Mnemonics: Allergic Rhinitis

Author: V. Dimov, M.D., Allergist/Immunologist and Assistant Professor at University of Chicago
Reviewer: S. Randhawa, M.D., Allergist/Immunologist and Assistant Professor at NSU

Prevalence of asthma is 8%, prevalence of AR is 3 times higher (24%). 40% of patients with AR have asthma, 80% of patients with asthma have AR.

How the allergens change during the season: mnemonic TGR MI DC/DC ("a Tiger with an MI went to DC")

"There's spring time, where you have the tree pollen. Summer time, where you have the grass pollens. And then there's the fall time when you have the weed pollen.”

This sequence is remembered by the mnemonic TGR MI DC/DC ("a Tiger with an MI went to DC").

Pollen calendar: TGR MI DC/DC

Tree pollens
Grass pollens
Ragweed and weed pollen

Mold spores
Indoor allergens - DC/DC - Dog/Cat and Dust mite/Cockroach


Pollen-producing plants (weeds and trees) in Omaha, Nebraska

References:

Characteristics of allergic sensitization among asthmatic adults older than 55 years: results from the National Health Allergy Season Year Round. WTOC-TV Savannah.
Interactive Allergy Map by Greer Labs. Click your state to find region-specific, common airborne allergens there.
‘Botanical sexism’ blamed for making life miserable for allergy sufferers as male trees fill city skies with pollen http://goo.gl/cx5tH

Symptoms of Allergic Rhinitis: CS DIES

Congestion
Smell impairment

Discharge - watery nasal discharge
Itching
Eye symptoms
Sneeze

Samter's triad include asthma, aspirin sensitivity, and nasal/ethmoidal polyposis:

ASPirin
Asthma
Sensitivity to aspirin
Polyps

Treatment

Stepwise approach to treatment of allergic rhinitis: OASIS

Omit (avoid) allergens
Antihistamines (oral and topical)
Steroids (topical)
Immunotherapy (SCIT, SLIT)
Surgery

References: Clinical review: ABC of allergies, Perennial rhinitis. BMJ 1998;316:917, figure.

Medications

S
Steroids
Single best drug in AR for
Stuffiness (congestion)

F
Fexofenadine
Free of sedation at any dose

S
Singulair
Single daily dose
Suicude risk (potential)



Treatment Options for Allergic Rhinitis (AR) and Non-Allergic Rhinitis (NAR) (click to enlarge the image).

Allergic Rhinitis and its Impact on Asthma (ARIA): Achievements in 10 years and future needs. ARIA has reclassified AR as mild/moderate-severe and intermittent/persistent. This classification closely reflects patients' needs and underlines the close relationship between rhinitis and asthma. http://buff.ly/QL1eYI

Published: 01/24/2008
Updated: 12/23/2012