Select desired medications for patient use from the list of Rhinitis and Allergic Conjunctivitis Medications
Antihistamines ☐ Allegra®
☐ Claritin® (fexofenadine) ☐ Clarinex® (loratadine) ☐ Xyzal®
☐ Benadryl® (levocetirizine)
☐ D__mg tab ☐ Syrup ☐ Astelin® ☐ D__mg tab ☐ Syrup
(desloratadine) (diphenhydramine) ☐ D__mg tab ☐ Syrup
☐ _____________________ ☐ D__mg tab ☐ Syrup Other Meds/Treatments ☐ Orapred®
(prednisolone)
☐ Prednisone ☐___ mg tab ☐ Medrol®
☐___ mg ODT ☐ Syrup (15mg/5 ml) (methylprednisolone) ☐___ mg tab
☐ Allergy injections ☐ Prescribed ☐ Not prescribed at this time
☐ Implemented environment control for_________________
Leukotriene Modifiers ☐ Singular®
Anticholinergies ☐ Atrovent®
__mg tab ☐ Granules Nasal (ipratropium)
☐ 0.03% ☐0.06% ☐ Nasal saline/moisturizer
Nasal Decongestants ☐ Oxymetazoline (Afrin® , Equate®
☐ Phenylephrine ☐ Use _______ before nasal spray
)
Mast Cell Inhibitors ☐ NasalCrom®
Oral Decongestants
☐ Pseudoephedrine (Sudafed PSE® ☐ Phenylephrine (Sudafed PE® ☐ ____ mg tab ☐ Syrup
)
Eye Drops ☐ Alamast®
☐ Alocril® ☐ Crolom® ☐ Elestat®
(pemirolast) (nedocromil) (cromolyn) (epinastine)
☐ Emadine® ☐ Optivar®
(emedastine) (azelastine)
☐ Pataday™ ☐ Patanol® (olopatadine) ☐__________________________
Abbreviations: AR, allergic rhinitis; bid, twice daily; h, hour(s); HEPA, high-efficiency particulate air; INS, intranasal corticosteroids; LTRA, leukotriene receptor antagonist; mo, month(s); NARES, nonallergic rhinitis with eosinophilia syndrome; NSAIDs, nonsteroidal anti-inflammatory drug; PAR, perennial allergic rhinitis; PO, orally; PRN, as needed; qid, four times daily; QOL, quality of life; SAR, seasonal allergic rhinitis; tid, three times daily; y, year(s)
References: 1. Wallace DV, Dykewicz MS, Bernstein DI, et al. The diagnosis and management of rhinitis: an updated practice parameter. J Allergy Clin Immunol. 2008; 122:S1-S84. 2. Correspondence correction. J Allergy Clin Immunol. 2008; 122:1237.
Disclaimer: This Guideline attempts to define principles of practice that should produce high- quality patient care. It is applicable to specialists, primary care, and providers at all levels. This Guideline should not be considered exclusive of other methods of care reasonably directed at obtaining the same results. The ultimate judgement concerning the propriety of any course of conduct must be made by the clinician after consideration of each individual patient situation.
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) (cromolyn)
Nasal Antihistamines , Astepro®
☐ D__mg tab ☐ Syrup ☐ Patanase® ☐ D__mg tab ☐ Syrup
___ sp./nostril ___ sp./nostril
(azelastine) (olopatadine)
Nasal Corticosteroids ☐ Flonase®
☐ Nasacort AQ® ☐ Nasonex® ☐ Rhinocort® ☐ Veramyst® ☐ Omnaris®
(fluticasone propionate) (triamcinolone)
(mometasone) (budesonide)
(fluticasone furoate) (ciclesonide)
FOR INTERNAL USE ONLY
