... Adrugreaction,somewhatdifferentfrom an allergy,candevelopfromusingantibiotics and causefever and/ orjointpain and swelling.Perhapsthemostcommonadverseeffectofantibioticsisthegastrointestinalsymptomstheyproduce.Thesecanincludestomachpain,nausea,vomiting, and diarrhea.Ifthesesymptomsaremild and tolerabletheyareprobablynotofconcern,butiftheyaresevere,thepatientshouldstoptheantibiotic and informhis/herphysician.Inrarecases,antibioticscancauseaseverediarrheaknownas“pseudomembranouscolitis.”Patientswiththisdisorderhaveseverewaterydiarrhea(notsimplyloosestools).Inthissituation,theantibioticshouldbestopped and thephysiciannotifiedimmediately.Patientsshouldnottrytotreatthemselveswith an anti‐diarrhealmedicationorhopethataseverediarrheaproblemwillsubside.Becauseantibioticsalterthenormalbacteriainthebodyaswellasthedisease‐causingbacteria,theycancauseothersideeffects.Ayeastinfection,mostcommonlyinthemouthorvagina,isonesuchcomplication. ... Cromolynsodium(alsoknownasNasalcrom)isatopicalnasalspraythatstabilizesmastcells,therebypreventingmastcelldegranulation and preventingreleaseofinflammatorymediatorssuchashistamine,leukotrienes,thromboxanes, and prostaglandins.(40)Whenusedprophylactically,cromolyncanpreventsymptomsfromoccurring.Cromolynsodiumstabilizesmastcellsbyreducingcalciumtransportacrosscellmembranes,therebypreventingthecalcium‐dependantdegranulationprocess.Cromolynsodiumiseffective for bothseasonal and perennialallergicrhinitis.Itworks for bothacute and late‐phaseallergicreactions.Cromolynsodiumismosteffectivewhentakenbeforeallergenexposure.Itisnoteffective for non‐allergicsinusitis, and itisnoteffective for thetreatmentofnasalpolyps.Cromolynsodiumisavailableasaspraypump.Thestandardinitialdoseisonesprayineachnostrilevery4hourswhileawake.Reliefofsymptomsusuallyoccurswithin4–7days,afterwhichthedosemaybereducedtoamaintenancelevelgearedtotheparticularpatient.Local and systemicsideeffectsaregenerallyminimal.Systemicabsorptionislessthan7%withrapidrenal and biliaryexcretion.Commonlocalsideeffectsincludesneezing,burning, and irritation.(40)Ratneretalreportontheuseofcromolyn for allergicrhinitis.(40)Theydescribetheneed for an efficaciousagentwithminimaladverseeffects and alackofdruginteractionstohelpsimplifytreatmentofallergicrhinitis,especiallyinpatientswithcomorbidities.Theyreportthatcontrolled ... well‐tolerated and notassociatedwithdruginteractions.Intranasalcromolynhas an excellentsafetyrecord,isavailableas an over‐the‐countermedication, and hasbeenprovedtobeefficaciousinpatientswithallergicrhinitis.(40)Baroodyreviewedthebroaderdiseaseeffectsofallergicrhinitis and theimplications for management.(41)Hepointsoutthatpoorlycontrolledallergicrhinitiscantriggerexacerbationsofasthma,sinusitis, and otitismedia,diseaseswithwhichitsharescommonpathophysiologicelements.Consequently,earlydiagnosis and treatmentshouldbeapriority for patients and physicians,notonlytocontrolthesymptomsofallergicrhinitisbutalsoto115improvethemanagementofassociateddiseases.Severalpharmacologictherapiescanbeconsideredin an armamentariumthatincludesintranasalcromolyn,antihistamines(intranasal and systemic),intranasalanticholinergicagents,intranasalsteroids,systemicsteroids,immunotherapy, and, leukotrienereceptorantagonists.Often,combinationsofthesetreatmentsareusedtomaximizecontrolofrefractorysymptoms.(41)I.LeukotrieneEsteraseInhibitors...