Patient Encounter Part 5

After one more year passes, AW returns to your clinic to ask for advice about her father. He has recently moved into town, because he has just retired. He will be living independently. He is 65 years old and has hypertension, and BPH. The daughter (AW) thinks he is taking two medications for his blood pressure, one of which is also partly for his prostate. He has had AR on and off in the past. That is all she knows about his medical history. Since he has moved to town 6 weeks ago, he notices increasing symptoms of AR. His most bothersome symptom right now is a runny nose that is worse than ever before. He bought some OTC diphenhydramine because he ran out of his previous prescription of intranasal triamcinolone. The diphenhydramine has helped some, but incompletely, and it makes him sleepy. She asks for your advice for additional OTC medication until they can get an appointment with a primary care provider for him.

What additional information would you like? What can you recommend at this time?


The use of certain medications is prohibited during national and international athletic competition. The list of prohibited drugs changes each year, and may not always be consistent among organizations. The most up-to-date information is available from the World Anti-Doping Agency (WADA)45 Additional information may be obtained from the United States Anti-Doping Agency (USADA)46 The USADA website has a

"drug reference online" section that is useful. Ocular Symptoms 1,24,28

Several products are available for instillation directly into the eyes for those patients with predominant or unresponsive ocular manifestations. They may be appropriate for occasional moderate-severe flares or episodic AR when other modes of therapy are not optimally effective. The combination (antihistamine and mast cell stabilizing) agents may be the most effective, and they have the advantages of rapid onset of action and (usually) only twice daily administration. See Table 62-8 for these products.

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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