Allergy Newsletter Spring 2012 : Page 1
spring 2012 A newsletter for patients of University of Missouri Health Care’s ENT and Allergy Center of Missouri Reviewing OVER-THE-COUNTER AND PRESCRIPTION ALLERGY AND ASTHMA MEDICATIONS In the midst of yet another high allergy season, we often turn to medications, either prescribed by a health care provider or available over the counter. These medications usually include antihistamines — with or without drying agents, moisture-producing products such as Mucinex®, anti-allergy eye drops, nose sprays, Singulair®, asthma medications or steroids. How do they work and how safe are they? It’s important to have some idea of the medications’ functions and problems. Remember that when using medications, combining several of them frequently may provide better results than a single drug used alone (for example, an antihistamine plus steroid nasal spray or Singulair® plus a steroid inhaler). Antihistamines There are good over-the-counter medications like Benadryl® or Atarax® that have been used and shown to be effective for many years. Antihistamines help to stop bad allergic reactions like hives, itching and swelling, but can make you drowsy and only last four hours. Other older over-the-counter antihistamines include Chlor-Trimeton™ and Actifed®, which work on the airway, but only last four to eight hours and can make you drowsy. Claritin® (Loratidine) was introduced in the 80s as the first non-drowsy 24-hour antihistamine. The two heavy-duty 24-hour antihistamines that most frequently work for adults are Zyrtec® (Cetirizine) and Allegra® (Fexofenadine). These over-the-counter antihistamines are reliable when used daily and can be used long term without losing potency in most people. Another recently released prescription antihistamine, Zyzal®, is excellent but can be expensive. Singulair® (Monteleukast) is a medication that stops the effects of one of the major granules put out by the inflammatory allergic system. It has proven to work well for asthma patients when combined with lung inhalers, and it also works well for patients with nasal allergies. Steroids Steroid nasal sprays are the workhorses for treating nasal allergies. They are delivered directly to allergic sites in the nose to stop inflammation. When used on the surface of allergic tissue, steroid nasal sprays are relatively safe. Oral steroids can be used for more serious allergic reactions and must be prescribed by your health care provider judiciously. IM depo (time-released) steroids are used when an allergic patient feels miserable and other medications don’t work. This steroid must be used occasionally and is available by prescription only. Steroid creams and ointments are okay for skin issues but over time can build up in your system and cause side effects. Drying agents Drying agents such as Sudafed® are okay if used infrequently but can have a rebound effect like dryness and bleeding, as well as thick post-nasal secretions (which can then cause sore throats, cough, etc.) from nasal tissue if used frequently. Eye drops Prescription or over-the-counter eye drops can help stabilize allergies of the eye surface lining, eyeball and eyelids. Eye drops can be available by prescription, but there are many good antihistamine and artificial eye-wetting products available over the counter. Asthma medications Asthma medications are potent and work well, but they must be prescribed by your health care provider once you are diagnosed having airway difficulty in your lungs. If you are having difficulty breathing, don’t hesitate to discuss your symptoms with your health care provider. Lungs that are left untreated frequently start scarring permanently, leading to permanent loss of lung function. When used properly, over-the-counter medications can really help relieve allergy symptoms. But as allergies progress and worsen over time, the ultimate medical treatment is to have the specific allergens discovered with testing and then treated with immunotherapy (either shots or drops). If you experience allergy or asthma symptoms, the specialists at the ENT and Allergy Center of Missouri are here to help. Call (573) 817-3000 for an appointment today or visit www.muhealth.org/allergy. To schedule an appointment at the University of Missouri Health Care’s ENT and Allergy Center of Missouri, please call (573) 817-3000.