Allergic Rhinitis (Hay Fever) affects about 30 million people in America and has increased in prevalence over the last 25 years. Allergy medications have dominated the shelves in many pharmacies as a result of the increasing brands of antihistamines, nasal sprays and decongestants. Despite the plethora of remedies, both over the counter (OTC) and by prescription, many people continue to suffer from chronic nasal congestion and post-nasal drainage.
Twenty five years ago intranasal steroids (INS) were ushered into the market as a novel approach to treating allergic rhinitis. Nasalid (flunisolide) led the way. Vancenase (Beclomethasone) and Nasacort (Triamcinolone) nasal sprays soon followed. These sprays offered a class of topically active steroids that, unlike previous nasal steroid sprays, had minimal systemic impact. This means the majority of the spray worked on the inner surface of the nose with very little absorption into blood vessels (reducing...
Millions of Americans in pursuit of a remedy for stuffy nose and sinus pressure turn to over the counter (OTC) nasal sprays because of their quick action, availability and presumed safety. But did you know prolonged use of topical nasal decongestants (TNDs) often leads to addiction? Case in Point: A 32-year-old male was referred to me because of complaints of chronic nasal blockage. The patient suspected his problem was hay fever (allergic rhinitis). During the interview, he revealed that a year ago he began to have trouble sleeping because of a stuffy nose. He felt considerably better after using a TND before going to bed. Within 2 weeks he began to awaken in the middle of the night requiring another dose of his nasal spray for relief. One month later he required doses 4 times daily in order to avoid severe nasal congestion. By the time I saw him, he was going through almost a bottle of nasal spray daily. His diagnosis was Rhinitis Medicamentosa (RM) which means nasal inflammation (rhi...
We are almost through ragweed season but some of my patients are wondering what made this year's season so bad. Actually, a certain number of allergy sufferers experience a peak in their nasal symptoms every spring and/or fall season which may be worse than previous years. But the most common mid-season question I encounter is: "Why have my medicines stopped working?"
Research on allergy and asthma patients has yielded some interesting information on the use of prescribed allergy medications and "control" of these disorders. [i] A major factor in the successful management of allergic airway problems is "adherence".
Adherence is a term that expresses the degree to which a patient consistently follows an agreed upon treatment plan under the doctor's supervision.
How often do you forget to take your medication?
Have you recently had to miss or reschedule your follow-up allergy appointment?
Recent allergy research questionnaires and surveys highlig...
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