Figure 2. Sample Rhinitis Medication Action Plan2 Rhinitis Steps
0 1
2 3
4 5
Episodic symptoms (eg, to prevent onset of symptoms)
Infrequent symptoms > Symptoms are not daily and there is no interference with activity most days
> Medications needed only occasionally
Mild, but frequent symptoms before treatment > Mild nasal symptoms on a regular basis and mild interference with activities
> Take noted medication daily
Moderate symptoms before treatment OR not controlled with Step 2 medications > Moderate nasal symptoms on a regular basis and moderate interference with activities
> Take noted medication (eg, nasal corticosteroids if not used in Step 2, or take 2 medications
> Consider referral of the child with allergic rhinitis to preventive allergen immunotherapy.
Moderate to severe symptoms before treatment OR
not controlled with Step 3 medications > Daily symptoms and severe interference with activities > Take noted 2-3 medications and/or change of ≥ 1 medications > Consider referral of the child with allergic rhinitis to preventive allergen immunotherapy.
Severe and not controlled with Step 4 medications > Can not function in usual activities
What to do for Increased Nasal SymptomsWhat to do for Increased Nasal It is your allergy season OR you are exposed to your triggers: First, take your usual m
Mild Episode: Action A
> Incomplete response to usual medication(s) > Increased nasal or eye symptoms > Move up one Step (to Step 2-4) > Call physician if you reach Step 5
Long-Term Management of Nasal Symptoms Controlled
> No interference with activities > < 2 days per week of nasal or eye symptoms > Stay at the same step or move down if directed
Moderate Epi
> Incomplete response to A after 24 h
> Move up one more Step > Call physician if you rea
Fair C
> Mild interference with ac > 2-6 days per week nasal o
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