A 35-year-old man visits the doctor with a 2-week history of nasal congestion. Since his symptoms began, he has used a topical decongestant every few hours. He felt better for nearly a week, but then his nasal congestion returned. The patient has a history of allergic rhinitis and has previously experienced rhinorrhea, but none of these episodes lasted more than a few days. He denies experiencing fever, throat pain, headaches, coughing, or lymph node enlargement. The patient has no other medical issues besides his allergic rhinitis. Physical examination reveals edematous and red nasal mucosa with a few areas of punctate bleeding. The rest of the examination shows no abnormalities. Which of the following is the most appropriate next step in the management of this patient?

Question

Quizplus · Accepted Answer

Eductional Objective: Topical preparations of alpha-adrenergic agonists cause nasal mucosa vessel constriction and are used as decongestants. Overuse of these drugs results in negative feedback, which reduces norepinephrine synthesis and release from nerve endings, reducing their effectiveness (ie, tachyphylaxis).

A 35-Year-Old Man Visits the Doctor with a 2-Week History