Antihistamines
If you have allergies, your physician may prescribe antihistamines to relieve or prevent the symptoms of allergic rhinitis (hay fever) and other allergies. Antihistamines prevent the effects of histamine - a chemical substance released by the body during an allergic reaction. By preventing the action of histamine the symptoms of the allergy will be reduced.

Antihistamines are divided into:

• Sedating: these are known to cause drowsiness in some people
• Non-sedating: these do not cause drowsiness more than a placebo

Possible Antihistamine Side Effects:

• Dry mouth
• Difficulty in urination
• Constipation
• Drowsiness

Discuss with your doctor the probable benefit of using an antihistamine versus the possible side effects.

Decongestants
Decongestants are used to reduce the nasal congestion and other symptoms associated with colds and allergies. They work by shrinking blood vessels, thereby decreasing the amount of fluid that leaks out into the mucus. The person taking the decongestant would be less congested and drier in the mucous membranes.

Decongestants

• Come in liquid form, nasal spray and tablets
• Most of these are available over-the-counter as well as by prescription
• Very often antihistamines and decongestants are combined so that their effect is stronger

Side effects of decongestants:

• Nervousness
• Sleeplessness
• Raise blood pressure

Anti-inflammatory agents
People with allergies and asthma develop inflammation. This inflammation can affect the skin as in eczema; the nose as in allergic rhinitis; the conjunctiva of the eyes or the bronchial tubes as in asthma. There are three classes of medications that are used as anti-inflammatory agents to treat allergies and asthma:

Mast Cell Stabilizers

• Non-steroidal medications that reduce inflammation by preventing the release of inflammatory chemicals
• Available in eye drops, as an inhalation, a nose spray, an eye drop and in an oral form

Corticosteroids (also known as “steroids”)

• Used to reduce the swelling and mucus as well as the reactivity or “twitchiness” of allergic airways
• Corticosteroids are available in topical creams or ointments, aerosols, pills and by injection
• Corticosteroid use needs to be supervised by a physician
• Minor side effects from using corticosteroid inhalers can include hoarseness and thrush (a fungal infection of the mouth and throat)
• Oral corticosteroids generally have more side effects than inhaled or topical agents
• Short-term use of oral corticosteroids is usually not a problem for an otherwise healthy person
• Side effects of short-term use include slight weight gain, increased appetite, menstrual irregularities, cramps, heartburn or indigestion. These side effects will go away shortly after stopping the corticosteroids
• Long-term use of oral corticosteroids is associated with ulcers, weight gain, cataracts, weakened bones and thinner skin, high blood pressure, elevated blood sugar, easy bruising and decreased growth in children
• Corticosteroids, when taken properly, are a very effective method of treatment for asthma and allergies
• Oral corticosteroids are usually considered as quick-relief medications for asthma flare-ups

Anti-leukotrienes
Many of the cells involved in causing airway inflammation are known to produce potent chemicals within the body called leukotrienes, which are responsible for causing the contraction of the airway muscle, increasing leakage of fluid from blood vessels in the lung, and further promoting inflammation by attracting other inflammatory cells into the airways.

• Several oral anti-leukotriene medications are available to help fight allergic inflammation
• Primarily used to help gain control over persistent asthma
• Available only in tablet form which for some people is a preferable way to take medication

Beta-agonist bronchodilators

• Used to relax the muscle of the bronchial tubes
• Short-acting beta-agonist bronchodilators for quick-relief medications Available as inhalations, liquids, injectables and pills
• Long-acting beta-agonists bronchodilators for long-term control of asthma
• Side effects of this class include nervousness, restlessness, insomnia and, rarely, headaches

Theophylline

• Type of bronchodilator that has been used for over 30 years to treat asthma
• Available as tablets or capsules
• Blood levels need to be monitored
• Side effects can include headaches and stomach upset

Anticholinergics

• Another class of bronchodilator available as an inhaler
• Can be used alone or combined with the beta-agonist bronchodilators
• Ipratropium is used for asthma treatment as a quick-relief medication
• Side effects include cough and headache

Be sure to let your allergist know that you understand exactly how and when to take your prescription allergy medications. Remember, the key to successful allergy management is a combination of proper medications and proper management of your allergy symptoms. To locate an allergist in your area, visit the Academy’s Physician Referral Directory.