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Pharmacologic (Medicine) 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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Food Allergy Facts and Figures – From Kids with Food Allergies and the Asthma and Allergy Foundation of America

May is Asthma and Allergy Awareness Month

What Is a Food Allergy?

  • A food allergy occurs when the body’s immune system sees a certain food as harmful and reacts by causing symptoms. This is an allergic reaction.
  • Foods that cause allergic reactions are called allergens.
  • Allergic reactions can involve the skin, mouth, eyes, lungs, heart, gut, and brain.
  • Mild and severe symptoms can lead to a serious allergic reaction called anaphylaxis [anna-fih-LACK-sis]. This reaction usually involves more than one part of the body and can worsen quickly.
  • Anaphylaxis must be treated right away with epinephrine to provide the best chance for improvement and prevent serious, potentially life-threatening complications.

How Common Are Food Allergies?

  • As of 2021, about 20 million people have food allergies in the U.S.
    • About 16 million (6.2%) U.S. adults have food allergies.
    • About 4 million (5.8%) U.S. children have food allergies.
  • In 2021, 7.6% of non-Hispanic Black children had food allergies, compared to 5.5% of non-Hispanic white children.
    • Food allergy has increased among U.S. children over the past 20 years, with the greatest increase in Black children.
  • Children with food allergies are two to four times more likely to have asthma or other allergic diseases.

What Are the Most Frequent Food Allergens?

  • Nine foods cause most food allergy reactions in the United States:

 o Milk

o Egg

o Peanut

o Tree nut (for example, almonds, walnut, pecans, cashews, pistachios)

o Wheat

o Sesame

o Soy

o Fish (for example, bass, flounder, cod)

o Shellfish (for example, crab, shrimp, scallop, clams)

  • Sesame is a rising food allergy. It impacts an estimated 1 million people in the United States.6 It was declared a major allergen in the United States in 2021.

What Is Anaphylaxis?

  • Anaphylaxis is a severe, potentially life-threatening allergic reaction. Not all allergic reactions are anaphylaxis.
  • Symptoms of anaphylaxis usually involve more than one part of the body such as the skin, mouth, eyes, lungs, heart, gut, and brain.
  • Symptoms of anaphylaxis can include:
    • Skin: hives (often very itchy), flushed skin, or rash
    • Mouth: swelling of the lips, tongue, and throat; tingling or itchy feeling in the mouth
    • Lungs: shortness of breath, trouble breathing, coughing, or wheezing o Heart: dizziness, lightheadedness, loss of consciousness, low blood pressure, shock o Stomach: cramps, vomiting, diarrhea
  • Each year in the U.S., it is estimated that anaphylaxis to food results in 90,000 emergency room visits.
    • From 2006-2015, emergency room visits from food-induced anaphylaxis in infants and toddlers more than doubled

How Are Food Allergies Managed and Treated?

  • Although new treatments are being developed, there is currently no cure for food allergies.
  • Not eating the food allergen is the primary way to prevent a reaction.
  • People with food allergies should carefully read food ingredient labels and always ask about ingredients before eating food prepared by other people.
  • Epinephrine is the first line of treatment for anaphylaxis.
  • People with food allergies should always have epinephrine with them.
  • If a person is having anaphylaxis, they should:
    • Follow their Anaphylaxis Action Plan
    •  Use their epinephrine
    •  Get emergency medical care to ensure symptoms resolve

 Are Food Allergies Outgrown?

  • Milk, egg, wheat, and soy allergies are often outgrown. Most people do not outgrow peanut, tree nut, fish, and shellfish allergies.

The post Food Allergy Facts and Figures – From Kids with Food Allergies and the Asthma and Allergy Foundation of America appeared first on Oklahoma Allergy and Asthma Clinic.

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