Allergy Medicine – Different Drug Categories and Released Forms

Allergy is a pathological reaction of the immune system, in which the body perceives substances that are safe for most people as dangerous. It can be food, plant pollen, wool, dust, etc. Upon contact with an allergen, an expressed skin, respiratory or other reaction occurs, which in some cases can be life-threatening.

Table of contents

1. The mechanism of allergy apperance
2. How is the allergy treated?
3. Types of allergy medicine
4. What is non-drowsy allergy medicine?

The mechanism of allergy apperance

More simply, the mechanism of allergy can be described as follows. If a person has a genetic predisposition to allergic reactions, under certain conditions, any substance is perceived by the body as an “aggressor/trigger”. There will be no immediate reaction to it, but the next time the immune system comes into contact with this irritant substance, it will try to counteract it.

The body will secrete antibodies and trigger a protective immune reaction – these are the unpleasant allergy symptoms that a person feels. With each new contact with the allergen, the strength of the reaction may increase.

Allergies can manifest themselves at any time of the year, but many people have an exacerbation regularly during the warm season – in spring and summer. During this period, plants bloom and bear fruit, it becomes dusty outside – all these can cause an allergic reaction.

In addition, sometimes allergies are acutely felt in the fall season, because mold and cold can also act as allergens. We together with Trust Pharmacy experts from sandelcenter.com collect as much information as possible about allergy medicine able to cope this disease of different severity. We hope this information will be useful.

How is the allergy treated?

The main principle during allergy treatment is to avoid contact with a substance that causes an undesirable reaction. It is important, if possible, not to provoke the immune system to produce antibodies, because every episode of allergy exacerbation is stress for the body and the risk of a severe reaction. Your doctor will give recommendations based on laboratory tests, which substances you need to beware of.

In parallel, an allergist can prescribe:

• Taking antihistamines – constantly or only with forced contact with allergens. Such medications significantly relieve most of the symptoms of allergies.
• Additional medications to relieve symptoms. To reduce the manifestations of allergies, individual medications in the form of ointments, sprays, inhalers may be required.
• Allergen-specific immunotherapy. This is a modern method of allergy treatment, the purpose of which is not just to relieve the symptoms of the disease, but to reduce the body’s susceptibility to a specific stimulus. You can compare this method with preventive vaccinations. Its essence is that a dose of allergen is injected into the body for a long time, which gradually increases. Immunotherapy is carried out according to a certain scheme for several years and requires patient’s patience: the intensity of the allergic reaction will decrease gradually. Such treatment is prescribed in a situation when the allergen is precisely known.

Types of allergy medicine

Allergy medications are produced in different types. They can be used orally or topically — instilled into the nose, eyes, applied to the skin. The list of release forms also includes solutions for intramuscular and intravenous administration.

You can purchase the following pharmacological forms for allergies:

• eye and nasal drops;
• sprays;
• pills;
• syrups;
• suspensions;
• capsuls;
• etc.

Antihistamines

Antihistamines are drugs aimed at blocking the receptors of histamine, a chemical in the body that regulates sleep and awakening.

First-generation antihistamines are not limited to inhibiting the activity of the central nervous system. They block the receptors of various neurotransmitters, not just histamine, so they have a number of side effects:

• heart acceleration;
• nausea and vomiting;
• increased eye pressure;
• stomach pains;
• violation of urination;
• dryness of the mucous membranes.

With prolonged use, the patient may lose weight, fall into a state of overexcitation, lose consciousness. In case of overdose, seizures are possible.

Antihistamines of the second generation act more selectively, and therefore their reception does not cause undesirable reactions from other organs except the heart. Patients should consider the risk of sinus and reflex tachycardia, as well as arrhythmia.

Pills and liquids

Antihistamines are divided into two main subtypes. The first subtype is called h1 receptor antagonists or h1 blockers. This subtype of antihistamines is used to treat allergy symptoms. The second subtype is called h2 receptor antagonists or h2 blockers. They are used to treat gastrointestinal diseases, including gastroesophageal reflux disease (GERD), peptic ulcers, gastritis, motion sickness, nausea and vomiting. The structure of the name (h1 or h2) informs doctors and scientists about the type of cells and the location of the histamine receptor that blocks the antihistamine drug.

The subtype of h1 blockers is divided into two groups – first-generation antihistamines and second-generation antihistamines.

The first generation of drugs appeared in the 1930s, they act on histamine receptors in the brain and spinal cord along with other types of receptors. The most remarkable thing about this generation of antihistamines is that they overcome the blood-brain barrier, which leads to pronounced central effects such as drowsiness.

Nasal sprays

Sprays and drops from allergic rhinitis are used for therapy and prevention. Nasal glucocorticoids are usually used in combination with antihistamine syrups, tablets for ingestion. Decongestants are common.

Seasonal allergic rhinitis is known as hay fever. Manifestations in 75% of all cases are associated with the period of exuberant flowering of plants. The reasons are compared with ecology, climate features and the season. To relieve the symptoms, it is used the following to improve the quality of life against allergic rhinitis:

• sprays for allergic rhinitis with a dispenser to save and distribute the dosage;
• drops from allergic rhinitis in glass and plastic containers;
• aerosols with vasoconstrictive effect.

Each drug is supplied with instructions.

Sprays, drops from a runny nose and allergies have a different principle of action. With allergic nasal congestion, decongestants, antihistamines, nasal corticosteroids are used. Contact with the allergen is minimized or eliminated altogether. It is important to consult a doctor before using medications. This will help to minimize the use of drops and sprays for allergic nasal congestion, choose an effective therapy with a minimum of adverse reactions and contraindications.

Eyedrops

Allergy eye drops are medications in the form of solutions designed to eliminate local (ocular) manifestations of allergies. They can be prescribed by both an ophthalmologist and an allergist.

There are the following types of allergy eyedrops:

• Vasoconstrictive drops

  These drugs constrict blood vessels, thereby reducing redness and swelling of the mucous membrane. They eliminate only the symptoms, but the problem is not solved. Such drops can be used “once”, in case of an urgent need to “look beautiful” for several hours. With long-term use, they are addictive, and their subsequent cancellation can create a “rebound effect” – a rapid return of all disease’s manifestations.

• Antihistamine eyedrops

  Drugs of this group prevent the accumulation of histamine, which is one of the main factors in the development of allergic reactions. These are H1-receptor blockers, they reduce the response of tissues to histamine. Antihistamine eye drops are effective against symptoms such as itching and swelling. As a rule, they are prescribed as the first remedy for the treatment of allergic eye diseases.

• Mast cell stabilizers

  Drugs of this group block the release of histamine and other substances that cause allergy symptoms from mast cells – highly specialized immune cells that play a major role in the mechanism of the allergic reaction development.

  The peculiarity of drugs belonging to this group is the accumulation effect – they do not act immediately after the intake: the effect is achieved more slowly, but lasts longer. Therefore, in order to reduce the manifestation of symptoms, it is recommended to start taking these anti-allergic medications in advance, before the oneset of the allergic season.

• Lacrimal substitute
  Lacrimal substitutes have a moisturizing effect on the eyes, coping with such manifestations of allergies as dryness, redness and irritation of the mucous membrane. To provide an additional soothing (cooling) effect in case of allergic inflammation, it is recommended to store these eye drops in the refrigerator.

  Lacrimal substitutes are completely safe, so they can be used without restrictions if necessary. Such drops significantly increase the comfort and quality of life of patients with allergies.

Decongestants

Decongestants, being α–adrenomimetics, constrict the vessels of the nasal mucosa, resulting in reduced swelling and hyperproduction of mucus by goblet cells. According to the duration of action, all drugs can be divided into short-acting, medium-duration and long-acting drugs. The short–acting derivatives include naphazoline and tetrisoline – their effect lasts no more than 4-6 hours, which requires their 4-times use. They negatively affect the ciliated epithelium of the nasal cavity.

Decongestants of medium duration (up to 8-10 hours) include xylometazoline derivatives. Oxymetazoline derivatives are vasoconstrictive drugs of long – lasting action – 10-12 hours . Due to this, it is enough to use them 2-3 times a day. The long–term effect of these α2-adrenomimetics is explained by their delayed removal from the nasal cavity due to a decrease in blood flow in the mucous membrane.

Pills and liquids

Oral decongestants provide the relief of the nasal and sinus congestion caused by hay fever (allergic rhinitis). Many decongestants, such as pseudoephedrine (Sudafed), are available over-the-counter.

A number of oral allergy medications contain a decongestant and an antihistamine. Examples include:

• Cetirizine and pseudoephedrine (Zyrtec-D 12 Hour);
• Desloratadine and pseudoephedrine (Clarinex-D);
• Fexofenadine and pseudoephedrine (Allegra-D);
• Loratadine and pseudoephedrine (Claritin-D).

Nasal sprays and drops

The use of sprays is considered the most effective method of fighting allergic rhinitis. It is necessary to “remove” the allergen / irritant and only then it will be possible to achieve optimal results. But sometimes it is impossible to do this – do not change your place of residence because of the flowering of ragweed once a year! Sprays have been developed for such patients to help cope with the unpleasant symptoms of the disease in question.

The most effective drugs are glucocorticosteroids, which will help to quickly cure an adult. Sprays on this basis can help almost instantly after their introduction into the nasal passages. One injection of the drug will be enough to relieve the condition for 6-8 hours.

Indications for the use of these funds are signs of an allergic rhinitis. Those patients who are not the first time faced with the development of hay fever, independently decide on the medical treatment of allergic rhinitis. These medicine is safe explained by:

• accidental overdose is impossible – the spray makes it possible to inhale a certain dose of the drug during one injection;
• sprays have a local effect, the drug does not penetrate into the blood – a minimum amount of the drug components is detected in it;
• they can be used during pregnancy and when breastfeeding a baby;
• if necessary, sprays can be used constantly (for year-round allergic rhinitis) or just for a long time (when therapy is carried out 3-6 months in a row).

Corticosteroids

I would like to note that topical corticosteroids are corticosteroids, but these are not the hormones that athletes use as doping. This is a completely different group of drugs that have a special nasal form. The fact is that when we assess the risk of side effects, it is very important for us to know what proportion of the drug enters the systemic bloodstream through the mucous membranes and can cause side effects.

What is the advantage of these drugs? The part of the drug that can potentially get into a topical corticosteroid is negligible. For the drug nasonex, it is mometasone furoate, this part is less than 0.1%. Experts can say that these drugs act only topically, reducing swelling from the mucosa, reducing the main manifestations of allergies. Patients can use these drugs in long courses for the entire period of allergic symptoms’ development. Patients often receive these drugs for months without experiencing side effects. These drugs do not cause atrophy of the mucous membrane, do not lead to nosebleeds. Therefore, they are safe and are currently the drugs of choice for the treatment of allergic rhinitis.

Topical corticosteroids for the treatment of allergies can be used in childhood, starting from the age of 2. There are several main drugs among tropical corticosteroids, they are divided according to the criterion of systemic bioavailability. The lower this criterion, the lower the risk of side effects.

Nasal sprays

Therapy of the disease is carried out using sprays from different categories. Only one of them can be prescribed drugs, or several different actions can be combined at once. Sprays directly against allergies have been developed for use when it is not possible to remove the effects of the allergen, and therefore it is simply necessary to eliminate the symptoms of the disease. In addition to sprays, most often it is also necessary to use systemic drugs that have a long-term effect and begin to work 2-3 hours after administration.

Antiallergic sprays of the following categories are used for the treatment of the disease:

• hormonal – effective formulations that allow to relieve inflammation and swelling of tissues in the shortest possible time. When using them, it is possible to restore normal nasal breathing and reduce the volume of mucus secreted. Penetrating into the bloodstream in a minimal amount, such sprays are quite safe;
• antihistamines are not hormonal – these drugs are used even before the first signs of seasonal allergic rhinitis appear in order to prevent the development of the disease. With this use, the spray will be the main medicine, and there is no need to use additional other formulations.;
• vasoconstrictive – such sprays for allergic rhinitis are used only as an auxiliary, since they can only temporarily facilitate nasal breathing without eliminating the inflammatory process and allergic reaction. Such a medicine is an urgent help that can be resorted to if the nose is completely blocked.

The doctor determines which category of medicines and specific drugs will be used by a patient. If necessary, he will also prescribe systemic medications to eliminate the disease of moderate and severe degree. Exclusively local treatment helps only with mild allergies.

Inhalers

When inhaled, the particles of the drug enter the respiratory tract, reduce the swelling of the mucous membranes, increase the activity of local immunity, stimulate blood flow. Since there are no age restrictions, inhalations are prescribed to children in the same way as adults. This helps to reduce symptoms and reduce the amount of medications that need to be taken.

Various compounds are added to the nebulizer compartment, which may have an anti-allergenic effect:

• antihistamines;
• hypertonic saline solution;
• corticosteroids;
• mast cell membrane stabilizers (cromons);
• mineral water;
• saline.

Salt solutions and cromons are used, among other things, when a preventive effect is needed. For example, inhalation for children, designed to prevent the harmful effects of ragweed, begins two weeks before the plant blooms.

Eyedrops

In ophthalmological practice, medications in the form of solutions are used to treat various pathological conditions. They help to moisturize the mucous membrane, accelerate tissue regeneration, narrows inflamed vessels, etc. Doctors can prescribe eye drops with hormones, the active components of which are derivatives of glucocorticoids produced by the adrenal cortex.

Ophthalmic solutions with hormones differ in that they are able to suppress severe allergic reactions and inflammatory processes. They act at the cellular level, which cannot be said about other medicines.

The role of the main component in such drops went to glucocorticosteroids. Despite their synthetic nature, they are completely identical to the hormones that our body produces. Hormonal eye drops penetrate into the deep structures of the organ of vision. This greatly enhances their therapeutic effect.

But it is dangerous to prescribe and apply hormone drops yourself. They have many contraindications and side effects that can only worsen the clinical situation.

In order not to harm the health of the organ of vision and to achieve positive dynamics in treatment, you need to adhere to a few simple rules:

• You can’t abruptly interrupt the course. The dosage decreases gradually, otherwise there is a risk of developing withdrawal syndrome, increased intraocular pressure.
• Only for treatment. Drugs with hormones are not used as a preventive measure. They are prescribed only if there are specific indications.
• It is better not to wear lenses. For the duration of treatment with hormonal drugs, it is better to refuse to wear lenses and use glasses for vision correction.
• It is undesirable to skip instillations. If for some reason you missed the next “intake” of the remedy, you need to instill drops as early as possible. If there is not much time left before the next instillation, the missed appointment can be canceled.

Skin creams

Corticosteroid ointment is a drug for external local exposure, the active substance of which is steroid hormones. Depending on the nature of the effect on the body, they are divided into glucocorticoids and mineralocorticoids.

Steroid hormones are divided into two types depending on their origin — synthetic and natural. The natural production of hormones is produced by the adrenal cortex. These substances take part in metabolism, and also control the state of the kidneys.

Glucocorticoids are used in the treatment of various allergic diseases, infectious mononucleosis, eczema and neurodermatitis. This group of steroid hormones has anti-inflammatory, anti-shock, anti-allergic and immunosuppressive effects. Glucocorticosteroid ointments improve blood microcirculation in the foci of inflammation. The drugs reduce fluid exudation and prevent the spread of inflammation. The antiallergic effect of corticosteroid ointments is expressed in a decrease in the synthesis of substances that cause allergic reactions.

Along with a positive effect on the body, steroid hormones lead to undesirable effects — they delay sodium and water in the body, promote the excretion of potassium and interfere with the calcium absorption. Prolonged use of corticosteroid medications can cause steroid diabetes. Therefore, before buying dermatological corticosteroids, it is necessary to consult a doctor. The appointment and reception of such drugs should be justified.

Allergen immunotherapy

If an allergy is suspected, the patient is examined in a medical institution, complaints and anamnesis of the disease are clarified.

In order to differentiate an allergic reaction from another disease, it may be necessary to conduct allergological tests.

For example, food poisoning can cause symptoms similar to alimentary or food allergies. Some medications (such as aspirin and ampicillin) can provoke skin rashes of a non-allergic nature. The cause of a runny nose or cough may not be an allergy, but an infection.

Skin tests are the most common way to diagnose allergies. The prick test (needle test) is one of the skin allergy tests. A small amount of a substance, a potential allergen, is applied to the skin, and then a skin injection is made so that the substance penetrates under the skin. For a certain time, the skin is monitored. Reactions such as redness and swelling indicate an allergy to a particular substance. This type of allergy tests can be used to diagnose allergies in young children and infants.

Other types of skin allergy tests include application tests and intradermal testing. For additional information, laboratory blood tests are carried out:

• Blood test for immunoglobulin E;
• General blood test with determination of the level of blood leukocytes and eosinophils.

In some cases, the doctor may ask to avoid contact with potential allergens or vice versa to contact these substances in order to assess the reaction and condition of the patient. This is called “use or exclusion testing”. Such tests are used to assess the reaction to food or medicines. The doctor can also assess the patient’s reaction to physical factors, for example, heat, cold or other potential provoker of allergies. In some cases, a potential allergen is dissolved and injected into the conjunctival sac cavity (under the lower eyelid), and the patient’s reaction is evaluated. This study is the most sensitive and it is carried out in a medical office in the presence of a doctor.

Shots

The method of allergenspecific immunotherapy involves the introduction of allergen-containing drugs into the body. This method of treatment is similar to conventional vaccination, so allergen-specific immunotherapy is sometimes called an allergy vaccine. Another name that is used among physicians is hyposensitizing therapy.

The main meaning lies in that the body receives an ever-increasing dose of allergen (in the form of specially treated drugs), gradually gets used to it and stops reacting. In ordinary life, the influence of the allergen occurs uncontrollably (a person never knows where, when and to what extent a dangerous factor will affect him). Immunotherapy, which, in fact, is a therapeutic and preventive procedure, is carried out purposefully: the doctor draws up a schedule and determines therapeutic doses – thanks to this, it is possible to achieve a positive result.

The allergenspecific immunotherapy is used in cases when allergens are substances that cannot be avoided (for example, pollen). This method is used if an IgE-dependent allergic disease is diagnosed.

The technique helps with:

• allergic rhinitis and/or rhinoconjunctivitis;
• insect allergy (reaction to dust mites, allergy to insect bites);
• pollinosis (seasonal rhinitis);
• atopic bronchial asthma.

Sublingual immunotherapy (SLIT)

When using SLIT, the drug is injected into the patient’s body sublingually – under the tongue, in the form of drops or tablets.

The drug should be instilled every day in the morning for several months. It is necessary to start treatment a few months before the start of the expected flowering of the plant to which there is an allergy.

The course continues throughout the flowering period.

The variants of SLIT are called preseason-seasonal, since the treatment is carried out immediately before the season and during the flowering of the plant that caused the allergy.

Among the advantages of the DRAIN can be distinguished:

• the convenience of using the drug – drops or tablets under the tongue;
• no need to do regular injections;
• the patient performs the procedure independently at home, there is no need for regular visits to the
  doctor;
• the risk of developing systemic reactions of the body to the introduction of an allergen is lower – a high
  safety profile.

Biological medications

Biological therapy is the newest and most effective method of treating chronic diseases. This type of treatment allows you to cope with severe bronchial asthma, chronic urticaria and atopic dermatitis, which are difficult to treat with traditional drugs. A significant part of patients with nasal polyps can be treated with the help of biological therapy, which avoids surgery and restores the ability to smell and enjoy taste.

Currently, monoclonal antibodies to each of the above factors have been created by genetic engineering methods. This distinguishes biological monoclonal antibodies from blood products — immunoglobulins, plasma, etc. In addition to high accuracy and selectivity of action, which allows you to influence a single factor and get the maximum effect with minimal side effects, biological drugs have a high safety profile. There is no effect on growth, sexual function, they do not cause addiction, weight gain, thinning of the skin. Monoclonal antibodies work as a switch, without destroying the entire system and without interfering with the fundamental processes of the body’s vital activity, they remove one link from the chain of pathological reactions and improvement occurs.

What is non-drowsy allergy medicine?

Officially, third-generation drugs have not yet been developed, however, unofficially, improved second-generation drugs belong to this group. This group is characterized by a quick start of action and high efficiency. Drugs have fewer side effects. Individual intolerance is possible. They can be used both to relieve allergy symptoms and for long-term treatment of the disease. They do not affect the heart rate.

Best non-drowsy allergy medication names

1. Allegra (fexofenadine);
2. Clarinex (desloratadine);
3. Claritin (loratadine);
4. Flonase (fluticasone);
5. Nasacort (triamcinolone);
6. Xyzal (levocetirizine);
7. Zyrtec (cetirizine HCL).

Category: General

Tags: allergy, allergy treatment, antihistamines, human health, medicine