Which medication is considered first-line therapy for allergic rhinitis?

Which medication is considered first-line therapy for allergic rhinitis?

• A. Topical nasal steroid
• B. Nonsedating antihistamine
• C. Decongestant
• D. Leukotriene blocker

Answer: (A)

Allergic rhinitis is an inflammatory condition of the nasal mucosa, so the most effective long-term control comes from directly reducing that inflammation. Intranasal corticosteroids address the inflammation broadly, lowering edema and suppressing multiple inflammatory mediators, which improves all major symptoms—nasal congestion, sneezing, itching, and runny nose. Because of this wide-reaching, durable effect and a favorable safety profile with regular use, they’re considered the initial choice, especially for persistent or more pronounced symptoms. They do take a few days to build full effect, so consistent use is important rather than intermittent dosing. In contrast, nonsedating antihistamines mainly target itching, sneezing, and rhinorrhea but don’t conquer congestion as well; decongestants relieve congestion quickly but don’t treat inflammation and have rebound risks with overuse; leukotriene blockers offer only modest symptom relief and aren’t preferred as first-line.

Allergic rhinitis is an inflammatory condition of the nasal mucosa, so the most effective long-term control comes from directly reducing that inflammation. Intranasal corticosteroids address the inflammation broadly, lowering edema and suppressing multiple inflammatory mediators, which improves all major symptoms—nasal congestion, sneezing, itching, and runny nose. Because of this wide-reaching, durable effect and a favorable safety profile with regular use, they’re considered the initial choice, especially for persistent or more pronounced symptoms. They do take a few days to build full effect, so consistent use is important rather than intermittent dosing. In contrast, nonsedating antihistamines mainly target itching, sneezing, and rhinorrhea but don’t conquer congestion as well; decongestants relieve congestion quickly but don’t treat inflammation and have rebound risks with overuse; leukotriene blockers offer only modest symptom relief and aren’t preferred as first-line.