Allergies are the 6th leading cause of chronic
illness in the United States. With spring arriving,
it is important to recognize seasonal allergy
symptoms, non-prescription treatment options,
and when to think about prescription alternatives.

Seasonal allergies symptoms are typically
intermittent throughout the year and include
runny and/or stuffy nose, watery eyes, itchy
eyes, nose, or throat, and sneezing. Nasal
drainage down the back of the throat may also
lead to a cough and hoarseness. These reactions,
also known as hay fever, are common in the
spring and fall as a result of pollen from trees,
grasses, and weeds in the air.

There are typically three pollen seasons that can
ause trouble for allergy sufferers. Trees pollinate
in the spring, grass pollen is released in the
summer, and finally in the fall weeds can lead to
issues. The best way to prevent symptoms is to
avoid exposure to the allergen. Some ways to
accomplish this include keeping windows closed
and running the air conditioner, showering or
changing clothes after being outside, or avoiding
the outdoors altogether on days when there is
high pollen count. Pollen counts are predicted,
just as a weather forecast and can be easily found
online.

Unfortunately, avoiding exposure is not always
a practical option. This is where medications can
play a role. Antihistamines are most commonly
used as there are many options, and they are
available without a prescription. They block the
release of histamine, which is responsible for the
symptoms commonly associated with allergies.
They are most effective when used one to two
hours prior to exposure of the offending allergen
or can be taken daily during peak symptom
periods. The most common antihistamines
include Claritin® and Allegra® which cause
little to no drowsiness, Zyrtec® which may lead
to slight drowsiness, and Benadryl® which
causes significant drowsiness. It’s important to
note that the “non-drowsy” claim is only
applicable when the medications are taken as
directed. Taking more than the recommended
dose, may increase the risk for sedation.
Everyone can be affected differently, so it is
important to not participate in any activities
requiring alertness after taking a medication for
the first time. A bedtime dose of antihistamine
drugs that cause drowsiness may actually be of
benefit in those individuals who are having
difficulty sleeping due to their symptoms.
However, there is a risk of residual sleepiness
the next day. Antihistamines may also cause
urinary retention, nausea, and heartburn. It is
best to use only one antihistamine at a time, so
it is important to check ingredients in sleep aids
and cold medicines, as many of these may
contain one. Zaditor® is an over the counter
eye drop that can alleviate itchy, red eyes when
oral options aren’t enough. All over the counter
antihistamines are available in generic
alternatives that are just as effective and typically
much lower in price.

Decongestants, both oral and intranasal, are a
short term option if an antihistamine doesn’t cut
it. These medications can improve air flow by
bringing down swelling in the nasal mucosa.
Nasal sprays, such as Afrin®, can be very
effective if used for a few days. However, if
used longer than 3-5 days, they can actually
make congestion worse. The oral decongestants,
such as Sudafed®, do not cause this “rebound
congestion,” but take longer to start working
and may cause sleeplessness and an increase in
blood pressure.

Several prescription options are an alternative or
can be used in addition to over the counter
products. Steroid nasal sprays are among the
most common. Again, these are most effective if
begun before experiencing symptoms and peak
response may not be seen for a couple of weeks.
They have limited side effects including stinging
sensation and headache. Prescription
antihistamines are also available in nasal sprays
and eye drops. Lastly, your physician could refer
you to an allergist for immunotherapy. This may
involve receiving several tiny injections to
determine what particular antigen an individual
is allergic to. Then, the patient receives injections
of increasing dosing of that particular antigen
over a period of time, typically several years.
The hope is that the body will gradually learn to
tolerate the allergen.

Spring should be an enjoyable time to get
outdoors and enjoy the nice weather. With
proper management of symptoms, allergy
suffers should not be forced to stay inside. It is
important to inform your primary care physician
of any medication you begin taking on a regular
basis, especially if you have any chronic health
conditions. For more information regarding
allergy symptoms and their treatment go to the
National Institutes of Health website
www.nih.gov and search “allergy”.

AuBurn Pharmacy Intern
Danielle Mattox
University of Kansas School of Pharmacy
Pharm D Candidate 2013