | dexbrompheniramine/ pseudoephedrine as above; oxymetazoline 2 sprays BID | Use antibiotic active against Haemophilus influenzae, Streptococcus pneumoniae, oral anaerobes; nasal CS after cough resolves |
| BID = twice daily; CS = corticosteroid; MDI = metered dose inhaler; QID = four times daily | |||
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Copyright
2002 The Cleveland Clinic Foundation
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