Seasonal Allergies

Seasonal Allergies and Ways to Lessen Their Effects
By Colleen Holt, RPh
Published in Neosho Daily News
Monday, April 5, 2010

With the budding of trees and plants come seasonal allergies and spring is typically the worst time for allergies. Allergies and allergic rhinitis affect approximately 40 million people in the U.S.

When you inhale an allergen, it triggers an immune response. Allergens, found both indoors and out, include pollens, molds, dust mites, and animal dander. Allergy symptoms include sneezing, congestion, runny and itchy nose, postnasal drip, and red itchy eyes. These symptoms are easily treated. Antihistamines, usually the first line of therapy for allergic rhinitis, reduce most symptoms except sinus congestion. Antihistamines block the action of histamine, the chemical released in response to an allergen, the cause of allergy symptoms.

Earlier antihistamines, referred to as first generation agents, have been available for years. These over-the-counter antihistamines include diphenhydramine (Benadryl®), chlorpheniramine (Chlor-Trimeton®), and clemastine (Tavist®). In addition to stopping allergy symptoms, these agents have many side effects. They include dry mouth, drowsiness, urinary retention, and difficulty with cognitive thinking. Because of the drowsiness side-effect, these agents are often used in sleep aids. People should use care when driving or using machinery when taking one of these older classes of antihistamines.

The second generation of antihistamines is nonsedating and has recently changed from prescription-only to over-the-counter status. These agents include loratadine (Claritin®, Alevert®) and cetirizine (Zyrtec®). These antihistamines are long-acting and only taken once a day.

A third agent, completely different from antihistamines, is cromolyn sodium, an over-the-counter nasal spray (Nasalcrom®). It blocks the action of mast cells, which produce the chemical histamine, in the sinus passages, preventing congestion and runny nose. The problem with this drug is it’s more of a preventive agent and actually takes two to four weeks of daily use to be effective.

A fourth line of defense against allergies involves eye drops. These drugs are helpful for itchy, watery eyes. Several, formerly prescription-only products are available. These include Zaditor®, Opcon-A®, Naphcon-A®, and their generic equivalents.

If allergies cause head congestion, two products available over-the-counter will help, pseudoephedrine and phenylephrine, nasal decongestants that open sinus passages. However, these agents only treat the symptoms and do not stop the allergic reaction. People with high blood pressure or heart disease should not take these decongestants unless directed by their doctor.

Of course, prevention is the best remedy. Try to avoid exposure to allergens that trigger symptoms. Use air conditioning to keep outside pollen and allergens out; encase pillows, mattresses and box springs in allergen impermeable covers; and wash pets weekly, as well as keep them out of the bedroom. Also, reduce indoor humidity and clean moldy surfaces.

If you still have allergy symptoms after trying to self-medicate, it’s time to see your healthcare provider. Several medications that can be prescribed, such as corticosteroids (both oral and nasal sprays), antihistamines, and eye drops. See your primary care provider if you have an underlying illness such as asthma.

Allergic rhinitis and allergies can make you feel miserable. Ask your pharmacist to suggest the best product for you. By trying over-the-counter products and avoiding exposure whenever possible, life can feel really good.

About Colleen Holt, RPh
Colleen Holt, a registered pharmacist with 30 years experience, manages QuickMeds Pharmacy in Neosho.