Post-Nasal Drip: This symptom is
very difficult to treat. The causes can be an allergy, infection, or a
nasal structural abnormality. Antihistamine decongestant products are
the OTC treatment of choice. I would recommend, however, seeing an
allergy or sinus specialist for a more specific etiology so that
treatment can be optimized.
Cough of two-week duration or less: This
kind of cough in the absence of other underlying medical problems such
as chronic bronchitis or emphysema, or without other associated symptoms
such as a fever is probably due to a cold. I usually recommend a product
with a cough suppressant such as dextromethorphan and a decongestant
such a pseudoephedrine to dry the post-nasal drip. If the drip is
particularly bad, one can add an OTC antihistamine to help dry the drip
further. I would especially recommend this at night when being sleepy is
not as big of an issue.
Cough of more than two weeks duration:
Now we are approaching the category of "chronic cough." The
overwhelming majority of chronic coughs are related to three causes.
These include:
Allergy and asthma
Sinus infection
Gastroesophageal Reflux (heartburn)
If a cough persists for more than a few weeks, one should see an
allergist, otolaryngologist, or a pulmonologist
(lung specialist).
Itchy, runny eyes: Most
over-the-counter medications treat the systems of eye allergies using a
topical decongestant (oxymetazoline, naphazoline) and an antihistamine (pheniramine).
Allergy
Medications
Sneezing, wheezing, coughing, and sniffling. So many
allergy symptoms and so little time to get to the doctor to get a
prescription to relieve you of these irritating and somewhat
debilitating symptoms. Well, now you will have the information necessary
to treat your symptoms with the appropriate over-the-counter (OTC)
medications, which at one time, were prescription products that for one
reason or another, were made into OTC medications. Furthermore, simply
because a medication is available over the counter does not make it
safer or less effective than its prescription equivalent.
We will concentrate on the generic rather than brand names because
there are multiple brands available of the same generic products. There
are also countless combination products available that combine some of
the more popular generics to treat a wider variety of allergy and cold
symptoms. Most brand-name, over-the-counter products have a generic
equivalent. For the most part, brand names and their generics are
comparable as far as efficacy and side effects go. By understanding what
is in your favorite OTC products, you will be able to save 25 to 75
percent by buying the generic equivalent. This article will discuss
various allergy symptoms along with the appropriate OTC products that
would treat your symptoms.
Allergy Symptoms
Sneezing, itchy nose, throat, and ears:
These are the most common complaints of the allergy sufferer. These
symptoms can be associated with seasonal triggers such as grass, tree,
or ragweed pollen, or perennial triggers such as dust mites, roaches, or
pets. The first-line treatment for these symptoms are antihistamines.
When exposed to an allergen, the mast cell,
which is found all over the body, especially in connective tissue such
as the skin, releases histamine. Antihistamines block the action of
histamine and prevent the allergic reaction from taking place. The most
popular OTC antihistamines are diphenhydramine (Benadryl), clemastine (Tavist),
and chlorpheniramine (Chlor-Trimetron).
Some of these products' manufacturers have used the side effect of
sleepiness to create a new product out of the same drug. Popular
examples include Unisom, Nytol, and Sominex. In fact, diphenhydramine is
almost as popular as a sleep aid as an allergy product.
Side effects
Be careful when driving. Over-the-counter allergy products may impair
your judgment as much as alcohol, and when combined with alcohol, may
affect you even more. Also, men with enlarged prostates may experience
urinary retention while taking these products. For moderate to severe
symptoms, or if the side effects of the treatment are intolerable,
a patient will benefit greatly from consulting an allergy specialist and
gaining access to one of the second generation antihistamines that have
a much improved side effect profile. Another class of products available
to treat these products is mast cell stabilizers.
Nasalcrom nasal spray recently was made available over the counter
for the treatment of allergic rhinitis. This product boasts an
impressive safety profile, but is limited as far as usefulness. To
achieve maximum benefit, one would need to use Nasalcrom (cromolyn
sodium) three to four times per day and give the medicine up to one
month to start to work. Some patients swear by it.
Congestion,
sinus pain: These symptoms may or may not be associated
with allergies. If you don't have sneezing, an itchy nose, throat,
or ears, you may want to avoid combination products that have
antihistamines to minimize occurrences of dry mouth and sedation.
The principal therapy for these symptoms is decongestants.
Decongestants can be taken orally or topically. The most popular
oral decongestant is pseudoephedrine. This product is also
available in prescription strength. Decongestants work by
shrinking the mucous membranes, thereby decreasing the surface
area. Unfortunately, when the medication wears off, so does the
symptom relief. Also, many patients get very jittery and shaky
while taking these products. These patients don't usually do well
on coffee or other forms of concentrated caffeine, either. If
these symptoms persist, it would be wise for the patient to
consult with an allergist or other sinus specialists such as an otolaryngologist
(ear, nose, and throat doctor) for further evaluation or
treatment.
Remember though, if you don't have allergy symptoms, you don't
need to take a combination product with antihistamines. Often
times, decongestants may come with guaifensisin, an expectorant to
loosen the phlegm or mucus and assist with drainage. Although in
theory, this is a good idea, in most OTC products, it is given at
such low dosages, it doesn't do much. You usually need the much
higher dosages of prescription products to do any good. If
congestion is particularly bothersome, you may want to use an OTC
decongestant spray for a few days to help relieve the symptoms and
allow some of the more long-term prescription and OTC medications
to kick in.
Side effects
Use of topical decongestants such as phenylephrine (Afrin, Neo-Synephrine,
Vicks Sinex) or oxymetazoline (Afrin Original Nasal Spray, Neo-Synephrine
12 hour) for more than three to four days may lead to a mucosal
dependence (or addiction), making it more difficult to wean off of
these medications. Also, if a patient abuses these products, they
may irreversibly damage the nasal mucous membranes.