Nasal Allergy Medications
Introduction
Although they are the cornerstone of allergy treatment,
avoidance measures are not always enough to manage all of
the symptoms. When the symptoms of nasal allergies are
mild or intermittent, antihistamines with or without
decongestants can help. Very often, some relief can be
found in taking over-the-counter (OTC) drugs and this is
usually the first step an allergy sufferer will take.
Self-medication, though, is frequently inadequate since OTC
drugs cannot adequately treat the inflammation that
develops in the nose. At this stage, anti-inflammatory
medications are required, usually in the form of intra-
nasal steroid sprays (sprayed into the nose).
The combination of an antihistamine (with or without a
decongestant) and a topical nasal steroid spray will
usually afford good relief with minimal side effects. The
addition of ipratropium bromide nasal spray (Atrovent - an
anticholinergic medication) is also very effective for a
runny nose that has been unresponsive to prior treatments.
Let's look at these medications in more detail to
understand their role in the treatment of nasal allergy.
What's the difference between a controller and a reliever?
Throughout this section on allergy management, we will
be referring to the various treatments as "controllers"
or "relievers" of symptoms. Controllers are used to
prevent symptoms by interfering with the underlying causes
of the inflammatory response or the actions of chemical
mediators. Examples of controllers include:
- Drugs that block the attachment of histamine to special
receptors on cells (e.g.,
antihistamines);
- Drugs that prevent mast cells from releasing chemicals
(e.g., Cromolyn); and,
- Drugs that prevent or reduce inflammation that arises
from an allergic reaction (e.g., steroids).
Other medications, called relievers, are used to
alleviate symptoms without affecting the inflammation.
They are also called "rescue" medications and in general
provide only temporary relief. Relievers should only be
used alone for mild or intermittent symptoms. Examples
include:
- Drugs that narrow (constrict) the blood vessels in the
nasal membranes, thereby helping "shrink" swollen tissues
and relieve congestion (e.g., decongestants); and
- Drugs that reduce mucous production by blocking the
nerve supply to the mucous glands (e.g.,
anticholinergics).
Next: What are antihistamines? »
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