What to do when Seasonal Allergies Strike?



Seasonal Allergies Don’t Have to Ruin Spring

For months I’ve been lamenting the cold, cold weather and have been looking forward to Spring. Indoor biking is just not that exciting for me. As the new season comes into focus, it reminds me that there are few things in life that are without some downside. My yard is muddy from the Spring rains, and my wife is trying to uproot dandelions faster than the neighbors yards can send over reinforcements.

This is also the time of year when members of the plant kingdom assault those patients who have seasonal allergies. Allergic rhinitis is one of the most common human complaints, and is estimated to affect about 1 in 6 Americans. Common symptoms include nasal congestion, clear and watery runny nose, itching nose, sneezing and red, watery eyes. Spring pollens are not the only cause; allergic rhinitis can develop with exposure to other environmental allergens, including dogs and cats.

Histamines and How They Impact Seasonal Allergies?

When allergens enter the body, they trigger the release of histamine from mast cells in the immune system. Histamine release encourages more histamine release which worsens all the symptoms of allergies. There are a variety of therapeutic approaches to allergies, from avoiding the allergen to symptomatic relief to desensitization.

Seasonal Allergies Don't Need to Keep You Indoors!

Seasonal Allergies Don’t Need to Keep You Indoors!

A young woman came into the pharmacy last week looking for relief from a runny nose and a scratchy throat; typical for this time of year. Many patients are looking for temporary relief until Spring pollination is over. Staying inside is an option since many heating and air conditioning systems help remove allergens from the air, but most of us have been waiting all Winter to get out and play or work in the yard.


What are some of my Options for Seasonal Allergy Medications?

Fortunately, there are some excellent nonprescription choices for allergic rhinitis.

  • Antihistamines have been a mainstay of allergy treatment since World War II.
  • The earlier antihistamines, such as diphenhydramine, were associated with drowsiness but are still used as sleep aids and when needed for their superior anti-itching activity.
  • Newer antihistamines, Claritin™ (loratidine), Allegra™ (fexofenadine) and Zyrtec™ (cetirizine) are available as nonprescription generic medications that are taken once or twice daily (fexofenadine).
  • The newer antihistamines are less likely to cross into the brain, so in most patients they do not produce drowsiness.
  • They begin to act within a few hours and can help further if continued regularly.
  • Adverse reactions to the newer antihistamines include headache, drowsiness, fatigue and dry mouth.
  • Fexofenadine has the lowest incidence of drowsiness; cetirizine has the highest.

I don’t suffer much from seasonal allergies, but I am allergic to animals. I can minimize exposure to my wife’s dog to stay comfortable at home. I don’t get too close and wash my hands after touching the dog. Most men recognize that no matter how severe your allergies might be, posing a “me or the dog” choice is way too easy a decision for many women. As a pharmacologist, I occasionally work with rats, and am seriously allergic. Claritin™ (loratadine) is like a miracle drug, and I found with repeated use and exposure to rats that my allergy appeared to desensitize.

Intranasal corticosteroids are another option.

  • Nonprescription Flonase™ (fluticasone) recently became available and works well for all the symptoms of allergic rhinitis.
  • The nasal corticosteroids broadly inhibit the inflammatory process that accompanies allergic rhinitis.
  • There are some adverse effects that are associated with the intranasal dosage even though they may not be due to the drug.
  • The major weakness of intranasal corticosteroids is that they take several days to achieve their maximum effectiveness.
  • They are also more expensive than the antihistamines.
  • Nevertheless, they are popular with many patients and are a very reasonable first or second choice as drug therapy for allergic rhinitis.
  • Don’t be influenced by the advertisements that corticosteroids target 6 allergy substances while antihistamines only target one; judge which medicine works better for you.

Fortunately, seasonal allergies can be time-limited and effectively controlled. If you’ve waited all Winter for baseball and kite-flying season to open but now find yourself suffering with seasonal allergies, try a nonprescription remedy and just wait a little longer till Summer arrives.

 

Dr. Peter J. Rice

About Dr. Peter J. Rice

Dr. Peter J. Rice is a professor of Pharmacology emeritus at the East Tennessee State University Quillen College of Medicine and Professor of Clinical Pharmacy at the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences. --------------------------------------------------------------------------He received his BS in pharmacy from Northeastern University, PhD in pharmacology from the Ohio State University and PharmD from the University of Kentucky. He is a Board Certified Pharmacotherapy Specialist and practices in the ambulatory care and community pharmacy settings. Professor Rice is the author of Understanding Drug Action: An introduction to pharmacology (APhA, 2014) and is a fellow of the American Pharmacists Association. --------------------------He welcomes interesting medication questions and suggestions for future columns.
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