May Is Allergy and Asthma Month

Posted on Wed, May 16, 2007

By Dr. Stephen J. Daniels

EVERY YEAR about this time, thousands of people are suddenly reminded that they have allergies and asthma. Wheezing, chest tightness and shortness of breath are associated with asthma. Head allergy symptoms include itchy and watery nose and eyes, sneezing and sinus congestion.

Allergies and asthma can be especially severe this time of year, especially in Central and East Contra Costa County where grasses and pollen proliferate.

What should allergy and asthma sufferers do during the peak allergy and asthma months of May and June?

First, remember what worked for you in past years. Plan ahead by checking your medicine cabinet, and calling your doctor for refills if you are out.

Generally, the most effective and safest medicines for both nasal allergies and asthma are the prescription steroid inhalers. Nasal inhalers such as Nasarel, Becanase and Flonase for a runny nose and sneezing. Asthma inhalers such as Flovent, Azmacort, and Qvar for the lungs. Advair is an asthma steroid inhaler that also contains additional, and faster-acting, medicine.

Some steroid inhalers take hours or days to work, so to get the most from your inhaler:

Use them early, before severe symptoms develop.
Take them regularly around the clock (according to your doctor's instructions) regardless of your symptoms.
Don't stop taking them right away when your symptoms improve.

If your allergy symptoms are already severe, it's often best to start with a fast-acting medicine, like Astelin spray, Sudafed pills or Claritin pills for head allergy symptoms. At the same time, begin and continue using a steroid nasal inhaler to start the process of preventing or controlling future symptoms.

The same treatment principles apply to asthma treatment. Start with a fast-acting inhaler such as albuterol or Xopenex, and, at the same time, begin and continue using a steroid asthma inhaler. Continue using the quick-acting medicine as long as symptoms persist.

When the symptoms improve, taper off the quick-acting medicine, but continue using the steroid inhaler.

Knowing when to stop the steroid inhaler can be difficult. Generally, gradually tapering the frequency or number of nasal or mouth inhalations over a few weeks is best. If the symptoms worsen, resume both the quick-acting medicines and the steroid inhaler.

If the steroid inhaler does not completely control your asthma or allergy symptoms, consult your doctor about additional medicines.

Allergic symptoms of the eye, such as redness, itching and watering can best be treated effectively with eye drops such as Patanol or Pataday, which act quickly. Cromolyn eye drops are also effective, but may take days to work.

Occasionally patients say: "Doc, I need an allergy shot to fix my allergies for the whole season." Such shots contain systemic steroids such as dexamethasone or betamethasone.

Most doctors are reluctant to begin allergy treatment with steroid injections or pills because of uncommon but potentially serious side effects. Generally, it is much safer to give steroids as nose or mouth sprays.

By contrast, weekly allergy shots by an allergist to address specific allergies are safe and effective, and don't contain steroids. These generally work better for head allergies than for asthma.

Allergies and medicines to treat them affect people differently, so consult your doctor before beginning or changing any medicine.

Daniels practices family medicine at the Pittsburg and Concord Health Centers of Contra Costa Health Services.