macro

rhinorrhea, post-nasal drip, congestion, sneezing, itchy eyes onset season triggers colds, activity / animals, pollens, dust / cold air, smoke, strong odors / perfume, hot/spicy, heat / foods, ASA/NSAID, sinusitis/other red flags? anosmia, purulent drainage, facial pain/pressure; nose bleed, systemic decline prior testing treatment tried

Allergic rhinitis, sensitized to ***. Current symptom control:

Non-pharmacologically, we discussed avoidance strategies for ***, including: Recommended use of OTC sterile saline rinses prior to use of intra-nasal corticosteroids (INCS) Start Ryaltris 2 sprays EN BID. They were counseled on correct technique. Risk of nosebleeds disclosed. While a combination anti-histamine/INCS spray offers more immediate relief, consistent use over weeks provides the most symptomatic benefit We briefly discussed immunotherapy (SCIT vs SLIT) to ***, and have provided a handout. They are welcome to contact our office if they wish to pursue it

History:

• We discussed non-pharmacologic treatment principles

Summary:

WIP

rough

INCS OTC flonase nasocort

INCS RX avamys naosnex omnaris rhinocort

INCS AH ryaltris - mometasone + olopatadine dymista -fluct prop + azel