“I cannot stop sneezing and itching my nose”
History of Present Illness
Anita Tissue is a 26-year-old female that presents with frequent sneezing and nasal itch for the last several weeks since the desert started to bloom. She endorses ongoing nasal drainage and congestion, as well as occasional watery eyes, without relief. She shares that her symptoms have affected her sleep and ability to function at work (she works at the local botanical gardens).
Drug Therapy Problems
Care Plan (by Problem)
Which of Anita’s symptoms are suggestive of a diagnosis of allergic rhinitis??
Hint: See Table 65-1 in PPP
Define her classification of allergic rhinitis and what criteria supports this classification?
Hint: See Table 65-3 in PPP
What are possible non-pharmacologic and pharmacologic treatment options for her allergic rhinitis?
Hint: See Treatment along with Table 65-4, 65-5, 65-6, 65-8 in PPP
Please describe an initial pharmacologic plan to help treat this patient’s condition. Please address alternatives as appropriate.
Hint: See Treatment and Tables 65-5, 65-6, 65-8 in PPP
What counseling and education points should be discussed with the patient initiating therapy?
Hint: See Treatment and Table 65-7 in PPP
How would your recommendations change (see question 4) if the patient was asking for recommendations to help her 4-year-old child with similar symptoms?
Hint: See Treatment in PPP
Allergic rhinitis is a common condition triggered by exposures to allergens, impacting 10-30% of the global population, with rising incidence. The prevalence of allergic rhinitis varies between socioeconomic status within the affected patient population, with a higher incidence in children and adolescents. Due to the high prevalence, this disease presents significant burdens to the quality of life in patients that are not adequately treated. There is a significant population of patients self-treating allergic rhinitis with suboptimal over-the-counter medications, without medical provider diagnosis or guidance, allowing meaningful opportunities for pharmacy intervention.
R. Allergic rhinitis: current options and future perspectives. Curr Opin Allergy Clin Immunol. 2014 Apr;14(2):168–76. doi: 10.1097/ACI.0000000000000043. PMID:
et al. Allergic Rhinitis. Nature Reviews Disease Primers. 95(2020).
J Allergy Asthma Immunol June 2021; 20(3):271–278. Doi: 10.18502/ijaai.v20i3.6331
et al. Identifying the hidden burden of allergic rhinitis (AR) in community pharmacy: a global phenomenon. Asthma ...