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February 8, 2012

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).



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Suggested Reading on Nasal Allergy Medications by Our Doctors

  • Related Diseases & Conditions

    • Chronic Rhinitis and Post-Nasal Drip
      • Allergic rhinitis symptoms include an itchy, runny nose, sneezing, itchy ears, eyes, and throat. Seasonal allergic rhinitis (also called hay fever) is usually caused by pollen in the air. Perennial allergic rhinitis is a type of chronic rhinitis and is a year–round problem, often caused by indoor allergens, such as dust, animal dander, and pollens that may exist at the time. Treatment of chronic rhinitis and post nasal drip are dependant upon the type of rhinitis condition.
    • Allergy
      • An allergy refers to a misguided reaction by our immune system in response to bodily contact with certain foreign substances. When these allergens come in contact with the body, it causes the immune system to develop an allergic reaction in people who are allergic to it. It is estimated that 50 million North Americans are affected by allergic conditions. The parts of the body that are prone to react to allergies include the eyes, nose, lungs, skin, and stomach. Common allergic disorders include hay fever, asthma, allergic eyes, allergic eczema, hives, and allergic shock.
    • Hay Fever
      • Hay fever (allergic rhinitis) is an irritation of the nose caused by pollen and is associated with the following allergic symptoms: nasal congestion, runny nose, sneezing, eye and nose itching, and tearing eyes. Avoidance of known allergens is the recommended treatment, but if this is not possible, antihistamines, decongestants, and nasal sprays may help alleviate symptoms.
    • Allergy Treatment Begins At Home
    • Indoor Allergens
      • Common sources of indoor allergens include dust mites, cockroaches, molds, pets, and plants. Managing allergies caused by indoor allergens means reducing your exposure to them.
    • Allergic Cascade
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Nasal Allergy Medications

What is the purpose of the nose?

The purpose of the nose is to warm, clean, and humidify the air you breathe as well as help you to smell and taste. A normal person will produce about two quarts of fluid each day (mucus), which aids in keeping the respiratory tract clean and moist. Tiny microscopic hairs (cilia) line the surfaces of the nasal cavity, helping to brush away particles. Eventually the mucus blanket is moved to the back of the throat where it is unconsciously swallowed. This entire process is closely regulated by several body systems.

Structurally, the nose is separated into two passageways (left and right nostrils) by a structure called the septum. Protruding into each breathing passage are bony projections, called turbinates, which help to increase the surface area of the inside of the nose. There are three turbinates on each side of the nose (inferior or lower turbinates, middle turbinates, superior or upper turbinates). The sin...

Read the Chronic Rhinitis and Post-Nasal Drip article »







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