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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

Oklahoma City Ranks Ninth for Most Challenging Cities for Asthma
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Oklahoma City Ranks Ninth for Most Challenging Cities for Asthma

AAFA’s 2021 Asthma Capitals™ Report Lists Most Challenging Cities to Live in the U.S. with Asthma; Oklahoma City takes ninth place for 2021

The Asthma and Allergy Foundation of America (AAFA) recently rolled out its 2021 Asthma Capitals™ report. The report coincided with World Asthma Day, part of National Asthma and Allergy Awareness Month. AAFA’s Asthma Capitals™ report analyzes data from the 100 largest cities in the United States to determine its ranking. Allentown, Pennsylvania takes the top spot as the most challenging place to live for asthma in the 2021 report. Oklahoma City was ranked ninth and Tulsa was 24th.

The ranking is based on three criteria: asthma prevalence, emergency department visits for asthma, and deaths due to asthma. The report also highlights risk factors including poverty, air pollution, access to specialists, pollen counts, medicine use, smoking policies, and the rate of uninsured residents in an area. AAFA previously identified existing “Asthma Belts” which continue to have a grip on the eastern half of the nation, however two western cities – Tucson, Arizona and Fresno, California, are also listed in the top 20 cities for this year’s report. The top 20 Asthma Capitals™ for 2021 are: 1. Allentown, Pennsylvania 2. Baltimore, Maryland 3. Richmond, Virginia 4. Milwaukee, Wisconsin 5. New Haven, Connecticut 6. Cleveland, Ohio 7. Philadelphia, Pennsylvania 8. Dayton, Ohio 9. Oklahoma City, Oklahoma 10. Tucson, Arizona 11. Worcester, Massachusetts 12. Springfield, Massachusetts 13. Columbus, Ohio 14. Birmingham, Alabama 15. Detroit, Michigan 16. Louisville, Kentucky 17. Hartford, Connecticut 18. Boston, Massachusetts 19. Fresno, California 20. Greensboro, North Carolina. To see the complete 100-city list, visit asthmacapitals.com.

“AAFA produces the Asthma Capitals report and similar research to help improve the lives of the estimated 25 million Americans living with asthma. It’s important to highlight areas which deserve our urgent attention and collective action. This includes the pressing need to develop more programs and policies that will effectively help us reduce stark disparities in asthma based on race, gender, income and where people live,” said Kenneth Mendez, CEO and president of AAFA. “This report also supports the need for climate action. Air pollution, extreme weather patterns, and natural disasters fueled by climate change continue to have a worsening impact on Americans living in certain communities. This is not only a critical area of investigation, but signals exactly where work needs to be done for those with the greatest needs.”

The report also calls attention to the role of the COVID-19 pandemic in determining the rankings. This includes some changes in health outcomes and risk factors like pollen exposure, medicine use, and emergency room visits. In 2020, fewer people experienced pollen allergies due to COVID-19 restrictions, recommendations to stay indoors, and other preventative measures like mask wearing. As a result, use of long-term asthma medicines were also down along with fewer people heading to hospital emergency rooms for asthma.

“The pandemic, economic recession, climate crisis, and racial injustice all had a significant impact on the asthma community in 2020. Despite some varying factors, asthma remains a serious public health threat with an average of 10 people dying each day. At AAFA, we reiterate that’s 10 too many. Most of these tragedies are preventable,” said Melanie Carver, chief mission officer at AAFA. “Stakeholders, policy makers, health officials, communities and individuals around the nation can use this information to join us in our mission to save lives.”

“It’s been an especially challenging year for allergies so far with high pollen and mold spore counts along with high allergy alert days,” said Oklahoma Allergy & Asthma Clinic Board-certified allergist Dr. Laura Chong. “All of these can be triggers for increases in asthma attacks too. It is important to get an evaluation to figure out your triggers and the best strategy to help optimize control of your asthma.”

The 2021 Asthma Capitals™ report is an independent research project of AAFA made possible in part by support from the Pharmaceutical Care Management Association (PCMA) Foundation. For the latest AAFA news and resources go to aafa.org.

The post Oklahoma City Ranks Ninth for Most Challenging Cities for Asthma appeared first on Oklahoma Allergy and Asthma Clinic.

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