Category Archives: Vasomotor (Non-allergic) Rhinitis

Put This Myth to Rest-(Dirt Jet Pro/SCRUBS hand sanitizer wipes)

Everyday I teach patients the difference between “allergy” and “irritant” reaction.  TV ads are overloaded with allergy advertisements in an attempt to sell antihistamines, so why wouldn’t you think that everyone has allergy of some kind.  The link below is a question about allergy (anaphylaxis in this case) to chemicals.  Consider the following:

  1. Adverse reactions to pollen, food, chemicals can be divided into “allergy” or “intolerance/irritants“.
  2. Allergy is defined as the production of IgE to the substance in question.  This is why you have positive skin tests and blood testing.  Why does this matter?
  3. You can only be “desensitized” to allergens, not chemicals.  IgE can be decreased and if you don’t have IgE to begin with you can’t delete its effect.
  4. The only treatment for irritants is to avoid them, regardless of whether the substance is a food or chemical.
  5. For chemical reactions or food intolerance, there’s not much to say except to stay away.  Click on the link below just to make sure!

Possible anaphylaxis to chemicals contained in cleaning agents (Dirt Jet Pro/SCRUBS hand sanitizer wipes).

Air fresheners–Go Organic…Not!

Tomorrow starts the American Academy of Allergy, Asthma, & Immunology national meeting in Orlando.  Great fun and food, but more importantly, great new information about allergy.  If you watch the news at all, you’re bound to hear about natural products for your health.  Organic anyone? 

Read this blog about a patient who only THOUGHT she had allergy; it was really volatile organic compounds (VOC) causing her symptoms of sneezing and nasal irritation that made her think she had allergies. 

Case reports like Mary’s are helpful to instruct allergists in the best treatment methods for our patients with rhinitis.  Sometimes it’s allergic and sometimes it isn’t. 

Take the following report for instance: 

Love the smell as long as I can breathe!

They may smell sweet, but popular air fresheners can cause serious lung problems.

That’s the message from a new study presented at the annual meeting of the American College of Allergy, Asthma and Immunology (ACAAI). Home fragrance products often contain volatile organic compounds (VOCs) that include such nasty chemicals as formalehyde, petroleum distillates, limonene, esters and alcohols. (Download a copy of the presentation here)

Exposures to such VOCs — even at levels below currently accepted safety recommendations — can increase the risk of asthma in kids. That’s because VOCs can trigger eye and respiratory tract irritation, headaches and dizziness, as Dr. Stanley Fineman, ACAAI president-elect, pointed out:

This is a much bigger problem than people realize. About 20 percent of the population and 34 percent of people with asthma report health problems from air fresheners. We know air freshener fragrances can trigger allergy symptoms, aggravate existing allergies and worsen asthma.

MORE: 5 Ways Americans’ Allergies Are Getting Worse

And if you hope that “all-natural” fragrance products can give you a nice scent without the chemicals, Fineman has bad news for you — even products marketed as organic tend to have hazardous chemicals. That shouldn’t be surprising since fragrance products don’t eliminate bad smells; they just cover them up, and that usually requires something strong.

Fineman suggests that you’d be better off simply opening up your window and letting fresh air in — though that advice might not work well where I live.  OK, I get it!

The study also gives some much-needed attention to the problem of indoor air pollution. While air freshener-related asthma is certainly a health hindrance in the developed world — at least among those who like to live in artificially sweet-smelling homes — indoor air pollution is a major health catastrophe for much of the developing world, one that leads to the premature deaths of nearly 2 million people a year according to the World Health Organization. The majority of those affected are very poor women and children who might spent hours cooking food over a wood-burning fire in a hut with little ventilation.

To read more about indoor air pollution and how to avoid it, see: http://healthland.time.com/2011/11/08/why-air-fresheners-can-trigger-respiratory-problems/#ixzz1dnQJp6cD

 

Now Here’s a New Medication I haven’t seen in a while

I have trouble getting patients to use ONE much less TWO nasal sprays for nasal allergy & congestion.  Now I may have a solution this year.  The buzz on the street is Meda pharmacueticals

First combination spray for the nose!

will be introducing a nasal spray product with two ingredients for patients suffering from congestion, runny nose and sneezing.  Yes, for what ails you! 

I’ll give you some tidbits from the College of Allergy/Asthma/Immunology meeting this past fall about this new medication.

November 16, 2011 (Boston, Massachusetts) — A novel nasal-spray formulation that combines the intranasal antihistamine azelastine with the intranasal corticosteroid fluticasone provides greater pharmacotherapeutic benefits for the treatment of seasonal allergic rhinitis than either of these agents alone, according to a study presented during an oral session here at the American College of Allergy, Asthma & Immunology 2011 Annual Scientific Meeting.

“There are many patients with moderate or severe allergic rhinitis whose symptoms are not adequately controlled with the currently available pharmacological agents,” Eli O. Meltzer, from the Allergy and Asthma Medical Group and Research Center in San Diego, California, told Medscape Medical News. “Because of their morbidity, it is important to seek new treatments.”

National guidelines have been in agreement with this for the past several years, said session comoderator Mark Dykewicz, MD, from Wake Forest University in Winston-Salem, North Carolina.

Dr. Dykewicz, who was invited to comment on the study by Medscape Medical News, said that the 2008 Rhinitis Parameter Update of the US Joint Task Force on Practice Parameters stated that using this combination was effective.

“In contrast, most studies have failed to demonstrate that the addition of an oral antihistamine to an intranasal corticosteroid adds to the benefit of the intranasal corticosteroid,” Dr. Dykewicz said.

American College of Allergy, Asthma & Immunology (ACAAI) 2011 Annual Scientific Meeting: Abstract 39. Presented November 7, 2011.

What does this mean for you? 

But Wait!

For years, patients have added OTC antihistamines (Allegra, Zyrtec, Claritin) for allergy symptoms.  Research shows you are much better off adding another nasal spray (like Astelin) than adding an oral tablet to the steroid nose spray you’re already taking.  That’s why antihistamines are often ineffective….you might as well take a vitamin!