Seasonal allergies are a common problem affecting children, adults, and the elderly. They cause a variety of symptoms, including nasal discharge, teary eyes, skin rash, fatigue, and cough. Thus, for patients who are prone to developing allergic reactions, it is essential to draw a suitable prevention and control plan for seasonal allergies. In the present case, the patient is a 42-year-old male suffering from seasonal allergies, who wants to receive a combination of treatments, including a shot, an inhaler, a nose spray, and tablets. The present paper will discuss the main treatment options for the case and provide recommendations.
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Proceeding with the Visit
First of all, it would be important to review the patient’s complaints and medical history to determine the presence of conditions that could influence seasonal allergies. In particular, it is essential to examine the patient’s history of asthma or other obstructive conditions. Secondly, it would be useful to ask about previous allergy tests to determine if the patient has received allergy-specific immunotherapy in the past. Furthermore, noting if the patient is taking any medications at the moment would help to avoid harmful drug interactions.
Last year, a physician prescribed the patient four different types of treatments: immunotherapy, inhalation, nasal spray, and oral treatment. However, using all of these types of treatments is unnecessary, as they all represent viable options for the treatment of seasonal allergies. The present section will outline key information about the three treatment options available: allergen-specific immunotherapy, inhaled corticosteroids, and antihistamine medications.
Allergen-specific immunotherapy is a treatment designed to reduce the body’s response to a specific allergen, thus reducing the symptoms. It can be used for asthma, allergic rhinitis, and allergic conjunctivitis, as well as some types of skin reactions (Pfaar et al., 2014). There are two options of allergen-specific immunotherapy available: subcutaneous and sublingual application. Both types of AIT can be used for preventing seasonal allergies, as they are both effective in preventing pollen allergy-induced allergic rhinoconjunctivitis, which is the key condition associated with seasonal allergies (Pfaar et al., 2014). However, the use of subcutaneous AIT is preferable if the patient has asthma (Pfaar et al., 2014). This treatment option is cost-effective and provides long-lasting results.
Inhaled anti-inflammatory medications are usually prescribed when the patient is diagnosed with allergic asthma. Inhaled corticosteroids are commonly used to promote healthy airflow to the lungs and reduce inflammatory reactions in the airways. The use of inhaled corticosteroids for patients with asthma and allergic rhinitis is supported by research, as well as clinical guidelines (Brożek et al., 2017). Thus, if the patient has asthma, it would be useful to consider the use of inhaled corticosteroids.
Lastly, antihistamines are a class of drugs that reduce the body’s allergic response by blocking histamine type 1 receptors (H1). They are effective for various allergic reactions and associated conditions, including allergic rhinitis, conjunctivitis, skin rash, and cough. They can be administered in forms of nasal drops or tablets, depending on the particular type of medication and the patient’s preferences. Antihistamines are effective in addressing mild to moderate allergic reactions and can quickly relieve the symptoms, thus being an essential part of allergy treatment.
Choice of Treatment
All of the three options have their benefits and drawbacks. For instance, allergen-specific immunotherapy is highly efficient but can be costly for the patient due to the necessity of allergy testing before the injection. Antihistamine drugs, on the contrary, have a broad spectrum of action, and can thus be prescribed without prior testing. Inhaled corticosteroids are different from the two other options, as they primarily target asthma and airflow obstruction as opposed to common allergic reactions.
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The ideal treatment for the patient who does not have asthma would include a combination of SCIT and antihistamines. If the patient has a history of asthma, inhaled corticosteroids should be prescribed in addition to SCIT to ensure symptomatic treatment of allergic asthma.
There are also two types of antihistamines available: first- and second-generation antihistamines. First-generation antihistamines include chlorpheniramine, dexchlorpheniramine, and diphenhydramine. Until the 1980s, they were the only choice for allergy treatment. First-generation antihistamines have a range of side effects, including sedation, dryness of nose and mouth, headaches, and dizziness. Also, they have shorter half-lives than second-generation drugs, thus requiring patients to take multiple doses daily. Second-generation antihistamines, such as cetirizine, blasting, and ebastine, have fewer side-effects and require only one or two doses daily, which is preferred by most patients (Demoly, Chiriac, Berge, & Rostin, 2014). Overall, given the information presented in the case, it would be necessary to prescribe allergen-specific immunotherapy coupled with blasting 20 mg for symptomatic treatment, if necessary.
A successful education plan for the patient should focus on two areas: raising awareness about prescribed medications and preventing harmful drug interactions. It is vital to provide information regarding the benefits of the chosen treatments and explain they’re proper use. Avoiding drug interactions is also a significant concern, particularly if the patient uses any over-the-counter medications. The health professional should outline the possible harmful effects of drug interactions and explain where to find information on the compatibility of different medicines.
The present paper outlined the main treatment options for the management of seasonal allergy in the patient. However, the final choice of treatment depends on the patient’s previous history of asthma. A combination of allergen-specific immunotherapy and either inhaled corticosteroids or second-generation antihistamines would help to prevent allergic reactions. Therefore, based on the recommendations provided in the paper, it will be possible to proceed with the visit and ensure that the patient receives sufficient therapy for his condition.
Brożek, J. L., Bousquet, J., Agache, I., Agarwal, A., Bachert, C., Bosnic-Anticevich, S.,… Schünemann, H. J. (2017). Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines—2016 revision. Journal of Allergy and Clinical Immunology, 140(4), 950-958.
Demoly, P., Chiriac, A. M., Berge, B., & Rostin, M. (2014). Reasons for prescribing second generation antihistamines to treat allergic rhinitis in real-life conditions and patient response. Allergy, Asthma & Clinical Immunology, 10(1), 29-37.
Pfaar, O., Bachert, C., Bufe, A., Buhl, R., Ebner, C., Eng, P.,… Schwalfenberg, A. (2014). Guideline on allergen-specific immunotherapy in IgE-mediated allergic diseases. Allergo Journal International, 23(8), 282-319.