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Allergy & Asthma Advocate: Spring 2003
Therapies for allergic
rhinitis
By Brian A. Smart, MD, FAAAAI
You don’t have to suffer
through spring allergy season this year. Take control and find relief by
seeing an allergist, who can recommend a variety of medication options.
The advantages and disadvantages of common allergic rhinitis medications
are described below to help you understand the many treatments that are
available.
What is Allergic
Rhinitis?
Allergic rhinitis causes the familiar symptoms of nasal congestion,
sneezing, runny nose, itchy nose, and itchy, watery eyes. These symptoms
occur because of inflammation within the nose in response to allergy
triggers, such as pet dander and pollens. The effective management of
allergic rhinitis involves the appropriate use of three categories of
treatment. These categories are:
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environmental control;
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medications; and
-
if needed, allergen
immunotherapy (allergy shots).
Available Medication
Options
Medications for allergic rhinitis, in general, reduce an allergy
sufferer’s sensitivity to allergy triggers. Medication options include
oral and nasal antihistamines, nasal inhaled corticosteroids,
decongestants and leukotriene modifiers. It is important to understand
how the different medications work and their strengths and weaknesses.
Allergic rhinitis affects
nearly 36 million Americans and causes a great deal of misery.
Fortunately, there are effective treatments available. By carefully and
thoughtfully using available treatments for allergic rhinitis, including
antihistamines, nasal corticosteroids, decongestants, and leukotriene
modifiers, most people can achieve excellent control of their symptoms.
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Oral and Nasal Antihistamines
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Description
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Blocks
histamine, one of the most important mediators of the allergic
response, and its release leads to many allergy symptoms, including
itching of the eyes and nose, runny nose, and sneezing.
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Advantage
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Blocks
what histamine does in the nose and eyes of allergy sufferers.
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Disadvantage
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They
are not very helpful for congestion. |
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Nasal inhaled
corticosteroids |
Description
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Reduces and controls the impact of all or most of the mediators that
can cause inflammation in the nose.
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Advantage |
It
improves all of the nasal symptoms of allergic rhinitis, including
itching, runny nose, and congestion.
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Disadvantage |
Lack
of effectiveness for eye symptoms and the potential for nasal
irritation |
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Decongestants
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Description
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These
medications are important in the care of allergic rhinitis because
congestion is, for the majority of patients with allergic rhinitis,
the most troublesome symptom.
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Advantage |
May
lead to vasoconstriction (narrowing of the blood vessels) in the
nose, which directly reduces mucus volume. |
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Disadvantage |
May
lead to difficulty sleeping, anxiety, and increased heart rate. |
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Leukotriene modifiers
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Description |
Blocks
the action of leukotrienes, a mediator of allergy symptoms and of
inflammation. |
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Advantage |
Ability to block both the early response to allergic triggers
(itching and sneezing) as well as the delayed response to allergic
triggers (congestion).
Medication is mild and has few side effects.
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Disadvantage
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Drug
class does not have much of a track record in the treatment of
allergic rhinitis; more clinical research needs to be published
about the use of this medication for this condition. |
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