HAYFEVER/NASAL ALLERGY

See also

Eye problems, cough,cold
ear pain

Symptoms

Hay fever occurs in allergic (atopic) individuals; their illnesses may include:

• Streaming nose
• Swollen/streaming eyes
• Itch and urticarial rashes
• Wheezing and bronchospasm

Hay fever is seasonal allergic rhinitis; many suffer perennial (all year round) rhinitis.

Danger signs

• Rarely allergic response may cause angio-oedema (lip, tongue and facial swelling) - give oral antihistamines if possible - Urgent medical attention required.
• Persistent wheezing or shortness of breath - may indicate Asthma -Contact GP.

Notes for children

• Beware of risks of sedating antihistamines.
• Antihistamines not recommended in patients under 1 year.

Notes for the elderly

• Maybe sensitive to antihistamine/decongestive side effects.
• Avoid Terfanadine and Astemizole in patients with prolonged QT interval.
• Do not exceed recommended dose.

General advice

Allergen reduction can be helpful as well as drugs:

• Pollen filters in cars.
• Anti house dust mite measures - Pesticides - High filtration hoovers.
• Excluding domestic pets from sleeping areas.

Therapy

• Sedating oral antihistamines.
• Non sedating oral antihistamines.
• Decongestive - short term relief.
• Cromoglycate eye drops.
• Lubricant eye drops.
• Aqueous low dose steroid nasal sprays.

Dictionary

Angio-oedema: an accumulation of an excessive amount of watery fluid in cells, tissues or serious cavities.
Bronchospasm: contraction of smooth muscle in the walls of the bronchi and bronchioles, causing narrowing of the lumen.
Rhinitis: inflammation of the nasal mucous membrane.
Urticaria hives: an eruption of itching weals usually of systemic origin, sometimes due to hypersensitivity to foods or drugs.

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