[最も共有された! √] chronic sinusitis medication 102498-What medication is used for chronic sinusitis

Feb 10, 21 · Subacute and chronic forms of a sinus infection usually are the result of incomplete treatment of an acute sinus infection Noninfectious sinusitis is caused by irritants and allergic conditions and follows the same general timeline for acute, subacute, and chronic as infectious sinusitisMar 01, 09 · Nasal irrigation and decongestants can help in the treatment of chronic sinusitis by keeping mucus loose and nasal passages clear The mucusthinning agent guaifenesin (Mucinex) is another option (Be sure to drink a full glass of water when you take it) Nasal steroids such as fluticasone (Flonase) or beclomethasone (Beconase) may be added toNasal decongestants work by reducing inflammation and allowing your sinuses to drain Antihistamines work by blocking your body's production of histamines, which cause many sinusitis symptoms Steroids and corticosteroids work by decreasing swelling and inflammation You shouldn't use decongestants for more than a handful of days

Tylenol Sinus Severe Daytime Caplets Tylenol

Tylenol Sinus Severe Daytime Caplets Tylenol

What medication is used for chronic sinusitis

What medication is used for chronic sinusitis-Treatment for sinusitis from a GP If you have sinusitis, a GP may be able to recommend other medicines to help with your symptoms, such as steroid nasal sprays or drops – to reduce the swelling in your sinuses antihistamines – if an allergy is causing your symptomsAntibiotics only help for bacterial infections Other ways to treat nonbacterial chronic sinusitis include Avoiding triggers (usually related to allergies and environmental factors) Using intranasal corticosteroid sprays and leukotriene antagonists (to reduce inflammation) or antifungal medication (rarely) to get rid of a fungus

How To Relieve Sinus Pressure 8 Home Remedies And Treatments

How To Relieve Sinus Pressure 8 Home Remedies And Treatments

Jan 25,  · In some cases, your doctor may prescribe inhaled steroids to bring down the swelling in the sinus membranes For tough cases of chronic sinusitis, you may need to take steroids by mouth SurgeryMar 21, 10 · Chronic rhinosinusitis (CRS) is defined as persistent symptomatic inflammation of the nasal and sinus mucosa Although insights into the pathophysiology of CRS have largely expanded over the last 2 decades, the exact etiology is still unknown and is likely due to multiple host and environmental factorsNov 26,  · For chronic sinusitis sufferers who are going through overthecounter allergy medications like water and want to finally find longlasting relief, immunotherapy treatment might be right for you If you haven't heard of immunotherapy treatment before now, don't worry!

Chronic sinusitis medication A 27yearold male asked i have a chronic sinusitis from a young age, medication prescibed by doctor's did not change is there any operation i can do to reduce my sinus?Jan 10, 18 · Chronic sinusitis usually persists longer than 10 days, but the symptoms are the same Those include pain and pressure above the eyes, along the sides of the nose, and behind the cheeks green orSinusitis treatment for chronic sinus infections Sinusitis (a sinus infection) occurs when the cavities around the nasal passage become swollen or inflamed Acute and chronic sinus infections are a common condition treated at the Ear, Nose, & Throat Center in Stamford, CT

For chronic sinusitis that does not respond to medication, your doctor may recommend endoscopic sinus surgery, which may be done to remove polyps or bone spurs Enlarging the sinus opening is also sometimes recommended A newer procedure called balloon rhinoplasty involves inserting a balloon inside the sinus cavity and then inflating itEndoscopic sinus surgery is a popular treatment for chronic or recurrent sinusitis that is caused by a permanent problem with your nose Endoscopic sinus surgery is an invasive procedure that can take weeks or months to fully heal from It is a permanent procedure that includes removing bone and tissue in your nose to prevent further blockagesTreatment for Sinusitis Don't just treat the symptoms Most sinusitis treatments focus on relieving the symptoms, but don't necessarily address the root cause For instance, typical treatment for sinusitis begins with medication prescribed by your doctor However, up to 60% of chronic sinusitis sufferers don't get relief with medication

Chronic Sinusitis And Its Effect On Mood Linked To Anxiety Depression

Chronic Sinusitis And Its Effect On Mood Linked To Anxiety Depression

Sinus Infections Signs And Symptoms

Sinus Infections Signs And Symptoms

People suffering from chronic sinusitis often seek relief from home remedies, many of which can be found online, or physicians may prescribe antibiotics, nasal steroid sprays or oral steroids Managing Chronic Sinusitis with Medical TherapyLeukotriene Inhibitors Leukotriene inhibitors—such as the medication Singulair®—can help people who have chronic sinusitis due to allergies by targeting chemicals produced by the body called leukotrienesJun 10, 19 · Antibiotics for Sinusitis or Sinus Infection If your physician thinks that the sinusitis is caused due to a bacterial infection, then you might be set on an antibiotic medication The course may last for 1014 days for acute sinusitis A longer duration of medication may be necessary for treating chronic sinusitis

Are You Using The Correct Treatment For Your Sinusitis Health24

Are You Using The Correct Treatment For Your Sinusitis Health24

Chronic Sinusitis Symptoms And Causes Mayo Clinic

Chronic Sinusitis Symptoms And Causes Mayo Clinic

Feb 17, 21 · A retrospective analysis of treatment outcomes and time to relapse after intensive medical treatment for chronic sinusitis Am J Rhinol 02;Postnasal drip (fluid from the sinuses and nose constantly drips down the back of the throat), which can lead to constant coughing, a sore throat and bad breath Treatment optionsSinus surgery is a treatment option for those whose sinus blockage symptoms are the result of a physical defect in the nose or sinus area These physical conditions may include Deviated septum Closed passages Nasal polyps Sinus surgery is a fully invasive procedure that involves the permanent removal of bone or tissue

Sinus Infection Sinusitis 18 Signs Symptoms Causes Medications Treatment

Sinus Infection Sinusitis 18 Signs Symptoms Causes Medications Treatment

1

1

The management of acute sinusitis is different than the management of chronic sinusitis, but may utilize many similar medications Here a few recommended treatments Nasal Wash A saltwater, or saline, nasal wash helps remove mucus and bacterial from the nose and sinuses This can temporarily reduce symptoms of nasal congestion and postnasal dripNov 21, 18 · The sort of medicines that may be considered include the following Steroids applied to the nasal lining using sprays (such as beclometasone nasal spray) or drops are recommended for all types of chronic sinusitis This is because they help to reduce inflammation A long course may be advised for example, for three monthsSep 24,  · Researchers are investigating new nonsurgical treatment for chronic sinusitis (Photo by Getty Images) Researchers at The University of Texas Health Science Center at Houston are investigating the efficacy and safety of an intranasal treatment for adults with chronic sinusitis with or without nasal polypsThe treatment is XHANCE®, which has been approved by the US

Sinusitis Sinus Infection Treatment In Hyderabad

Sinusitis Sinus Infection Treatment In Hyderabad

Do I Have Chronic Sinusitis My Sinusitis

Do I Have Chronic Sinusitis My Sinusitis

Sep 19, 19 · Current treatment includes a combination of therapies that target symptoms These include medical and surgical treatments, such as antibiotics, shortterm oral corticosteroids, steroid nasal sprays, sinus irrigation, and endoscopic sinus surgery However, many people continue to experience symptoms despite treatmentChronic sinusitis is treatable At University of Utah Health, our fellowshiptrained rhinologists are experts who specialize in managing nasal and sinus problems They can diagnose chronic sinusitis and provide personalized treatment, including nonsurgical therapies and, if needed, endoscopic sinusGlucocorticoid nasal sprays, washes, and drops Because all forms of chronic rhinosinusitis involve some degree of inflammation ie irritation and swelling), most people with the condition need medications to reduce inflammation Glucocorticoids (commonly called "steroids") are very effective antiinflammatory drugs

Clinical Outcomes In Patients With Chronic Sinusitis Metson 00 The Laryngoscope Wiley Online Library

Clinical Outcomes In Patients With Chronic Sinusitis Metson 00 The Laryngoscope Wiley Online Library

Deaconess Managing Treating Chronic Sinusitis

Deaconess Managing Treating Chronic Sinusitis

Ozturk F, Bakirtas A, Ileri F, Turktas I Efficacy and tolerability of systemic methylprednisolone in children and adolescents with chronic rhinosinusitis a doubleblind, placebocontrolledChronic sinusitis is the result of long term irritation to the sinus cavities that have resulted in inflammation and swelling In most cases, the sinuses fill with air as we breathe For a person with chronic sinusitis, the nasal passages and sinuses can become so inflamed that they begin to trap bacteria, viruses, allergens and other airborneChronic Sinusitis Treatment Options When treating sinusitis, a doctor's goal is to decrease inflammation of the nose Through this process, a physician can also narrow down the specific cause of sinusitis The first line of treatment is a salt water wash combined with a topical nasal steroid spray to promote mucus drainage and to reduce

5 Best Ways To Treat A Sinus Infection Unitypoint Health

5 Best Ways To Treat A Sinus Infection Unitypoint Health

Healing Chronic Sinusitis Without Medication A Cure That Has A 92 Success Rate Letourneau Stephane Amazon Com Books

Healing Chronic Sinusitis Without Medication A Cure That Has A 92 Success Rate Letourneau Stephane Amazon Com Books

Dr Bernard Seif answered 40 years experience Clinical PsychologyAug 16, 19 · Antibiotics Although doctors still disagree about the role of antibiotics as a treatment for chronic sinusitis, some people may find that amoxicillin with potassium clavulanate can help Sometimes, doctors may prescribe other antibioticsChronic sinus symptoms are one of the most common reasons for purchasing overthecounter products When those home remedies and overthecounter medications, fail to help, sufferers must turn to their doctor for treatment Antibiotics, prescription medications and nasal sprays may solve the problem But if not, what are the alternatives then?

Cureus An Uncommon Presentation Of The Common Sinusitis

Cureus An Uncommon Presentation Of The Common Sinusitis

Chronic Sinusitis Ent Of Georgia South

Chronic Sinusitis Ent Of Georgia South

No antibiotics are Food and Drug Administration (FDA)approved for use in chronic sinusitis The rationale for treatment in chronic sinusitis is to eradicate bacterial infection Antibiotics are also used in the short term for acute exacerbations, with a treatment duration shorter than 4 weeksPeople with chronic sinusitis may have other problems which affect the nose, throat and ears at the same time, including Middle ear infection and temporary deafness;Mar 13, 21 · Balloon sinus dilation in Hudson Valley has helped many to correct their chronic sinusitis conditions The treatment involves the use of a balloontipped catheter The doctor will insert this tool in the right place in your sinus passage guided by imaging and inflates the balloon

For Sinuses Entoffice Org

For Sinuses Entoffice Org

Tips For Treating Chronic Sinus Infections

Tips For Treating Chronic Sinus Infections

Jun 21, 17 · Overthecounter (OTC) pain medications can help relieve the pain of a headache or pressure from swelling These include ibuprofen (Advil) orJan 19, 17 · Chronic Sinusitis Treatment Options Anyone can use nasal irrigation to relieve congestion and sinus pressure You don't need a prescription for a simple saline rinse However, compounded solutions such as antibiotics, antifungals or antiInflammatories may be prescribed by your doctor Sinus irrigation is often prescribed for acuteThere are many home remedies associated with chronic sinusitis treatment from fungal sources Given their natural antifungal properties, oregano oil for sinus infection treatment is sometimes used as so is garlic, another natural antifungal

Sinus Headache Relief Symptoms Medicine Treatment Remedies Causes

Sinus Headache Relief Symptoms Medicine Treatment Remedies Causes

Treating Chronic Sinusitis To Eliminate Brain Fog

Treating Chronic Sinusitis To Eliminate Brain Fog

If your acute or chronic sinusitis doesn't clear up with the use of nasal sprays, saline solutions, pain medications, you still have options Balloon sinuplasty is a minimally invasive, inoffice procedure that lasts less than 30 minutes, requires little to no recovery time, and can provide fast relief from your sinusitis symptomsAcute sinusitis normally gets better on its own within 1 to 3 weeks, but when symptoms persist for 3 months or more, it is called chronic sinusitis Chronic sinusitis is treated with medications, surgery, nonsurgical treatments or a combination of these There are things you can do to help prevent you getting chronic sinusitisJan 16, 21 · Medications for Chronic Sinusitis As most of the cases are viral in origin so antibiotics are infective if symptoms do not resolve within 10 days, amoxicillin is a reasonable antibiotic to use first for treatment Antibiotics are specifically not recommended in those with mild / moderate disease during the first week of infection due to risk

4 Ways To Treat Chronic Sinusitis Wikihow

4 Ways To Treat Chronic Sinusitis Wikihow

Chronic Rhinosinusitis American Family Physician

Chronic Rhinosinusitis American Family Physician

A summary of a Canadian guideline on chronic sinusitis advises avoidance of allergic triggers and smoking Kaplan, 13 Although there is no strong evidence that smoking causes chronic sinusitis, there is a hypothetical risk that tobacco smoke may exacerbate chronic sinusitis symptoms, particularly in people with allergies Benninger, 1999

An Advanced Way To Treat Chronic Sinusitis

An Advanced Way To Treat Chronic Sinusitis

Do You Suffer From Chronic Sinusitis You May Have Nasal Polyps Bergerhenry Ent Specialty Group

Do You Suffer From Chronic Sinusitis You May Have Nasal Polyps Bergerhenry Ent Specialty Group

Sinusitis In Children Cedars Sinai

Sinusitis In Children Cedars Sinai

What Works For Chronic Sinusitis Evidently Cochrane

What Works For Chronic Sinusitis Evidently Cochrane

What Works For Chronic Sinusitis Cochrane Uk

What Works For Chronic Sinusitis Cochrane Uk

Chronic Sinusitis Medical Treatments Euforea

Chronic Sinusitis Medical Treatments Euforea

Sinusitis

Sinusitis

Study Pack 1 Module 3 Sinusitis And Congestion Pharmacy Academy

Study Pack 1 Module 3 Sinusitis And Congestion Pharmacy Academy

The Best Medicine For Sinus Infections Health Com

The Best Medicine For Sinus Infections Health Com

Balloon Sinus Dilation Tampa Florida Ent Chronic Sinusitis Treatment Tampa Ear Nose And Throat

Balloon Sinus Dilation Tampa Florida Ent Chronic Sinusitis Treatment Tampa Ear Nose And Throat

Acute Rhinosinusitis In Adults American Family Physician

Acute Rhinosinusitis In Adults American Family Physician

How Sinus Infection Is Treated

How Sinus Infection Is Treated

Acute Chronic Sinusitis Treatment 12 Home Remedies For Sinus Infection

Acute Chronic Sinusitis Treatment 12 Home Remedies For Sinus Infection

Sinusitis Treatment Plus Home Remedies For Sinusitis Youtube

Sinusitis Treatment Plus Home Remedies For Sinusitis Youtube

Signs Symptoms And Complications Of Sinus Infections

Signs Symptoms And Complications Of Sinus Infections

Houston Balloon Sinuplasty Surgery Houston Tx Houston Sinus Surgery

Houston Balloon Sinuplasty Surgery Houston Tx Houston Sinus Surgery

Tired Of Sinus Infections Nilesh Patel Md Ear Nose Throat Doctors

Tired Of Sinus Infections Nilesh Patel Md Ear Nose Throat Doctors

4 Ways To Treat Chronic Sinusitis Wikihow

4 Ways To Treat Chronic Sinusitis Wikihow

Chronic Sinusitis Symptoms Treatment And Causes

Chronic Sinusitis Symptoms Treatment And Causes

Chronic Sinus Infections How To Get Relief When To See A Doctor Houston Methodist On Health

Chronic Sinus Infections How To Get Relief When To See A Doctor Houston Methodist On Health

6 Symptoms Of Sinusitis Infection Treating A Sinus Infection

6 Symptoms Of Sinusitis Infection Treating A Sinus Infection

1

1

Nasal Obstruction Symptoms Causes Treatment Fort Worth Ent

Nasal Obstruction Symptoms Causes Treatment Fort Worth Ent

Cure Sinus Infection In 24 Hours Sinusitis Symptoms Treatment Chronic Sinusitis Headache Sinus Surgery Problems Relief Remedies Sinus Medication Medicine Antibiotics Respiratory Book By Stefan Lawyer

Cure Sinus Infection In 24 Hours Sinusitis Symptoms Treatment Chronic Sinusitis Headache Sinus Surgery Problems Relief Remedies Sinus Medication Medicine Antibiotics Respiratory Book By Stefan Lawyer

Acute And Chronic Sinusitis And Allergies

Acute And Chronic Sinusitis And Allergies

Sinusitis

Sinusitis

What To Know About Chronic Sinusitis Steemit

What To Know About Chronic Sinusitis Steemit

Acute And Chronic Sinusitis

Acute And Chronic Sinusitis

Sinusitis

Sinusitis

Mayo Clinic Chronic Sinusitis Sinus Medication Sinusitis

Mayo Clinic Chronic Sinusitis Sinus Medication Sinusitis

What Causes Sinus Infections Sun City West Az Otolaryngology

What Causes Sinus Infections Sun City West Az Otolaryngology

6 Common Symptoms Of Chronic Sinusitis

6 Common Symptoms Of Chronic Sinusitis

How To Relieve Sinus Pressure 8 Home Remedies And Treatments

How To Relieve Sinus Pressure 8 Home Remedies And Treatments

How To Treat A Sinus Infection At Home Upmc Healthbeat

How To Treat A Sinus Infection At Home Upmc Healthbeat

Treating Sinus Infections Don T Rush To Antibiotics Choosing Wisely Canada

Treating Sinus Infections Don T Rush To Antibiotics Choosing Wisely Canada

The 9 Best Sinus Infection Medications On Amazon

The 9 Best Sinus Infection Medications On Amazon

Acute And Chronic Sinusitis And Allergies

Acute And Chronic Sinusitis And Allergies

Sinusitis Ear Nose And Throat Disorders Merck Manuals Professional Edition

Sinusitis Ear Nose And Throat Disorders Merck Manuals Professional Edition

Sinusitis Or Sinus Infection Symptoms Casues And Treatment

Sinusitis Or Sinus Infection Symptoms Casues And Treatment

Secret Sinus Treatments

Secret Sinus Treatments

Chronic Sinusitis Care Recurring Sinus Infections

Chronic Sinusitis Care Recurring Sinus Infections

How To Get Rid Of A Sinus Infection Home Remedies And Medication

How To Get Rid Of A Sinus Infection Home Remedies And Medication

Chronic Sinusitis Treatment South Florida Sinus Allergy Center

Chronic Sinusitis Treatment South Florida Sinus Allergy Center

Novel Approach For Treating Chronic Sinusitis

Novel Approach For Treating Chronic Sinusitis

Healing Chronic Sinusitis Without Medication A Cure That Has A 92 Success Rate Kindle Edition By Letourneau Stephane Health Fitness Dieting Kindle Ebooks Amazon Com

Healing Chronic Sinusitis Without Medication A Cure That Has A 92 Success Rate Kindle Edition By Letourneau Stephane Health Fitness Dieting Kindle Ebooks Amazon Com

Snot What You Think The Unknown Toll Of Chronic Sinus Problems

Snot What You Think The Unknown Toll Of Chronic Sinus Problems

Acute Bacterial Rhinosinusitis In Adults Part Ii Treatment American Family Physician

Acute Bacterial Rhinosinusitis In Adults Part Ii Treatment American Family Physician

Chronic Rhinosinusitis American Family Physician

Chronic Rhinosinusitis American Family Physician

1

1

Cbd For Chronic Sinusitis Ways To Treat Chronic Sinusitis

Cbd For Chronic Sinusitis Ways To Treat Chronic Sinusitis

Sinus Infection Sinusitis Symptoms Treatment Causes Narayana Health

Sinus Infection Sinusitis Symptoms Treatment Causes Narayana Health

Acute Sinusitis Guide Causes Symptoms And Treatment Options

Acute Sinusitis Guide Causes Symptoms And Treatment Options

18 Symptoms Of Sinus Infection Sinusitis Treatment Causes Complications

18 Symptoms Of Sinus Infection Sinusitis Treatment Causes Complications

Sinusitis In The Summer Of Covid 19 Sinus Expert Glendale Beverly Hills Los Angeles Ca

Sinusitis In The Summer Of Covid 19 Sinus Expert Glendale Beverly Hills Los Angeles Ca

Chronic Rhinosinusitis American Family Physician

Chronic Rhinosinusitis American Family Physician

Chronic Sinusitis Symptoms Treatment And Causes

Chronic Sinusitis Symptoms Treatment And Causes

Tylenol Sinus Severe Daytime Caplets Tylenol

Tylenol Sinus Severe Daytime Caplets Tylenol

Chronic Sinusitis Surgery Euforea

Chronic Sinusitis Surgery Euforea

Acute Sinusitis Guide Causes Symptoms And Treatment Options

Acute Sinusitis Guide Causes Symptoms And Treatment Options

The 7 Best Sinus Decongestants Of 21

The 7 Best Sinus Decongestants Of 21

Acute Sinusitis A Cost Effective Approach To Diagnosis And Treatment American Family Physician

Acute Sinusitis A Cost Effective Approach To Diagnosis And Treatment American Family Physician

Chronic Rhinosinusitis American Family Physician

Chronic Rhinosinusitis American Family Physician

Sinus Infection And Sinusitis Treatment In Boise Boise Ent Services

Sinus Infection And Sinusitis Treatment In Boise Boise Ent Services

Several Sinus Surgery Types That Make A Big Impact Dr Momma Says

Several Sinus Surgery Types That Make A Big Impact Dr Momma Says

How To Get Rid Of Sinus Infection Treatments And Home Remedies

How To Get Rid Of Sinus Infection Treatments And Home Remedies

How A Sinus Infection Is Diagnosed

How A Sinus Infection Is Diagnosed

63 Best Chronic Sinusitis Ideas Chronic Sinusitis Sinusitis Chronic

63 Best Chronic Sinusitis Ideas Chronic Sinusitis Sinusitis Chronic

New Medication Advances Treatment For Chronic Rhinosinusitis With Nasal Polyps Harvard Health

New Medication Advances Treatment For Chronic Rhinosinusitis With Nasal Polyps Harvard Health

Walgreens Severe Sinus Congestion Pain Caplets Daytime Cool Blast Walgreens

Walgreens Severe Sinus Congestion Pain Caplets Daytime Cool Blast Walgreens

1

1

Chronic Sinus Infection Sinusitis Everyday Health

Chronic Sinus Infection Sinusitis Everyday Health

Chronic Sinusitis Symptoms Causes Treatments

Chronic Sinusitis Symptoms Causes Treatments

Chronic Sinusitis And Nasal Polyps Diagnosis And Treatment Northwestern Medicine

Chronic Sinusitis And Nasal Polyps Diagnosis And Treatment Northwestern Medicine

Chronic Sinusitis Doctor Philadelphia Chronic Sinus Pain Relief

Chronic Sinusitis Doctor Philadelphia Chronic Sinus Pain Relief

Chronic Sinusitis Mexico Pdf Ppt Case Reports Symptoms Treatment

Chronic Sinusitis Mexico Pdf Ppt Case Reports Symptoms Treatment

6 Common Symptoms Of Chronic Sinusitis

6 Common Symptoms Of Chronic Sinusitis

The Best Medicine For Sinus Infections Health Com

The Best Medicine For Sinus Infections Health Com

How To Cure Chronic Sinusitis And Sinus Headaches Permanently Harley Street Ent Clinic

How To Cure Chronic Sinusitis And Sinus Headaches Permanently Harley Street Ent Clinic

Sinus Infection Signs Symptoms 10 Natural Remedies Dr Axe

Sinus Infection Signs Symptoms 10 Natural Remedies Dr Axe

What To Do About Sinusitis Harvard Health

What To Do About Sinusitis Harvard Health

How To Relieve Sinus Pressure 8 Home Remedies And Treatments

How To Relieve Sinus Pressure 8 Home Remedies And Treatments

Symptoms And Treatments Of A Sinus Infection San Diego Sharp Health News

Symptoms And Treatments Of A Sinus Infection San Diego Sharp Health News

Balloon Sinuplasty For Chronic Sinusitis Tupelo Corinth Sinus Doctors

Balloon Sinuplasty For Chronic Sinusitis Tupelo Corinth Sinus Doctors

Chronic Sinusitis Diagnosis And Treatment Mayo Clinic

Chronic Sinusitis Diagnosis And Treatment Mayo Clinic

Incoming Term: chronic sinusitis medication, what medication is used for chronic sinusitis, what is the best medicine for chronic sinusitis, what is the best medication for chronic sinusitis, what is the treatment for chronic sinusitis, what is the best treatment for chronic sinusitis,

コメント

このブログの人気の投稿

デスクトップ壁紙 1920x1080 紫陽花 壁紙 pc 309218

√100以上 テレビ 公開 捜査 179188-テレビ 公開 捜査 その後 2019

Tamarindo fruta puerto rico 240613-Tamarindo fruta puerto rico