Which medications in the drug class Corticosteroids are used in the treatment of Allergic Rhinitis in Otolaryngology and Facial Plastic Surgery?

Updated: Jan 02, 2020
  • Author: Quoc A Nguyen, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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These agents have a potent anti-inflammatory action. Oral preparations affect late-phase reactions. Intranasal preparations reduce both acute and late-phase reactions after several days of use. These medications relieve rhinorrhea, sneezing, itching, and congestion. Many physicians currently consider intranasal steroid use to be the first-line therapy for allergic rhinitis.

Mometasone (Nasonex)

Nasal spray; demonstrated no mineralocorticoid, androgenic, antiandrogenic, or estrogenic activity in preclinical trials. Decreases rhinovirus-induced up-regulation in respiratory epithelial cells and modulate pretranscriptional mechanisms.

Ciclesonide (Omnaris)

Corticosteroid nasal spray indicated for allergic rhinitis. Prodrug that is enzymatically hydrolyzed to pharmacologic active metabolite C21-desisobutyryl-ciclesonide following intranasal application. Corticosteroids have a wide range of effects on multiple cell types (eg, mast cells, eosinophils, neutrophils, macrophages, lymphocytes) and mediators (eg, histamines, eicosanoids, leukotrienes, cytokines) involved in allergic inflammation. Each spray delivers 50 mcg.

Prednisone (Deltasone, Orasone, Sterapred)

Immunosuppressant for treatment of allergic reactions; may decrease inflammation by reversing increased capillary permeability and suppressing PMN activity; dosage and tapering schedule vary.

Triamcinolone (Kenalog-40)

Injectable corticosteroid used to treat inflammatory dermatosis responsive to steroids; decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reversing capillary permeability.

Beclomethasone (Beconase AQ, QNASL)

Topical nasal steroid spray that inhibits bronchoconstriction mechanisms and produces direct smooth muscle relaxation; may decrease number and activity of inflammatory cells, decreasing airway hyper-responsiveness. QNASL available as intranasal dry powder.

Fluticasone propionate (Flonase)

Topical nasal steroid spray. Has an extremely potent vasoconstrictive and anti-inflammatory activity. Has weak HPA axis inhibitory potency when applied topically.

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