HAY FEVER
nature of these drugs, they should not be recommended for “as-required” treatment, as they will not bring about a speedy effect, and are targeted for longer-term use. When it comes to the recommendation of intranasal corticosteroids, it is also important that you correctly counsel the patient on how to use the product correctly, as the drug will be in the form of a drop, or more commonly, a spray, which the patient will not be familiar with – the correct use of these products is essential to their success.
A COMBINATION APPROACH As mentioned above, the treatment of hay fever should be stepwise in manner, and as such, the likes of oral antihistamines and intranasal antihistamines can be combined if deemed appropriate. For example, this strategy can be combined if the patient is unresponsive to a intranasal corticosteroid, or if this can be justified by the combination of symptoms that the patient is affected by. For example, if the patient is strongly affected by sneezing, nasal congestion and allergic conjunctivitis, there may be a case for the recommendation of both products.
ITCHY, RED OR WATERY EYES?
Look no further than DUAL ACTION Otrivine Antistin® Eye Drops Don’t let Hayfever spoil your Summer! Dual action brings relief from itching AND redness
• Blocking the action of histamine on the eye’s surface from first use • Combined with a long acting vasoconstrictor to reduce redness • Effective for both seasonal and perennial allergies - hayfever, house dust etc.
Otrivine Antistin® (Xylometazoline hydrochloride 0.05% Antazoline sulphate 0.5%). For the temporary relief of redness and itching of the eye due to seasonal and perennial allergies such as hay fever or house dust allergy. Suitable for adults and children over 12 years.
OTHER PRODUCTS Of course, there are other products on the market for the treatment of the various symptoms of hay fever. One obvious omission from above is that of sodium cromoglicate eye drops. This particular preparation, which functions by stabilisation of the mast cells, reducing the inflammatory
response, is indicated for symptoms of conjunctivitis brought about by hay fever, and may be a suitable additional product, should these issues persist when another treatment is used. These drops can also be a suitable alternative product, should first line treatments such as oral antihistamines not be suitable for your patient.
AVOIDANCE OF ALLERGENS We are at an advantage when it comes to hay fever, in that we have a good idea about what causes the condition, and that advantage is even greater because the causative is environmental. This all adds up to the fact that advising your patients about allergen avoidance is a critical piece of patient counselling, and if done well, should go great lengths to reducing their symptoms, and improving their quality of life. Another benefit is that for the most part, these steps are not particularly complicated. For example, if your patient possesses an allergy to grass pollen, you should advise to:
• Avoid walking in grassy spaces during times when pollen counts are at their highest (early morning, late evening, and night time)
• Keeping windows in cars and rooms closed
• Changing car pollen filters regularly, and in line with manufacturer’s recommendations
• Check pollen forecasts regularly, and carry out the steps above at any point when pollen counts are elevated
As such, this advice should always be 54 - SCOTTISH PHARMACIST
given to patients who you supply with treatment for hay fever.
A PROBLEM WITH EASY SOLUTIONS
Overall, hay fever is a condition that can have a massive impact on a patient’s life, but in most cases, can be easily and very effectively treated. It is critical that we offer the full service to patients suffering from the condition – the right medications (or combination of medications, tailored to the patient’s symptom profile), and advice can get a patient to a point where their hay fever becomes outdated. Knowledge of these areas and how to use our knowledge to structure a management plan for the patient will guarantee satisfaction, and importantly return custom, ensuring that your expertise remains as profitable as always! •
REFERENCES:
1 Allergy UK. Allergy Statistics. 2015; Available at:
https://www.allergyuk.org/ allergy-statistics/allergy-statistics. Accessed 03/08, 2016.
2 Asthma UK. Hay fever treatments. 2015; Available at:
https://www.asthma.org. uk/advice/inhalers-medicines-treatments/ other/hay-fever/?gclid=CP2VwY_hs MsCFUko0wodppoFNw&gclid=CP2V wY_hsMsCFUko0wodppoFNw. Accessed 03/08, 2016.
3 Min Y. The pathophysiology, diagnosis and treatment of allergic rhinitis. Allergy, asthma & immunology research 2010;2(2):65-76.
4 Mygind N, Nielsen LP, Hoffmann H, Shukla A, Blumberga G, Dahl R, et al. Mode of action of intranasal corticosteroids. J Allergy Clin Immunol 2001;108(1):S16-S25.
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