How is acute rhinoconjunctivitis treated?
Last reviewed: 23.04.2024
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Treatment of allergic rhinitis, conjunctivitis is the use of antiallergic agents of various groups. The main drugs in the treatment of allergic rhinitis are antihistamines. Their therapeutic effect is associated with the blockade of histamine receptors on the cellular structures of different tissues. Almost all antihistamine preparations of the first generation [chloropyramine (suprastin), clemastine (tavegil), diphenhydramine (dimedrol), promethazine (pipolphene), mebhydroline (diazolin), hifenadine hydrochloride (fenkarol)] have significantly antihistaminic activity. After parenteral administration or ingestion, the therapeutic effect of antihistamines appears after 15-30 minutes and reaches a maximum in an hour. It should be emphasized that an important place in the therapy of allergic rhinitis belongs to new generation antihistamines such as loratadine, cetirizine, ebastine (kestin), desloratadine (erius), levocetirizine.
Local treatment of allergic rhinoconjunctivitis
Currently, topically (in the form of eye drops and nasal spray), topical antihistamines such as levocabastine, azelastine are used.
Among the agents that stabilize the membranes of mast cells, it is possible to isolate eye drops and intranasal forms of cromoglycic acid (kromoglin, kromogeksal, lekrolin). With acute conjunctivitis, instillation of eye drops gives a quick effect. They can be used as a monotherapy or combined with each other. It is necessary to use topical antihistamines (azelastine). A pronounced preventive effect in allergic lesions is cromoglycic acid (cromogexal, lomusol, optic). Drugs significantly reduce itching, photophobia, lacrimation, hyperemia and prevent papillary growth of the lining of the eyelids.
Local therapy should begin with lavage of the eyelids and conjunctiva. To ensure anti-edema and antipruritic action, 10 drops of 0.1% solution of epinephrine (adrenaline) and 0.05 g of tetracaine (dicaine) are added to 10 ml of this mixture. An effective injection of 0.05% naphazoline (naphthyzine) solution 1-2 drops 2-3 times a day, 0,25-0,5% phenylephrine (mezatonone) solution 1-2 drops 2-3 times a day can be effective in a conjunctival bag a day for several days. With severe symptoms of allergic eye damage and in cases of low effectiveness of therapy with antihistamine and sympathomimetic agents, the appointment of topical glucocorticoid drugs is indicated. When the conjunctiva is damaged, suspensions of cortisol (adzona) or hydrocortisone, solutions of prednisolone, dexamethasone (dexazone), and hydrocortisone ointment and ophthalmic medicinal films with dexamethasone are installed in the eye slit.
In the treatment of allergic rhinitis also used vasoconstrictive drugs (decongestants): phenylephrine, xylometazoline (otrivin, galazolin). Their use is symptomatic, limited to 10 days because of the effect of tachyphylaxis and the possibility of developing drug rhinitis; use combinations with antihistamines, for example, the preparation vibrocil.
In severe manifestations of allergic rhinitis, treatment is mainly carried out with topical corticosteroids [mometasone (nazonex), fluticasone (fliksonase), beclomethasone (aldecine)]. With regular and prolonged use, they suppress various stages of allergic inflammation. Achieving high concentrations in the nasal epithelium, they suppress nasal congestion, rhinorrhea, sneezing, itching.
When joining the infection to allergic conjunctivitis, there is a need for local antibiotics. Recently, wide use has been made of droplets of sfradex, which include gramicidin C, dexamethasone, and scramblycine.
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