Medications
For people who find they cannot adequately avoid airborne allergens, the
symptoms often can be controlled with medications. Effective medications
that can be prescribed by a physician include antihistamines and topical
nasal steroids–either of which can be used alone or in combination.
Many effective antihistamines and decongestants also are available
without a prescription.
Antihistamines. As the name indicates, an antihistamine counters the
effects of histamine, which is released by the mast cells in the body’s
tissues and contributes to allergy symptoms. For many years,
antihistamines have proven useful in relieving sneezing and itching in
the nose, throat, and eyes, and in reducing nasal swelling and drainage.
Many people who take antihistamines experience some distressing side
effects: drowsiness and loss of alertness and coordination. In children,
such reactions can be misinterpreted as behavior problems. During the
last few years, however, antihistamines that cause fewer of these side
effects have become available by prescription. These non-sedating
antihistamines are as effective as other antihistamines in preventing
histamine-induced symptoms, but do so without causing sleepiness. Some
of these non-sedating antihistamines, however, can have serious side
effects, particularly if they are taken with certain other drugs. A
patient should always let the doctor know what other medications he/she
is taking.
Topical nasal steroids. This medication should not be confused with
anabolic steroids, which are sometimes used by athletes to enlarge
muscle mass and can have serious side effects. Topical nasal steroids
are anti-inflammatory drugs that stop the allergic reaction. In addition
to other beneficial actions, they reduce the number of mast cells in the
nose and reduce mucus secretion and nasal swelling. The combination of
antihistamines and nasal steroids is a very effective way to treat
allergic rhinitis, especially in people with moderate or severe allergic
rhinitis. Although topical nasal steroids can have side effects, they
are safe when used at recommended doses. Some of the newer agents are
even safer than older ones.
Cromolyn sodium. Cromolyn sodium for allergic rhinitis is a nasal spray
that in some people helps to prevent allergic reactions from starting.
When administered as a nasal spray, it can safely inhibit the release of
chemicals like histamine from the mast cell. It has few side effects
when used as directed, and significantly helps some patients with
allergies.
Decongestants. Sometimes re-establishing drainage of the nasal passages
will help to relieve symptoms such as congestion, swelling, excess
secretions, and discomfort in the sinus areas that can be caused by
nasal allergies. (These sinus areas are hollow air spaces located within
the bones of the skull surrounding the nose.) The doctor may recommend
using oral or nasal decongestants to reduce congestion along with an
antihistamine to control allerigic symptoms. Over-the-counter and
prescription decongestant nose drops and sprays, however, should not be
used for more than a few days. When used for longer periods, these drugs
can lead to even more congestion and swelling of the nasal passages.
see also: Sinusitis
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