Hay fever medical therapy

Revision as of 17:55, 28 August 2012 by Vishnu Vardhan Serla (talk | contribs) (Created page with "__NOTOC__ {{Hay fever}} {{CMG}} == Overview == == Treatment == The goal of treatment is to reduce allergy symptoms caused by the inflammation of affected tissues. The bes...")
(diff) ← Older revision | Latest revision (diff) | Newer revision → (diff)
Jump to navigation Jump to search


Hay fever Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hay fever from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Alternative Therapy

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hay fever medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Hay fever medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hay fever medical therapy

CDC on Hay fever medical therapy

Hay fever medical therapy in the news

Blogs on Hay fever medical therapy

Directions to Hospitals Treating Hay fever

Risk calculators and risk factors for Hay fever medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Treatment

The goal of treatment is to reduce allergy symptoms caused by the inflammation of affected tissues. The best "treatment" is to avoid what causes your allergic symptoms in the first place.

Medical Therapy

The most appropriate medication depends on the type and severity of symptoms. Specific illnesses that are caused by allergies (such as asthma and eczema) may require other treatments.

Options include the following:

Systemic therapy

Therapies that have an overall effect on a person's body and therefore thay may help for all of the symptoms include:

Antihistamines
these are taken by mouth and may relieve mild to moderate symptoms. The first-generation (non-selective or classical) antihistamines such as chlorphenamine and promethazine are perhaps the most effective, but their sedative side effects limits their usefulness compared to the newer second-generation and third-generation (selective, non-sedating) antihistamines such as loratadine and cetirizine. Most of these antihistamines are available as over-the-counter drugs.
Glucocorticoids
Corticosteroids administered to the whole body, such as Triamcinolone (Kenalog) by intramuscular injection, are also effective, but their use is limited by their short duration of effect, lasting a few weeks, and the side effects of prolonged steroid therapy.
Leukotriene receptor antagonists
these newer products, such as montelukast (Singulair) and zafirlukast (Accolate), have proven very effective in dealing with allergic rhinitis, without the common side-effects of the first-generation antihistamines, such as drowsiness. These medicines are also long-acting and are taken once-daily.

Topical therapy

Localised treatments may give more effective relief of eye or nasal symptoms.

Nasal treatments

Steroid nasal sprays
are effective and safe, and may be effective without oral antihistamines. These medications include, in order of potency: beclomethasone (Beconase), budesonide (Rhinocort), flunisolide (Syntaris),mometasone (Nasonex), fluticasone (Flonase, Flixonase), triamcinolone (Nasacort AQ). They take several days to act and so need be taken continually for several weeks as their therapeutic effect builds up with time.
Cromoglicate
is a drug that stabilizes mast cells to prevent their degranulation and subsequent release of histamine. It is available as a nasal spray (Nasalcrom) for treating hay fever, although it is generally less effective than nasal steroid sprays.
Antihistamine
Azelastine (Astelin) is the only antihistamine available as a nasal spray.
Topical decongestants
may also be helpful in reducing symptoms such as nasal congestion, but should not be used for long periods as stopping them after protracted use can lead to a rebound nasal congestion (Rhinitis medicamentosa).
Saltwater sprays, rinses or steam
this removes dust, secretions and allergenic molecules from the mucosa, as they are all instant water soluble. A suitable solution is 2-3 spoonful of salt dissolved in one litre of lukewarm water.[1]

Eye treatments

Cromoglicate
is also used as eye drops (Crolom in US and Opticrom in UK being best known brands). Nedocromil is a newer variant of cromoglycate and has essentially the same activity.

Allergy immunotherapy

Allergy immunotherapy is commonly used in patients suffering from allergic rhinitis, allergic asthma, or life threatening stinging insect allergy. This type of therapy has been found to potentially alter the course of all three of the above disorders. Allergen immunotherapy provides long-term relief of the symptoms associated with rhinitis and asthma.

"Allergy shots" (Hyposensibilization, immunotherapy) are occasionally recommended if the allergen cannot be avoided and if symptoms are hard to control. This includes regular injections of the allergen, given in increasing doses, which may help the body adjust to the antigen. These tend to be offered as a last resort as the therapy is more expensive at first, although patients may save money on medications and doctor visits in the long run. They may also increase the risk of triggering a secondary allergic reaction such as an asthma attack.

Allergy shot treatment is the closest thing to a ‘cure’ for allergic symptoms. This therapy requires a long-term commitment.

Over-the-counter treatments

A large number of over-the-counter treatments are sold without FDA approval but are known for their positive effects, including herbs like eyebright (Euphrasia officinalis), nettle (Urtica dioica), and bayberry (Myrica cerifera), which have not been shown to reduce the symptoms of nasal-pharynx congestion. In addition, feverfew (Tanacetum parthenium) and turmeric (Curcuma longa) has been shown to inhibit phospholipase A2, the enzyme which releases the inflammatory precursor arachidonic acid from the bi-layer membrane of mast cells (the main cells which respond to respiratory allergens and lead to inflammation) but this is only in test tubes and it is not established as antiinflammatory in humans.

References

  1. {{url = http://www.allergy.org.au/aer/infobulletins/hayfever_treatment.htm | Australian Society of Clinical Immunology and Allergy

Template:WH

Template:WS