Allergic Rhinitis

Nov 23, 2017

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

"I lost Dad yesterday. Now everyone gets a tracking app on their phone." My children are more than a little annoyed that they are now being tracked. Doris told them she is turning on the tracking capabilities on their phones. She will now know where they are at all times. And the children know who to blame. They blame someone who didn't check in when he was supposed to.

When you have a runny nose and watery eyes, we often blame allergic rhinitis. What is allergic rhinitis? Most people would probably just call them allergies. When a person with allergic rhinitis breathes in an allergen such as pollen, mold, animal dander, or dust the body overreacts as if these benign substances were attacking the body. The body releases chemicals like histamine that cause inflammation and allergy symptoms. Symptoms may include: itchy, watery eyes, stuffy nose, cough, sore throat, and fatigue.

What can you do about allergic rhinitis? Well, if you've never had any of these symptoms before, get assessed by your doctor. They will want to rule out other illnesses, and possibly have you sent to a specialist to find out exactly what substances are your triggers. If you and your doctor are sure your problems are just allergies and the symptoms aren't too severe, you can start with trigger avoidance.

To avoid your allergy triggers, you have to know what they are. Allergy testing can determine your triggers, and you can help yourself by keeping an allergy diary. In an allergy diary you list what you did and what you were exposed to and how your symptoms were in a given day. If it turns out you are allergic to pollen or outdoor molds try to remain inside during pollen season. Watch the pollen counts on the Weather Station and avoid outdoor activities on high pollen count days. Shower or bathe after outdoor activity to remove pollen from hair and skin and to prevent contamination of bedding. If you have indoor allergies like dust mites, then try to avoid carpeting. The less carpeting in the house, the better, especially the bedroom. A central vacuum system that exhausts outside is best, and the allergic person shouldn't even be in the home when the vacuuming is done, if possible. Encase all mattresses, box springs and pillows in zippered, allergen-proof casings. Keep indoor humidity under 50%.

Allergen avoidance isn't always possible or sometimes even desirable. While getting people to not smoke in the house is probably attainable, getting rid of the family cat is probably not. If the person's symptoms are not too severe, over the counter antihistamines can be effective. Oral antihistamines work best if they are taken before exposure to the allergy trigger and taken consistently. So, if you suffer from "spring fever" due to pollens, you would start taking the antihistamine before the snow finished melting and take them daily for the first month or two of spring until the pollen count drops.

Antihistamines are divided into two major classes: the first and second generation. All are equally effective. The major differences between them are the side effects. First generation antihistamines like chlorpheniramine (Chlor-Tripilon), and diphenhydramine (Benadryl) can cause dry mouth, trouble passing urine, and drowsiness. They should be avoided in narrow-angle glaucoma, urinary problems, thyroid and heart problems. Second generation antihistamines like loratadine (Claritin), fexofenadine (Allegra), and cetirizine (Reactine) generally don't cause those side effects, especially not the drowsiness.

In the last few years, we've gotten another option for allergic rhinitis without a prescription. Some nasal steroid sprays like fluticasone are available without seeing your doctor. This is great news because nasal steroid sprays are much more effective at allergic rhinitis symptoms than antihistamines. Nasal steroid sprays are very good, but they aren't Dristan. They don't work quickly. It may take 2-4 weeks for them to be fully effective and they are designed to be used everyday during allergy season. If you find you need your over-the-counter nasal steroid for more than 2-3 months, it is time to talk to your doctor to see if a prescription might be a good idea. Side effects are usually mild and may include sore nose, nose bleeds or sneezing.

The children blame me for their maternal electronic tracking. I was at an evening event. I put my phone on mute so it wouldn't annoy the other attendees. There were alcoholic beverages served, so I chose to walk home. So far so good, right? Here was my fatal flaw. I didn't check in. The event went later than I thought, and I didn't tell Doris. She tried to call and text me, but I didn't respond, because my phone was on mute. Emily reported Doris getting angry enough for some smoke to come out of her ears. I unwittingly walked in the front door to very angry glares and a few angry words. So now I will be tracked via my phone and so will the kids. Sorry kids. If I'd only called home and told Doris.....

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

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