How to choose the right allergy medication
Treatment of allergies a is challenging but common task in Oklahoma.
More than 50 million American experience allergies each year. In the United States, allergies is the most common health issue affecting children and the 6th leading cause of chronic illness in adults.
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How do I know if my symptoms are allergies or a cold?
Symptoms can vary, depending on the severity of your allergies but can include:
Sneezing
Coughing
Itching (eyes, nose, throat, skin)
Runny or stuffy nose
Headache
Pressure in the nose and sinuses
Ear fullness and popping
Sore throat
Watery, red, or swollen eyes
Dark circles under your eyes
Trouble smelling
Rash or hives
Allergic rhinitis can last several weeks (longer than a cold or the flu) and does not include fever. The nasal discharge from allergies is typically thin, watery, and clear. Nasal discharge from colds tends to be thicker.
What are the causes of allergies?
Seasonal allergies that occur in the spring (April and May) are often due to tree pollen. Those that occur in the summer (late May to mid-July) are often due to grass and weed pollen. And fall allergies (late August to the first frost) are often due to ragweed.
Allergens that can cause perennial allergic rhinitis include mold, animal dander, and dust.
How can I avoid allergies?
You can help your allergy symptoms by taking steps to avoid allergens, including:
Keep windows closed, especially on high pollen seasons.
Use nasal saline irrigation and shower to wash off allergens directly after exposures or outdoor activities.
Avoid tobacco smoke and irritating fumes.
Avoid pets and animals that are known to trigger symptoms.
Vacuum and dust regularly (including the tops of ceiling fans) to reduce indoor allergens.
Track allergy counts to identify outdoor allergy triggers and plan activities.
How do I choose the right allergy medication?
There are many good over the counter treatments for allergies. While some allergy sufferers need a combination of medications to adequately treat their symptoms, most people can treat their allergies with two types of medications - intranasal corticosteroids and oral antihistamines.
Intranasal corticosteroids (steroid nasal sprays) are the mainstay of treatment for persistent allergies including sneezing, runny nose, nasal congestion, nose/throat itching, and watery/itchy eyes. Their onset of action can be less than 30 minutes, although peak effect may take several hours to days, with maximum effectiveness usually noted after 2-4 weeks of use. Examples of intranasal corticosteroids include fluticasone (Flonase), triamcinolone (Nasacort), mometasone (Nasonex), and budesonide (Rhinocort).
Oral antihistamines (allergy pills) effectively treat sneezing, pruritus, and runny nose but are less effective than intranasal corticosteroids at treating nasal congestion and eye symptoms. Their onset is typically 15-30 minutes and are useful for mild symptoms requiring as-needed treatment. First-generation antihistamines, including diphenhydramine (Benadryl), may cause sedation and have been associated with poor school performance and impaired driving. Second-generation antihistamines include cetirizine (Zyrtec), loratadine (Claritin), levocetirizine (Xyzal), and fexofenadine (Allegra). These are preferred over Benadryl because they cause less sedation, with the exception of cetirizine.
Although many people will get adequate control of their allergies with just one medication, combination therapy may be needed for those with severe or persistent symptoms. Additional prescription allergy medications may be necessary.
Do I need allergy testing or allergy shots?
Allergy testing should be considered for moderate to severe persistent allergic rhinitis that is not responsive to usual treatment, for individuals who cannot tolerate standard therapies or want to avoid long-term medication use, and for those with allergic asthma. Over-the-counter allergy tests are not always reliable and can give misleading “false-positive” results. When considering allergy testing, it should be done in a physician’s office to get accurate results for targeted immunotherapy treatments. Immunotherapy consists of administering a small amount of allergen extract subcutaneously (shots) or sublingually (under the tongue). These forms of treatment are effective in alerting the course of allergic rhinitis but have higher potential side effects and can be expensive.
For your health,
Terry Rimmer, MD
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