A 27-year-old woman, 10 weeks pregnant with her first pregnancy, presents in early May with 3 weeks of severe nasal congestion, sneezing, clear rhinorrhea, and itchy watery eyes. She has had similar symptoms every spring for years, and symptoms worsen on windy days. She has taken pseudoephedrine PO daily for the past 2 weeks with limited benefit and says she feels jittery. She has no history of hypertension, thyroid disease, or glaucoma and takes only a prenatal vitamin. On examination the nasal mucosa is pale and boggy with clear secretions, the conjunctivae are mildly injected, and the chest is clear.
| Heart rate | 84/min |
| Respiratory rate | 14/min |
| Temperature | 36.8 °C |
| O2 saturation | 99%, room air |
| Blood pressure | 112/70 mm Hg |
Question 1 of 12
Which one of the following is the most appropriate medication to initiate for this patient's nasal congestion?
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