EXTERNAL OTITIS SEND TO B14 FOR WICK . USE GENTISONE HC IF INTACT DRUM SOFRADEX IF PERFORATED OR CAN'T SEE IT
ALLERGIC RHINITIS GUIDELINE http://www.pcrs-uk.org/opinions/allergic_rhinitis_final.pdf
ENT Lecture at YHPA Nov 2017
Allegic Rhinitis
Causes real problems insomnia eye symptoms
Goes with asthma if you treat the nose the asthma becomes less
Antihistamines Cetirizine best
Steroid nose spray ..point spray away from septum to avoid bleeding from it
Chromones
Monteleukast better effect in asthma
Not Ipratropium
Not Kenolog can cause avascular necrosis of hip
Skin prick test best. Stop antihistamines first [British Society of Allergy and Immunology]
RAST if eczema, Don’t have to stop antihistamines
So:
Intra nasal steroids
DYMISTA is an expensive new drug
Immunotherapy [ Not in astghma may cause anaphylaxis]
New sublingual immunotherapy