TY - CHAP M1 - Book, Section TI - Allergic Rhinitis A1 - May, J. Russell A2 - DiPiro, Joseph T. A2 - Talbert, Robert L. A2 - Yee, Gary C. A2 - Matzke, Gary R. A2 - Wells, Barbara G. A2 - Posey, L. Michael Y1 - 2017 N1 - T2 - Pharmacotherapy: A Pathophysiologic Approach, 10e AB - Patient Care Process for the Management of Allergic RhinitisCollectPrimary complaint(s) (e.g., sneezing, clear rhinorrhea, postnasal drip, nasal congestion, ocular or otic symptoms, pruritic nose or palate)Patient characteristics (e.g., age, race, sex, pregnant)Past medical history and allergy testing Patient family, social history—dietary habits; presence of pets, mold, or wall-to-wall carpeting; times of year, situations, or locations (indoor or outdoor) when symptoms are worseCurrent OTC products, prescription medications, dietary supplements; past medications or interventions used for treating rhinitis symptomsPast or current use of environmental controls of potential allergens (e.g., removal of carpeting or pets, air-filtration systems)Objective data (see Box 13-1)Presence of allergic "shiners" (dark circles under eyes) or "salute" (crease across nose caused by constant rubbing)Labs when available (e.g., IgE, serum eosinophil count)Other diagnostic tests when available (e.g., allergy testing)AssessPresence of atopic disorders (e.g. asthma, atopic dermatitis) and complications of allergic rhinitis (e.g. acute otitis media, middle ear effusion, sinusitis, epistaxis)Timing of symptoms – seasonal or persistent (see Figure 95-2)Effectiveness for environmental controls of allergens (primarily for persistent cases)Which symptoms to control (e.g. nasal congestion, clear rhinorrhea, sneezing, pruritus, ocular conjunctivitis)Appropriateness and effectiveness of current regimenPlan*Nonpharmacologic interventions (e.g., allergen avoidance, nasal rinses, nasal strips; see Table 95-3)Drug therapy regimen including specific agent(s), dose, route, frequency, and duration; specify the continuation and discontinuation of existing therapies (see Table 95-2 and Figure 95-2)Monitoring parameters including efficacy (e.g., bothersome symptoms), safety (e.g. drowsiness, anticholinergic effects, effects on blood pressure; medication-specific adverse effects; see Table 95-8)Patient education (e.g., purpose of treatment, allergen avoidance, nonpharmacologic interventions, drug therapy; immunotherapy)Self-monitoring of symptoms and adverse effects—where and how to record resultsReferrals to other providers when appropriate (e.g., physician, allergist)Implement*Provide patient education regarding all elements of treatment plan Use motivational interviewing and coaching strategies to maximize adherenceSchedule follow-up if neededFollow-up: Monitor and EvaluateAssess patient perception of control of bothersome symptomsPresence of adverse effectsContinued presence of physical signs of nasal and ocular pruritusPatient adherence to treatment plan using multiple sources of information*Collaborate with patient, caregivers, and other health professionals SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesspharmacy.mhmedical.com/content.aspx?aid=1149712208 ER -