Seasonal Allergies: A Gift of Spring

May 5, 2014, Elizabeth “Liz” Buxton, BS, MS, PharmD, Pharmacy Manager (Wellington)
Elizabeth “Liz” Buxton, BS, MS, PharmD, Pharmacy Manager (Wellington)

You can feel it coming-the stuffy yet drippy nose, the itchy and watery eyes, sore throat, and skin irritation.  Every year, the landscape starts turning green, and you and your family start to suffer.

This year can be different, however!  With a little bit of thought and planning, you can reduce the Spring keep your kleenex handy days to a minimum.

Here are a few strategies to consider:

Know your triggers:  Are you most miserable when the Cottonwood fluff flies?  Or is it when the grasses bloom?  Knowing what pollens, danders, spores, and mites activate your body’s defenses helps you plan ahead for the next steps:  Reduce, Avoid, Treat, and Desensitize.  A trip to your doctor or allergist can help you figure out the allergens to which you’re most sensitive.

Reduce:  Spring cleaning is not just a tradition!  And, it’s not just for Spring.  Going through your house frequently with dust elimination in mind can help reduce allergens that have found their way in.  Make sure your screens are in good repair as we enter the windows wide open season.  Wiping animals down weekly with a cloth dampened with distilled water can knock down their dander burden, reducing their effects on you, without the fun and excitement of a bath or the expense of a trip to the groomer.  Replace your furnace filters every 3 months; investing in the allergen-removing filters can help prevent recirculation of irritants by your heating and cooling system, but the better they are at removing allergens, the more frequently they need to be changed to prevent clogging.  The same goes for your vacuum cleaner filter- clean or replace your filters per the manufacturers’ instructions to maximize allergen removal and prevent irritants and dust from being kicked back up as you vacuum.  Dust mite-proof covers for your pillows and mattresses can help reduce reactions to these invisible but potent allergens.  Sprays are also available to kill these tiny mites; their presence can cause chronic cold symptoms or asthma exacerbations.

Avoid:  If you know that corn pollen triggers your allergies or asthma, avoid a situation where you’ll be exposed to it.  Keep your windows closed during the pollination period and during harvesting, for example.  If you receive a bouquet of flowers that are a particular sneeze-producing hazard of yours, re-home them to a school, nursing home, or other organization where they can be enjoyed.  If avoidance isn’t possible—Pre-Treat!  Baseball games at the neighborhood park are much more enjoyable when your eyes aren’t swelled shut from the alfalfa field upwind.

(Pre-) Treatment:  We have a variety of medication options to help with your seasonal allergies.  Some are over-the-counter (OTC) and some by prescription only.  Typically, the majority of people can get at least some relief from their allergies with OTC remedies, but your pharmacist or doctor can help you decide which options are the best for you.  These include:

1.      Antihistamines – These medications work by blocking where the histamine molecules, triggered by an irritant, provoke the itchy, sneezy, watering eyes responses that are part of the body’s defenses.  These responses were developed to help remove irritants from the body, trying to keep you safe when your environment might not be.  Unfortunately, they form the base of seasonal allergies when a too-vigorous response makes you miserable.  Blocking the majority of the over-the-top part of the reaction keeps you comfortable.  First-generation antihistamines (Benadryl, Chlortrimeton, etc.) work quickly, but carry sedation as a side-effect.  Second-generation antihistamines (Claritin, Zyrtec, and Allegra) work without as much (or any) sleepiness, although some patients are more vulnerable to this side-effect than others.  Antihistamine eye drops like Zaditor work in the same fashion, but are local-only and may be a good option for those sensitive to oral medications like Zyrtec.

2.      Steroids – Nasal steroids have long been a mainstay of prescription nasal allergy treatments.  Nasacort has recently been approved for OTC use.  They all reduce inflammation of the nasal passages, while blocking several other of the pathways by which allergic reactions are triggered.  They can be good for both treating allergies on their own, or in combination with other medications, but they do not work as quickly as antihistamines and must be used daily for up to several weeks to provide good effect.  Some patients can experience an increase in nosebleeds or throat infections, due to the way the medications work, but they are typically well-tolerated without large systemic effects.

3.      Mast cell stabilizers – NasalCrom prevents the release of histamines, the trigger for an allergic reaction, from being released when the body senses an irritant in the nose.  This is a highly effective medication available OTC, but it must be used multiple times a day during your vulnerable period to work.  There are eye drops and inhalers available as well, by prescription.  Side effects are very minimal with its use.

Desensitize:  Allergy “shots” or drops under the tongue work to decrease the body’s over-enthusiastic response to allergens.  They can take months or years to be effective, and are available at a provider’s office only.  The program starts with testing to identify which allergens are the most problematic and exposing the body to very low doses of those substances.  As the body’s response to the low doses decreases, the dose increases, until the body no longer “sees” those irritants as needing a reaction.  Then, no more allergies!

These strategies and treatment options will hopefully help you navigate the allergy season with clear eyes and no sniffles, but don’t hesitate to ask your Good Day Pharmacist or health care provider for more specific information!

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