Allergic Rhinitis Ebook
Allergic rhinitis An inflammation of the mucous membrane lining the nose caused by an allergic reaction as inhaled allergens are trapped by the nasal filtration system. In allergic rhinitis, sneezing is a prominent feature and nasal symptoms may be accompanied by itchy watery eyes and intense itching of the nose and soft palate. The disease is triggered in susceptible children by allergic reactions to pollen, mold, dust mites, and other allergens. Seasonal allergic rhinitis is called hay fever or seasonal allergic rhinitis. In this condition, both the nose and the eyes are affected. Allergic rhinitis that occurs year-round is known as perennial allergic rhinitis. seasonal pollen allergy may exacerbate symptoms of perennial rhinitis. Allergic rhinitis is the most common chronic disease in children, affecting about one in five children by the age of two or three years up to 30 percent are affected during adolescence. Boys are twice as likely to get allergic rhinitis than girls, but the...
As with other penicillins, some children may be allergic to this medication. Hypersensitivity reactions are more likely to occur in children who have previously demonstrated hypersensitivity to penicillins and in those with a history of allergy, asthma, hay fever, or hives. Nausea and vomiting also are common side effects.
Phenindamine An antihistamine used to temporarily relieve runny nose, sneezing, itching of the nose or throat, and itchy, watery eyes due to hay fever or other upper respiratory allergies. In people with HIV, the drug is also used to reduce certain drug-induced allergic side effects, including skin rashes, swelling, hives, and breathing difficulties. Drowsiness is the most common side effect less often, dry mouth, nervousness, insomnia, and increased irritability or excitement may occur. Available over the counter in tablets. (Trade name is Nolahist.)
Chlorpheniramine An antihistamine used to treat allergic reactions such as hay fever, hives, and inflammation of the eye, among others. It is also taken to prevent or treat allergic reactions to blood transfusions or compounds taken to enhance x-ray images. occasionally it is used as a supplementary therapy to epinephrine for the treatment of anaphylactic shock. In people with HIV, the drug is used to reduce certain drug-induced allergic side effects, including skin rashes, redness, swelling, hives, and breathing difficulties. The drug is available in a wide variety of formulations, including capsules, tablets, syrup, and oral suspension. Drowsiness is the most common side effect. (Trade names include Alermine, Aller-Chlor, Chlor-Trimeton, Comtrex, Histex, and Teldrin.)
Many drugs will cause adverse effects if the dose is excessive but some cause adverse effects at the correct dose in certain individuals. This can be due to an increased sensitivity of the patient because of genetic or other factors (see pp. 29-31). There may also be side effects which are not apparent at low or therapeutic doses but which become more important at higher doses. Occasionally, unexpected and serious adverse effects occur in a few patients. Sometimes this is due to an interaction between two drugs or between a drug and a food constituent such as occurred with the drug terfenadine (used to treat hay fever) and grapefruit juice (see case note, pp. 33-4).
Multiple Phase I human clinical trials have been designed to explore the safety and immunostimulatory properties of CpG ODNs administered alone, or in combination with vaccines, antibodies or allergens. Several Phase II studies are also underway to evaluate the therapeutic potential of CpG ODNs in the treatment of cancer, allergy and asthma, or as vaccine adjuvants. Studies have investigated the use of CpG ODNs to reduce allergic rhinitis and immunization of allergen mixed with CpG ODN, allergen-CpG ODN conjugates, and CpG ODN alone have proved effective in the reduction of the allergic phenotype in mice 59 . Preliminary results using vaccines containing allergen-CpG ODN conjugates in human patients show that this combination reduces allergic symptoms with relatively few adverse reactions 60 . Clinical trials have used CpG ODNs as vaccine adjuvants coadministered with the Engerix B hepatitis B vaccine and the Fluarix influenza vaccine 61, 62 . Healthy adult volunteers were immunized...
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On the surface, findings related to the actions of TLRs in allergic asthma appear highly contradictory as endotoxin has been reported to both exacerbate asthma and diminish its incidence. Multiple epidemiologic studies have shown that exposure to TLR ligands in childhood is protective against developing asthma later in life. Examples of this include individuals living on farms who have a reduced risk of developing hay fever or asthma 66-68 , the inverse relationship shown between prior measles infection and allergic disease 69 , episodes of fever early in life affect the natural history of asthma by preventing the development of atopy 70 , the risk of developing asthma is decreased with increased numbers of siblings 71 and levels of endotoxin in the bed linen of school-aged children are inversely proportional to the incidence of hay fever and atopic asthma 72 . This general epidemiological observation, that exposure to pathogens or their products early in life protects against the...
Genetic approaches to identify associations between airway disease and activation of the innate immune system are not limited to TLR4. Polymorphisms of the TLR4 co-receptor CD14 are associated with increased levels of soluble CD14 and an enhanced biological response to endotoxin. Polymorphisms of CD14 have been associated with both a decrease in total serum IgE in asthmatic children 122 and a decrease in lung function among endotoxin exposed farmers 123 . The observation among children is consistent with the hygiene hypothesis concerning attenuation of allergic symptoms with enhanced response to endotoxin. The enhanced biologic response among farmers with exposure to high levels of occupational endotoxin would be expected to demonstrate decreased lung function, as was observed. In another study, common polymorphisms of TLR2 among European farmers were associated with protection from asthma, atopy and hay fever 124 . This observation would suggest that a blunted response to TLR2...
Pharmacological profiling can also reveal potential beneficial effects drug discovery by serendipity. In this case, it may be that the drug has dual activity on two targets that may play a role in a disease. For example, a drug that is a dual antagonist at histamine Hj receptors and platelet-activating factor (PAF) receptors (e.g., rupatadine) has added benefit over a selective histamine H antagonist (e.g., loratadine) for the therapy of allergic rhinitis because both PAF and histamine play key roles in mediating inflammatory responses.6 Similarly, a drug that has dual activity at the dopamine D2 receptor and -adrenoceptor (e.g., sibenadet) has the potential for greater efficacy in the therapy of chronic obstructive pulmonary disease when compared with a selective -adrenoceptor agonist (e.g., salbutamol).7,8
Parents often are able to diagnose hay fever. While a common cold or upper respiratory infection can be confused with allergic rhinitis, parents should suspect rhinitis if the child has irritated eyes and no fever. Food allergies can also cause rhinitis symptoms in 70 percent of infants and young children, but with food allergies there are often other symptoms of skin or stomach irritation as well. A careful history usually reveals the seasonal nature of the complaint and the suspected role of seasonal allergens. Physical examination usually reveals puffy, reddened watery eyes, a red throat, and nostrils filled with clear watery mucus.
Left untreated, allergic rhinitis also can lead to other serious conditions, including asthma, recurrent middle ear infections, sinusitis, sleep disorders, and chronic cough. Appropriate management of rhinitis is an important part of effectively managing these coexisting or complicating respiratory conditions. The type and severity of allergy symptoms vary from child to child. Airborne allergens can cause allergic rhinitis (sneezing, itchy nose or throat, nasal congestion, and coughing). These symptoms are often accompanied by allergic conjunctivitis itchy, watery, red eyes, and dark circles around the reddened eyes. Allergic rhinitis occurs in about 15 percent to 20 percent of Americans and typically develops by age 10, reaching its peak in the early 20s. The symptoms of allergic rhinitis and conjunctivitis can be mild or severe and may occur only at certain times of the year or all year round. If symp
A young man, just 29 years old, had been taking the antihistamine drug terfena-dine twice daily for two years because he suffered from hay fever. One day he took his normal dose, drank two glasses of grapefruit juice and went into his garden to mow the lawn. He suddenly became ill, stumbled back into his house, collapsed, and died. The coroner reported that there were increased levels of the drug in his blood and concluded that he had died from the adverse effects of terfenadine.
Those who react to airborne allergens usually have allergic rhinitis and allergic conjunctivitis. Airborne allergens include dust mites, cockroach parts, pollens, and molds Pollen Trees, weeds, and grasses release these tiny particles into the air to fertilize other plants. Most people know pollen allergy as hay fever or rose fever. Pollen allergies are seasonal, and the type of pollen a child is allergic to determines when he will be symptomatic. For example, in the mid-Atlantic states, tree pollination begins in February and March, grass from May through June, and ragweed from August through October. Pollen counts measure how much pollen is in the air. Pollen counts are usually higher in the morning and on warm, dry, breezy days they are lowest when it is chilly and wet. Although they are not exact, the local weather report's pollen count can be helpful when planning outside activities.
Latex allergy Allergy to the fluid or sap produced by some plants. people with this allergy could be allergic to such simple things as balloons, doctors' gloves or condoms made out of latex. This is a potential problem for doctors, fast-food workers, toll takers, janitors, police officers, and especially health care workers who routinely wear latex gloves as protection against AIDS. Mild sensitivity can produce a skin rash. Extreme sensitivity can include symptoms similar to hay fever or asthma. Severe allergic reactions to latex can include ana-phylactic shock and death. Medical and dental personnel should ask every patient about the possibility of latex allergy, especially those scheduled for surgery. patients who have had multiple surgeries are at high risk. Also at high risk are those allergic to bananas, chestnuts, avocados, and some tropical fruits. potential sexual partners should also be queried about latex allergy. The government has yet to set standards on safer alternatives.