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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.

Recent News

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OKC ranked 6th most challenging city in the U.S. for pollen allergies

The Asthma and Allergy Foundation of America (AAFA) released its annual Allergy Capitals™ report for 2022 on March 2. The report identifies the most challenging cities for spring and fall allergies in the top 100 metropolitan areas in the continental United States. Cities are ranked based on spring and fall pollen scores, over-the-counter medicine use, and availability of board-certified allergists/immunologists. Oklahoma City was ranked sixth most challenging city and Tulsa ranked 21st.

For the second year in a row, Scranton, Pennsylvania, takes the top spot based on its high spring and fall pollen scores and lower-than-average number of allergy/immunology specialists per patient. The top 20 Allergy Capitals™ for 2022 are: 1. Scranton, PA 2. Wichita, KS 3. McAllen, TX 4. Richmond, VA 5. San Antonio, TX 6. Oklahoma City, OK 7. Hartford, CT 8. Buffalo, NY 9. New Haven, CT 10. Albany, NY.

AAFA began identifying annual Allergy Capitals™ in 2003. Since that first report, seasonal allergies have worsened. Climate change has caused the growing seasons to get longer and warmer, leading to higher pollen counts in both spring and fall. The warmer temperatures also get trapped in urban areas, which impacts air pollution. Urban areas are also often designed to have wind-pollinating trees instead of fruiting (or insect-pollinating) trees.

“Climate change is a public health emergency. More than 24 million people in the U.S. have seasonal allergic rhinitis which is most often caused by pollen allergies,” says Kenneth Mendez, CEO and president of AAFA. “If we don’t slow down the warming temperatures, pollen production will only intensify. This means symptoms could worsen as climate change continues to evolve.”

Allergies can also trigger asthma episodes or attacks. Around 60-80 percent of the 25 million people in the U.S. with asthma have allergic asthma.

“We see spikes in emergency room visits that coincide with spikes in pollen seasons,” said Mendez. “Around 3,600 people per year die from asthma, so it is important to address and manage asthma and allergy triggers where you live.”

Black, Hispanic, and Indigenous populations bear the disproportionate burden of air pollution, asthma, allergies, and climate change. This is the result of long history of housing policies in the U.S. that discriminate against these groups. These policies have pushed people of color to live in undesirable neighborhoods with greater environmental and social risks. As a result of systemic racism in U.S. policies, governance, and culture, racial and ethnic minority populations are more vulnerable to the health impacts of climate change.

“AAFA’s Allergy Capitals™ report helps raise awareness of the impact of pollen and climate change on individual and community health,” says Melanie Carver, chief mission officer of AAFA. “While there are steps individuals can take to manage their allergies, we need communities to improve their city planning and take action on health disparities impacting higher risk populations.”

For people who are impacted by pollen allergies, there are options available to prevent or treat allergy symptoms.

A board-certified allergist can diagnose allergies, and determine the specific triggers that cause them, through simple tests. The allergists at Oklahoma Allergy & Asthma Clinic (OAAC) evaluate and manage patients of all ages.  The main clinic is on the Oklahoma Health Center campus.  For patient convenience, satellite offices are in Edmond, Norman, Midwest City and Yukon.

The post OKC ranked 6th most challenging city in the U.S. for pollen allergies appeared first on Oklahoma Allergy and Asthma Clinic.

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