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Pharmacologic (Medicine) Treatment for Nasal Allergies

Patients Educational Materials Pharmacologic Treatment for Nasal Allergies

Pharmacologic (Medicine) Treatment for Nasal Allergies

Antihistamines which are prescribed for the treatment of allergies fall into two categories, first generation and second generation. The first generation antihistamines are the oldest ones and date back several decades. Their chemical makeup is such that it gets into brain tissue very easily and, therefore, cause the most side effects. Almost all first generation antihistamines are over-the-counter. Examples are Benadryl, Chlor-Trimeton, Tavist, Allerest, etc.

The more recent advance in antihistamines, the so-called second generation antihistamines, are made up so that they do not get into brain tissue so easily and, therefore, cause less drowsiness. Examples are Claritin, Clarinex, Allegra, Zyrtec, Xyzal, and even Astelin and Patanase which are unique in that they are the only nasal spray antihistamines.

Antihistamines can be combined with decongestants. Pseudoephedrine and Phenylephrine are examples of decongestants that can be combined with antihistamines. Their purpose is to alleviate nasal and sinus congestion which can be a significant part of allergic symptoms in many people. Allegra-D, Clarinex-D, Zyrtec-D and Claritin-D are examples.

Singulair (classified as anti-inflammatory) is another category of medication shown to be effective for both nasal allergies and asthma. If the leukotriene pathway of inflammation is involved in a person’s allergies, then Singulair can be highly effective.

Intranasal steroid sprays are probably the mainstay of treatment for nasal allergies. Examples include Nasonex, Nasacort AQ, Rhinocort AQ, Flonase, Veramyst, Nasarel, Beconase AQ, and Vancenase AQ, and the most recent Omnaris. These are corticosteroids and are true antiinflammatory medicines to combat allergic inflammation. They are universally considered the drug of choice for nasal allergies. They are topically active and, therefore, poorly absorbed, so there is very little risk of systemic steroid side effects from them.

Another category of medication is the anti-cholinergic Atrovent (ipratropium) which is basically a drying agent for people who have significant runny noses.

NasalCrom (Cromolyn Sodium) is an older medication which supposedly prevents histamine from coming out of the allergy cell. It is not a very effective treatment and can be purchased over-the-counter.

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Asthma, Allergies and Pregnancy

 

If you are pregnant and have asthma or allergies, you may feel uneasy about taking medications, but it is very important to keep your symptoms under control.

How do you stay healthy and know which medications are best for you during your pregnancy?

An allergist / immunologist, often referred to as an allergist, can tell you which asthma and allergy medications are the safest and most effective to take throughout pregnancy. Make an appointment with an allergist soon after you discover you are pregnant to develop or review your personal treatment plan and to give you peace of mind.

In the meantime, here are answers to some common questions.

Can women with asthma have safe pregnancies?
Yes. With good asthma management, you can keep your asthma under control and have a healthy baby.

How does uncontrolled asthma affect the fetus?
Uncontrolled asthma symptoms can cause a decrease in the amount of oxygen in your blood supply. The fetus gets its oxygen from your blood. Since a fetus needs a constant supply of oxygen for normal growth and development, managing asthma symptoms is very important to allow you and your baby to get enough oxygen.

Is it safe to take my asthma medications?
The risks of asthma flare-ups are greater than the risks of taking necessary asthma medications. Studies show that most inhaled asthma medications are safe for women to use while pregnant. However, oral medications (pills) should be avoided unless necessary to control symptoms. Knowing which medications to take is a good reason to stay in close contact with your allergist so he or she can monitor your condition and alter your medications or dosages if needed.

Will being pregnant affect my asthma symptoms?
Pregnancy may affect the severity of your asthma symptoms. One study showed that asthma symptoms were worse in 35% of pregnant women, improved in 28% and remained the same in 33% of pregnant women. Asthma has a tendency to get worse in the late second and early third trimesters.

Can I continue to get allergy shots during pregnancy?
Allergy shots (a form of immunotherapy) are safe to take while you are pregnant. As always, your allergist will monitor your dose to reduce the risk of an allergic reaction to the shots. These reactions are rare; however, a reaction could be harmful to the fetus. Allergy shots are not started on patients who are pregnant but can be continued on patients who become pregnant while receiving it. Although current immunotherapy doses can be maintained during pregnancy, doses should not be increased until after delivery.

What should I avoid if I have asthma or allergies?
Whether you are pregnant or not, you should stay away from things that trigger your symptoms. This might include dust mites and animal dander, and irritants such as cigarette smoke.

Can women with asthma perform Lamaze?
Most women with asthma are able to do Lamaze breathing techniques without any problems. Asthma symptoms are rare during labor and delivery in women whose asthma has been managed during pregnancy.

Can I breastfeed if I am taking medications for my asthma or allergies?
Breastfeeding is a good way to increase your child's immunity, and it is strongly recommended. Medications recommended for use during pregnancy can be continued while nursing, because the baby gets less maternal medicine through breast milk than in the womb. Your allergist can discuss with you the best treatments while nursing.

Healthy Tips
Although these are common questions during pregnancy, each patient's individual treatment varies. It is best to visit your allergist regularly during pregnancy so that any worsening of asthma can be countered by appropriate changes in your asthma management plan. Make sure to discuss any specific concerns with your physician to ensure the healthiest pregnancy for your well being and that of your baby.

• You can have a healthy pregnancy if you have asthma or allergies.
• Managing your symptoms is very important during pregnancy.
• Do not stop taking your medications.
• An allergist has special training to develop or review a treatment plan that is right for you while you are pregnant.

 www.aaaai.org

 

The post Asthma, Allergies and Pregnancy appeared first on Oklahoma Allergy and Asthma Clinic.

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