HAY FEVER

Hay fever is also called Allergic Rhinitis. The symptoms occur after an inflammatory response caused by a person coming into contact with an allergen, which the body recognises as foreign. Hay fever is usually seasonal and is aggravated by some pollens, grass seeds and fungal mould spores. Certain allergies may be present all year round and these allergies are generally caused by the house dust mite, animal dander and feathers. Hay fever can start at any age although it is most common in young children and young adults. Pollen that is released into the air tends to be at its highest in the morning and evening. The pollen is breathed in and lands on the skin and eyes. The body recognises the pollen as foreign and releases a chemical called Histamine which causes irritation and inflammation and leads to the Hay fever symptoms. Symptoms are similar to a cold and anyone with a summer cold of several weeks duration may in fact have hay fever. Symptoms include sneezing, runny nose, nasal congestion, an itchy nose, itchy and watery eyes and an itchy palate (roof of the mouth).

TREATMENT

Oral antihistamines

Antihistamines stop the action of Histamine, therefore easing the irritation and inflammation that cause the hay fever symptoms. There are two types of antihistamines:

1. Non-Sedating
These are particularly effective for sneezing and runny noses. They have a long duration of action and so only need to be taken once a day. Although classed as "non-sedating", drowsiness can still occur in some people. It is a good idea to take the first dose at night time so you can see how it affects you.

2. Sedating
Sedating antihistamines have a short duration of action and need to be taken several times a day. Drowsiness is very likely and so it poses a risk for anyone driving or operating machinery. Other side effects of these also include dry mouth and blurred vision in some people. Alcohol should be avoided as it can increase the sedative effects of antihistamines.

Topical antihistamines

Topical antihistamines are contained in eye drops to help symptoms of runny or itchy eyes e.g. antazoline. Contact lenses may need to be removed before applying eye drops so take care to check the instructions. Patients using other eye drops need to speak to their pharmacist. Eye drops usually go out of date 4 weeks after opening.

Oral decongestants

Many patients with Hay fever can complain of a blocked nose. For this reason it might be necessary to take a decongestant e.g. pseudoephedrine. This can help to dry up a runny nose but may cause restlessness, especially in children due to their stimulant action. They should be avoided in people with high blood pressure, heart problems and diabetes. You should always speak to your pharmacist before combining medication.

Topical (nasal) decongestants

Decongestants are often found in drops and sprays to help relieve a blocked nose in hay fever suffers e.g. oxymetazoline, xylometazoline. Topical decongestants work quickly but have a short effective time span. They must not be used for more than 7 consecutive days as they cause rebound congestion.

Topical (nasal) corticosteroids

Topical corticosteroids are useful for both treatment and prevention. They act by reducing the inflammation, irritation and mucus production in the nose. For prevention they need to be used continuously to maintain symptom control and may take 5-7 days to start working properly, therefore patients may also require a relieving nasal decongestant for the first few days. They should however only be used for short periods of time

Mast cell stabilisers

An example of a mast cell stabiliser is sodium chromoglycate. It is contained in both eye drops and nasal sprays. It prevents hay fever symptoms and can be used throughout the hay fever season. It should be started 2-3 weeks before the hay fever season begins. They need to be used several times a day.

Generally, treatment for hay fever depends on the symptoms that the patient is suffering from. You should visit your pharmacist to find out what the best treatment is for your particular symptoms.
Visit your pharmacist or doctor:
  • If there is shortness of breath, tightness of the chest, cough or wheeze, which could indicate the onset of an asthma attack./li>
  • If you have swollen glands and/or a persistent headache. This could indicate an infection.
  • If there is a yellow discharge or pus from the nose or eyes.
  • If only one side of the nose or eye is affected.
  • If you are asthmatic
  • A child is under 2 years of age
  • If you are epileptic, if you have Glaucoma or if you are on other medication.
Helpful Tips from Mulligans Pharmacy:
  • Treatment should be started as early as possible and taken regularly
  • Avoid trigger factors e.g. animal dander, freshly cut grass
  • Close windows at night when pollen falls and causes problems
  • Drops may not be suitable with contact lenses so check with the pharmacist
  • Wear sunglasses to help keep pollen out of the eyes
  • If using a nasal spray, spray in the air first before use
  • Vaseline around eyes or nasal passage can help trap pollen before it enters the body
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