Chapter 26: Discussion Mr. H – Discussion group 5

Mr. H works as an animal caretaker for the local boarding school. He enjoys his job and loves tending to the school’s animals. However, he is visiting you at the Clinic today to discuss his allergies and wants your professional opinion. Mr. H has a history of allergic rhinitis with rhinorrhea, itching throat, watery eyes, and sneezing when in the presence of cats. His co-worker Mr. F, who lives and works at the boarding school, owns a cat who seems to follow him everywhere. Because Mr. H and Mr. F work together every day, Mr. H has been using a nasal decongestant spray several times daily for the past few weeks. He tells you the nasal spray does not seem to be helping anymore, even though he has increased the amount of sprays he is using. Mr. H is desperately looking to you for a solution to his allergy problem or he says that, “as for that cat, I’d like to introduce her to my dog sometime”.

Discuss:

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1. How do you explain to Mr. H the reaction he is having to the nasal spray and what would you counsel him to do?

2. Because the cat is aggravating his allergies, Mr. H has also been taking an over the counter antihistamine for several weeks, but this regimen does not seem to be working as well as it once did. What do you tell Mr. H about drug tolerance with antihistamines and how can this be avoided?

3. Would you as a health care professional suggest that Mr. H use an oral antihistamine or an oral decongestant to treat his symptoms? Explain why you would choose one instead of the other and suggest an over the counter medication from that category

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