What are the discharge instructions for a 17-year-old patient with seasonal allergies?

From the Guidelines

For a 17-year-old patient with seasonal allergies, I recommend a combination of environmental modifications and medications to manage symptoms, prioritizing monotherapy with an intranasal corticosteroid as the initial treatment, as suggested by the 2017 Joint Task Force on Practice Parameters 1.

Key Recommendations:

• Take an over-the-counter second-generation antihistamine like cetirizine (Zyrtec) 10mg or loratadine (Claritin) 10mg once daily in the morning, as needed, for mild symptoms.
• Use fluticasone propionate (Flonase) nasal spray, 1-2 sprays in each nostril once daily, which reduces inflammation in the nasal passages, as the primary treatment for nasal congestion.
• Avoid known allergen triggers by keeping windows closed during high pollen seasons, showering after outdoor activities, and using air purifiers with HEPA filters.
• Stay hydrated and consider saline nasal rinses to flush allergens from nasal passages.
• If symptoms include itchy, watery eyes, try ketotifen (Zaditor) eye drops, 1 drop in each affected eye twice daily as needed.

When to Seek Medical Attention:

If these measures don't provide adequate relief within 2-3 weeks, or if symptoms worsen with difficulty breathing, seek medical attention for possible prescription medications or referral to an allergist for further evaluation and possible immunotherapy, as recommended by the Joint Task Force on Practice Parameters 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Discharge Instructions for a 17-Year-Old Patient with Seasonal Allergies

The following discharge instructions are based on the latest guidelines for the management of seasonal allergic rhinitis:

• Medication: The patient may be prescribed nasal glucocorticoids, nasal and oral antihistamines, and antileukotrienes to manage symptoms 2.
• Allergen Avoidance: The first step in management is allergen avoidance, which can help reduce symptoms 3.
• Symptomatic Relief: Symptomatic relief and improved quality of life can be achieved with the appropriate use of pharmacotherapy, such as oral/intranasal second-generation antihistamines or intranasal corticosteroids alone for mild to moderate cases 3.
• Severe Cases: More severe cases may require treatment with an intranasal corticosteroid in combination with various agents 3.
• Immunotherapy: Patients who require medications for more than 6 months per year, have two or more seasons of unacceptable pollinosis, or have intolerable side effects from pharmacotherapy may be candidates for immunotherapy 3.
• Treatment Options: Current pharmacologic options include oral and intranasal antihistamines, intranasal corticosteroids, oral and intranasal decongestants, oral and intranasal anticholinergics, and leukotriene receptor antagonists 4.
• First-Line Treatment: Intranasal corticosteroids are recommended as first-line treatment for moderate to severe allergic rhinitis 4.
• Combination Therapy: Combination therapy of an intranasal corticosteroid and an oral antihistamine may be effective in reducing nasal symptom scores 5.