Allergies Health Article

Bronchodilators or metered-dose inhalers (MDI)

Because allergic reactions involving the lungs cause the airways or bronchial tubes to narrow, as in asthma, bronchodilators, which cause the smooth muscle lining the airways to open or dilate, can be very effective. When inahlers are used, it is important that the patient be educated in the proper use of these medications. The inhaler should be shaken, and the patient should breathe out to expel air from the lungs. The inhaler should be place at least two fingerbreadths in front of the mouth. The medication should be aimed at the back of the throat, and the inhaler activated while breathing in quite slowly 3-4 seconds. The breath should be held for at least ten seconds, and then expelled. At least thirty to sixty seconds should pass before the inhaler is used again. Care should be taken to properly wash out the mouth and brush the teeth following use, as residual medication remains in this area with only a small amount actually reaching the lungs. Some bronchodilators used to treat acute asthma attacks include adrenaline, albuterol, or other "adrenoceptor stimulants, " most often administered as aerosols. Futicasone (Flovent) is another commonly prescribed inhaler. Some bronchodilators used to treat acute asthma attacks include adrenaline, albuterol, Maxair, Proventil, or other "adrenoceptor stimulants, " most often administered as aerosols. Another group of medications, the long-acting beta agonists, are proving useful to reduce the use of inhalers. and include salmeterol xinafoate (Serevent). Theophylline, naturally present in coffee and tea, is another drug that produces brochodilation. It is usually taken orally, but in a severe asthma attack is may be given intravenously. Side effects include gastrointestinal disturbances, insomnia, headaches, and seizures.

Anticholinergics

Ipratropium bromide (atrovent) and atropine sulfate are achticholinergic drugs used for the treatment of asthma. Ipratropium is used for treating asthmatics in emergency situations with a nebulizer.

Nonsteroidal drugs

MAST CELL STABILIZERS. Cromolyn sodium prevents the release of mast cell granules, thereby preventing the release of histamine and other chemicals contained in them. It acts as a preventive treatment if it is begun several weeks before the onset of the allergy season. It can also be used for year round allergy prevention. Cromolyn sodium is available as a nasal spray for allergic rhinitis and in aerosol (a suspension of particles in gas) form for asthma.

LEUKOTRIENE MODIFIERS. These medications are useful for individuals with aspirin sensitivity, sinusitis, polposis, urticaria. Examples include zafirlukast (Accolate), montelukast (Singulair), and zileuton (Zyflo). When zileuton is used, care must be taken to measure liver enzymes.

Immunotherapy

In this form of therapy, allergen is injected into the skin in increasing doses over a specific period of time. This may be helpful for patients who do not respond to medications or avoidance of allergens in the environment. This type of therapy may reduce the need for medications.

Treatment of contact dermatitis

A variety of herbal remedies, either applied topically or taken internally, may possibly assist in the treatment of contact dermatitis. A poultice (crushed herbs applied directly to the affected area) made of jewelweed (Impatiens spp.) or chickweed (Stellaria media) may soothe the skin. A cream or wash containing calendula (Calendula officinalis), a natural antiseptic and anti-inflammatory agent, may help heal the rash when applied topically. Homeopathic treatment may include such remedies as Rhus toxicodendron, Apis mellifica, or Anacardium taken internally. A qualified homeopathic practitioner should be consulted to match the symptoms with the correct remedy. Care should be taken with any agent taken internally.

Treatment of anaphylaxis

The emergency condition of anaphylaxis is treated with injection of adrenaline, also known as epinephrine. People who are prone to anaphylaxis because of food or insect allergies often carry an "Epi-pen" containing adrenaline in a hypodermic needle. Other medications may be given to aid the action of the epi-pen. Prompt injection can prevent a more serious reaction from developing. Paticular care should be taken to assess the affected individual's airway status, and he or she should be placed in a recumbent pose and vital signs determined. If a reaction resulted from insect sting or an injection, a tourniquet may need to be placed proximal to the area where the agent penetrated the skin. This should then be released at intervals of ten minutes at a time, for one to two minutes duration. If the individual does not respond to such interventions, then emergency treatment is appropriate.