Doctor, Should I take Antihistamines?
Doctor, Explain Allergies and Hay Fever?
Allergic Rhinitis (Hay Fever)
Doctor, Should I take Antihistamines?
Insight into decongestants and cold remedies
Drugs for stuffy nose, sinus trouble, congestion,
and the common cold constitute the largest segment of the over-the-counter
market for America's pharmaceutical industry. When used wisely,
they provide welcome relief for at least some of the discomforts
that affect almost everyone occasionally and that affect many
people chronically. Drugs in these categories are useful for
relief of symptoms from allergies, upper respiratory infections
(i.e., sinusitus, colds, flu), and vasomotor rhinitis (a chronic
stuffy nose caused by such unrelated conditions as emotional
stress, thyroid disease, pregnancy, and others). These drugs
do not cure the allergies, infections, etc.; they only relieve
the symptoms, thereby making the patient more comfortable.
Antihistamines, Decongestants, and "Cold"
Remedies
Antihistamines
Histamine is an important body chemical that is responsible
for the congestion, sneezing, and runny nose that a patient
suffers with an allergic attack or an infection. Antihistamine
drugs block the action of histamine, therefore reducing the
allergy symptoms. For the best result, antihistamines should
be taken before allergic symptoms get well established.
The most annoying side effect that antihistamines
produce is drowsiness. Though desirable at bedtime, it is a
nuisance to many people who need to use antihistamines in the
daytime. To some people, it is even hazardous. These drugs are
not recommended for daytime use for people who may be driving
an automobile or operating equipment that could be dangerous.
Newer non-sedating antihistamines, available by prescription
only, do not have this effect. The first few doses cause the
most sleepiness; subsequent doses are usually less troublesome.
Typical antihistamines include
Benadryl,®* Chlor-Trimetron,®* Claritin,® Dimetane,®* Allegra,®
PBZ,®* Polaramine,® Tavist,®* Teldrin,® Zyrtec,® etc.
Decongestants
Congestion in the nose, sinuses, and chest is due to swollen,
expanded, or dilated blood vessels in the membranes of the nose
and air passages. These membranes have an abundant supply of
blood vessels with a great capacity for expansion (swelling
and congestion). Histamine stimulates these blood vessels to
expand as described previously.
Decongestants, on the other hand, cause constriction
or tightening of the blood vessels in those membranes, which
then forces much of the blood out of the membranes so that they
shrink, and the air passages open up again.
Decongestants are chemically related to adrenalin,
the natural decongestant, which is also a type of stimulant.
Therefore, the side effect of decongestants is a jittery or
nervous feeling. They can cause difficulty in going to sleep,
and they can elevate blood pressure and pulse rate. Decongestants
should not be used by a patient who has an irregular heart rhythm
(pulse), high blood pressure, heart disease, or glaucoma. Some
patients taking decongestants experience difficulty with urination.
Furthermore, decongestants are often used as ingredients in
diet pills. To avoid excessively stimulating effects, patients
taking diet pills should not take decongestants.
Typical decongestants are phenylephrine (Neo-Synephrine®*),
phenylpropanolamine (Dura-Vent,® Entex,®), and pseudoephedrine
(Novafed,®* Sudafed,®* etc.)
* May be available over-the-counter without
a prescription. Read labels carefully, and use only as directed.
Combination remedies
Theoretically, if the side effects could be properly balanced,
the sleepiness sometimes caused by antihistamines could be cancelled
by the stimulation of decongestants. Numerous combinations of
antihistamines with decongestants are available: Actifed,®*
Allegra-D,® Chlor-Trimetron D,®*, Clarinex D,®, Zyrtec D,®Claritin
D,® Contac,®* Co-Pyronil 2,®* Deconamine,® Demazin,®* Dimetapp,®*
Drixoral,®* Isoclor,®* Nolamine,® Novafed A,® Ornade,® Sudafed
Plus,® Tavist D,®* Triaminic,®* and Trinalin,® to name just
a few.
A patient may find one preparation quite helpful
for several months or years but may need to switch to another
one when the first loses its effectiveness. Since no one reacts
exactly the same as another to the side effects of these drugs,
a patient may wish to try his own ideas on adjusting the dosages.
One might take the antihistamine only at night and take the
decongestant alone in the daytime. Or take them together, increasing
the dosage of antihistamine at night (while decreasing the decongestant
dose) and then doing the opposite for daytime use.
For example:
Antihistamine (Chlor-Trimetron,®* 4mg)-one tablet three times
daily and two tablets at bedtime.
Plus
Decongestant (Sudafed,®* 30mg)-two tablets three times daily
and one tablet at bedtime.
| Medicine |
Symptoms Relieved |
Possible Side Effects |
| Antihistamines |
Sneezing
Runny Nose
Stuffy Nose
Itchy Eyes
Congestion |
Drowsiness
Dry Mouth & Nose |
| Decongestants |
Stuffy Nose
Congestion |
Stimulation
Insomnia
Rapid Heart Beat |
| Combinations of above |
All of above |
Any of above (more or less) |
"Cold" remedies
Decongestants and/or antihistamines are the principal ingredients
in "cold" remedies, but drying agents, aspirin (or
aspirin substitutes) and cough suppressants may also be added.
The patient should choose the remedy with ingredients best suited
to combat his own symptoms. If the label does not clearly state
the ingredients and their functions, the consumer should ask
the pharmacist to explain them.
Nose sprays
The types of nose sprays that can be purchased without a prescription
usually contain decongestants for direct application to nasal
membranes. They can give prompt relief from congestion by constricting
blood vessels. However, direct application creates a stronger
stimulation than decongestants taken by mouth. It also impairs
the circulation in the nose, which after a few hours, stimulates
the vessels to expand to improve the blood flow again. This
results in a "bounce-back" effect. The congestion
recurs. If the patient uses the spray again, it starts the cycle
again. Spray-decongestion-rebound-and more congestion.
In infants, this rebound rhinitis can develop
in two days, whereas in adults, it often takes several more
days to become established. An infant taken off the drops for
12 to 24 hours is cured, but well-established cases in adults
often require more than a simple "cold turkey" withdrawal.
They need decongestants by mouth, sometimes corticosteroids,
and possibly (in patients who continuously have used the sprays
for months and years) a surgical procedure to the inside of
the nose. For this reason, the labels on these types of nose
sprays contain the warning "Do not use this product
for more than three days." Nose sprays should
be reserved for emergency and short term use.
(The above description and advice does not apply
to the type of prescription anti-allergy nose sprays that may
be ordered by your physician.)
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Doctor, Explain Allergies and Hay Fever?
Forty-five million Americans suffer from a recurring problem
called allergy. Allergic rhinitis was once known as hay fever
because workers would sneeze and develop nasal and sinus congestion
when they worked around hay in the fields. Hay fever, asthma,
and eczema are the most common symptoms of an allergic reaction.
Allergy symptoms appear when the body's immune
system begins to respond to 
a
substance as though it were a dangerous invader (called an antigen
or allergen). It does this by sending specific defenders called
antibodies to the entry site. The battle between allergen and
antibody results in a release of chemical mediators, such as
histamine, into the bloodstream. Those chemical mediators cause
changes in the body, which produce the symptoms that we feel.
Symptoms that may be caused by allergy are itching
eyes, sneezing, nasal stuffiness, nasal congestion and drainage,
and sometimes headache. Some people experience hearing changes,
scratchy sore throats, hoarseness, and cough. Other less common
symptoms include balance disturbances, swelling in face or throat
tissues, skin irritations, and even respiratory problems and
asthma.
Some
allergy sufferers experience symptoms all year. Others find
certain seasons bring on attacks. Allergy symptom control is
most successful when multiple management approaches are used
simultaneously. Minimizing exposure to allergens, managing symptoms
with medications, and desensitization with allergy shots are
all methods that can be useful in controlling allergic symptoms.
Medications properly used can be very helpful.
Over the counter drugs can be beneficial, but some cause drowsiness.
Sometimes prescription medications offer the best chance for
good control.
Immunotherapy, or allergy shots, provide the
only treatment method that can offer lasting relief or cure
from allergies. Before beginning a series of such shots, allergy
testing must be performed.
Beware of the Allergens
Anything can be an allergen. Some substances,
because of their chemical make-up, are more prone to generate
an allergic response in humans. Pollens, food, mold, dust, feathers,
animal dander, chemicals, drugs such as penicillin, and environmental
pollutants commonly cause many to suffer allergic reactions.
Hay fever is
caused by pollens. The most significant cause of hay fever in
the United States is ragweed. It begins pollinating in late
August and continues until the first frost. Late springtime
pollens come from the grasses, i.e., timothy, orchard, red top,
sweet vernal, Bermuda, Johnson, and some bluegrasses. Early
springtime hay fever is most often caused by pollens of trees
such as elm, maple, birch, poplar, beech, ash, oak, walnut,
sycamore, cypress, hickory, pecan, cottonwood, and alder.
Certain allergens are always present. These include house dust,
household pet danders, foods, wool, various chemicals used around
the house, and more. Symptoms from these are frequently worse
in the winter when the house is closed up.
Mold spores cause at least as many allergy problems as pollens.
Molds are present all year long, and grow outdoors and indoors.
Dead leaves and farm areas are common sources for outdoor molds.
Indoor plants, old books, bathrooms, and damp areas are common
sources of indoor mold growth. Molds are also common in foods,
such as cheese and fermented beverages.
Colorful or fragrant flowering plants rarely cause allergy because
their pollens are too heavy to be airborne.
Can Allergies Be Serious?
Allergies are rarely life threatening, but often
cause lost workdays, decreased work efficiency, poor school
performance, and less enjoyment of life. It is common for allergy
sufferers to develop sinus or respiratory infections if allergy
symptoms are not controlled. Considering the millions spent
in anti-allergy medications and the cost of lost work time,
allergies cannot be considered a minor problem.
Treatment and Prevention
A number of medications are useful in the treatment
of allergy including antihistamine, nasal decongestant sprays,
steroid sprays, and saline sprays. The medical management of
allergy also includes counseling in proper environmental control.
Based on a detailed history and thorough examination, your doctor
may advise testing to determine the specific substances to which
you are allergic.
| Medicine |
Symptoms Relieved |
Possible Side Effects |
| Antihistamines |
Sneezing
Runny Nose
Stuffy Nose
Itchy Eyes
Congestion |
Drowsiness
Dry Mouth & Nose |
| Decongestants |
Stuffy Nose
Congestion |
Stimulation
Insomnia
Rapid Heart Beat |
| Combinations of above |
All of above |
Any of above (more or less) |
The treatments employed by your otolaryngologists will depend
on the materials to which you are allergic and the degree of
your sensitivity to them. The only “cure” available for inhalant
allergy is the administration of injections that build up protective
antibodies to specific allergens (pollens, molds, animal danders,
dust, etc.). Your physician will oversee your progress and care
for any other nasal and sinus disorders that may contribute
to your symptoms.
Tips for Controlling Your Environment:
Wear a pollen mask when mowing grass or house cleaning (most
drugstores sell them).
Change the air
filters monthly in heating and air conditioning systems, and/or
install an air purifier.
Keep windows
and doors closed during heavy pollen seasons.
Rid your home
of indoor plants and other sources of mildew.
Don't allow
dander-producing animals (i.e., cats, dogs, etc.) in your home.
Change feather
pillows, woolen blankets, and woolen clothing to cotton or synthetic
materials.
Enclose mattress,
box springs, and pillows in plastic barrier cloth.
Use antihistamine
and decongestants as necessary and as tolerated.
Sleep with a
brick or two placed under bedposts at the head of the bed to
help relieve nasal congestion.
Observe general
good health practices; exercise daily, stop smoking, avoid air
pollutants, eat a balanced diet, and supplement diet with vitamins,
especially C.
Consider a humidifier
in the winter. Dry, indoor heat aggravates many allergic people.
Be sure to clean the humidifier regularly.
Your otolaryngologist has extensive training in the diagnosis,
testing, and treatment of allergies and is the specialist best
trained to help you with sinus problems or other complications
from nasal allergy.
We have extensive training in the diagnosis,
testing, and treatment of allergies and we are best trained
to help you with sinus problems or other complications from
nasal allergy. Call today for an appointment 972-492-6990.
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Allergic Rhinitis (Hay Fever)
What is an allergy?
An allergy is your body’s reaction to something
in your environment. Have you ever visited a friend’s house
and started sneezing as soon as Fluffy, the Golden Retriever,
ran up to give you a big wet kiss? Have you had a rash, or a
red splotch, on your skin after using a particular kind of soap?
These are types of allergic reaction.
What is rhinitis?
Rhinitis is the term for what occurs when the
inside of your nose swells and 
hurts.
So………
When you pet your friend’s dog or play outside
and you sneeze and your nose starts to run, you have allergic
rhinitis. Your Dad or Mom may call this ‘hay fever.’ Read on
to find out why this happens, and what you can do to help stop
it.
What causes allergic rhinitis?
There
are two causes of allergic rhinitis: First, if your Mom or Dad
is allergic to stuff like soap and dogs, you are more likely
to have allergies too than someone whose family does not have
allergies. Second, your body reacts to exposure to allergens
(ah-lur-jenz). An allergen is anything that causes an allergic
reaction in you.
You might have allergies if you sneeze when you get around these
things:
Dust
Animal
hair, or animal saliva
Mold
and mildew
Trees,
grass, and flowers
Why do allergies make me sneeze and wheeze?
When you are allergic to something, your immune
system, which normally tries to keep you healthy by fighting
bad bacteria or germs in your body gets confused and thinks
a good allergen is actually a bad germ. Because your immune
system’s job is to kill germs, it attacks the allergen and tries
to get rid of it. This reaction causes us to sneeze, makes our
eyes water, and causes our noses to run.
How
do I know I have allergies?
Sometimes it can be hard to tell whether you
have allergies or just a bad cold. Here’s a quick way to find
out: do your eyes, nose, or throat itch? Then you probably have
allergies.
Do you think you might have allergies? Ask your
Mom or Dad if you have had any of these symptoms for over two
weeks (A symptom is a condition of your body that is not normal,
and may be a signal that something is wrong.):
Itchy, watery eyes
Runny nose
Clear gunk in
the tissue when you blow your nose
‘Stuffed up’
nose
Sore throat
Will I have to visit the doctor?
Before going to the doctor, your parents might
give you a nasal spray or a 
medication
called an antihistamine that fights the allergic reaction. If
these medicines work, you’re home free. If not, an otolaryngologist
(oh-toe-lair-in-goll-oh-gist), a special doctor for ears, noses,
and throats, can examine you and prescribe other remedies. The
doctor may suggest:
Washing your sheets in hot water to get rid of dust
mites (a very tiny insect that can only be seen with a microscope)
Keeping your
bedroom neat and clean
Running a special
air cleaner in your house
Playing inside
more in the spring and fall.
Your parents
will have to discuss what to do if you are allergic to family
pets.
DID YOU KNOW?
If your runny
nose produces a liquid that is green or yellow, you may have
a condition called sinusitis. This is treated differently than
allergic rhinitis.
Several of our
Presidents have had allergies.
They include:
Theodore Roosevelt (26th president, 1901-1909),
Calvin Coolidge (30th president, 1923-1929),
John F. Kennedy (35th president, 1961-1963),
and
Bill Clinton (42nd president, 1993-2001).
The original Tin Man from the “The Wizard of Oz,” had an allergic
reaction to the make-up used to make him look silver. He ended
up in the hospital for two weeks and someone else had to play
that part.
Sometimes it can be hard to tell whether you have allergies
or just a bad cold. Here’s a quick way to find out: do your
eyes, nose, or throat itch? Then you probably have allergies.
Call today for an allergy evaluation 972-492-6990.
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972-394-4405 (fax)
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