Allergy oral medications

Strom BL, Reidenberg MM, West S, Snyder ES, Freundlich B, Stolley PD. Shingles, allergies, family medical history, oral contraceptives, and other potential risk factors for systemic lupus erythematosus. Am J Epidemiol 1994 140(7) 632 12. 

The first-generation Hi antihistamines, also referred to as sedating antihistamines, and the second-generation antihistamines, the less or nonsedating antihistamines, are among the most frequently used oral medications for ocular allergies. Table 13-3 lists commonly used oral antihistamines and some of their important pharmacologic properties. 

The principal applications for 8-azapurines have been found in cancer research and treatment, in oral medication for allergies (still at the clinical trial stage), antiviral research, and in phototechnology. 

Benadryl is an antihistamine that is available as an ointment to inhibit the itchy rash response to allergens. It is also available as an oral medication to block the symptoms of systemic allergies. You need only visit the "colds and allergies" aisle of your grocery store to find dozens of medications containing antihistamines. 

A 57-year-old African-American man presents to the clinic for follow-up management of UC. He has had left-sided disease for 3 years and has been maintained in remission on maximal doses of oral mesalamine and prednisone 35 mg orally once daily. His provider has attempted several times to taper the prednisone dose, but the patient experiences a reappearance of symptoms if the dose is lowered below this level. Medical history is also significant for hypertension and heart failure. He has no known drug allergies. 

A 22-year-old female college student with no remarkable medical history notes shortness of breath when she takes her daily 5-mile run, which has worsened progressively over the past 3 weeks. On review of systems, it is discovered that she has experienced intermittent sensations of chest tightness over the past 2 months that she ascribed to pollen allergies, and 3 days prior to presentation she experienced an episode of hemoptysis. Her only medication is oral contraceptives, and she reports no known drug allergies. A chest x-ray is remarkable for a 10 x 12 cm mediastinal mass. 

Prior to oral food challenges, patients should avoid the suspected food(s) for at least two weeks and discontinue antihistamines or long-term asthma medications (beta-agonists) according to their elimination half-life. They should be evaluated carefully, before the challenge, for the presence of any clinical symptoms (The Food Allergy and Anaphylaxis Network, 2005 Chapman et al 2006). 

Mucosal adjuvant and vaccine delivery system development is an area of importance for improving public health. Mucosal immunization can serve in the future in increasing mucosal immune function, induction of protective immunity against infections, and induction of tolerance or modifying autoimmune disorders, allergies, and autoimmune diseases. Development of oral vaccines would have large implications for rural and remote populations where access to trained medical staff to administer vaccines by injection can be lacking. 

Other prescription drugs commonly excluded from coverage include injectables administered by a clinician, anorexiants (appetite suppressants), smoking cessation products, fertility drugs, oral contraceptives, vitamins, prescriptions used for cosmetic purposes, allergy and biological sera, dental fluorides, and therapeutic or medical devices. 

Omalizumab is indicated for adults and adolescents older than 12 years of age with allergies and moderate to severe persistent asthma. In this population, it has proven to be effective in reducing the dependency on inhaled and oral corticosteroids and in decreasing the frequency of asthma exacerbations. Omalizumab is not an acute bron-chodilator and should not be used as a rescue medication or as a treatment of status asthmaticus. 

Hyland ME, Kenyon CAP, Allen R, Howarth P. Diary keeping in asthma comparison of written and electronic methods. Br Med J 1993 306 487 89 Kelloway JS, Wyatt RA, Adlis SA. Comparison of patients compliance with prescribed oral and inhaled asthma medications. Arch Intern Med 1994 154 1349-1352. Steiner JF, Fihn SD, Blair B, Inut TS. Appropriate reductions in compliance among well-controlled hypertensive patients. J Clin Epidemiol 1991 44 1361-1371. Chmelik F Doughty A. Objective measurements of compliance in asthma treatment. Ann Allergy 1994 73 527-532. 

---