Feb 5, 2010

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

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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.

Na Na-Na Na Na. Thunder. Na Na-Na Na Na. Thunder. The opening bars of AC/DCs Thunder Struck played over the speakers as the Parkland Source for Sports Thunder whizzed around the Ste Rose arena warming up. Okay whizzed around might be a little strong. Rode their sticks like ponies, ambled aimlessly, and made the occasional snow angel on the ice is more accurate, but the Source For Sports Thunder Novice team eventually got started on their warm up drills. The seven and eight year old mostly boys and a couple of girls like my daughter on the Thunder were psyching up to play the mighty McCreary Mustangs. I was lost in thought about how cool it would have been if my seven year old friends and I had a theme song playing over the speakers when we played hockey way back when. Anthony Wiens was remarking how cold it was in the Ste. Rose rink eventhough it was up to -3 C outside. Then he noted that not all music was created equal. He said it was funny how the older rock songs just seemed to suit hockey games better than newer music. And as I listened to the songs during the breaks in play, I began to think he was right. Different pop music has different uses.

If you get an allergic reaction, one of the types of medication we reach for are antihistamines. Not all medications that block histamine are created equal either. Histamine blockers that block the H2 histamine receptor dont even treat allergies. They have names like ranitidine and actually are used to reduce stomach acid and treat heart burn and ulcers. For our purposes, H2 blockers are like classical music, interesting but irrelevant for a discussion of pop music. For allergies, we want H1 receptor blockers which are usually just called antihistamines.

Allergic reactions start more or less the same way. When your body comes in contact with what you are allergic to (the allergen), certain cells in your immune system release a chemical messenger called histamine. The histamine connects with the H1 histamine receptor and tells your body to start the allergy symptoms, like the runny nose, or the itchy rash. So the easiest and best way to avoid an allergic reaction is to identify and avoid the allergen. If you are allergic to the cat at your mother-in-laws house, avoid your mother-in-law. If that horrible cologne your wife bought gives you an itchy rash, dont use it. Simple, right? Well, even if we can identify the allergen, sometimes they are hard to avoid. If you are allergic to pollens that are common in Manitoba, you will probably get a stuffy nose in the fall no matter what you do. So if we cant identify and avoid the allergen, we may need to block the H1 histamine receptor with a medication.

There are two basic types of antihistamines. The first generation antihistamines are have names like chlortripolon (chlorpheniramine), and benadryl (diphenhydramine). They are inexpensive, work quite well, but they also often cause drowsiness, and some other side effects like urinary retention, and worsening glaucoma. They work fast, which is great if you have an itchy rash, but they dont last that long and you may have to take several pills a day. So they are cheap and fast, but have no staying power and might bore you to sleep. So, lets call first generation antihistamines dance music.

Second generation antihistamines cause much less sedation, have far fewer side effects, but they are more expensive. These are agents like reactine (cetirizine), and claritin (loratadine). A nice benefit is one pill often lasts all day. Reactine is good for both runny noses and itchy rashes, but I have seen it make some people sleepy. Claritin only works well on runny noses, but it is much less likely to make someone sleepy. So they are more expensive, but have fewer side effects and more staying power. So, lets call second generation antihistamines classic rock.

So, different antihistamines have different uses. Classic rock is what should be played during breaks at hockey games. Any beware the Source For Sports Thunder. Or youll be Thunder Struck!

As always if you have any questions or concerns about these or other products, ask your pharmacist.


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