Seasonal changes often herald an array of allergens and sensitivities that affect many individuals.
Seasonal changes often herald an array of allergens and sensitivities that affect many individuals.
Pollen, mold, dust mites, and pet dander can lead to a spectrum of symptoms ranging from mild discomfort to severe respiratory issues. In South Africa, the impact of seasonal allergens varies by region and climate. Physicians should be vigilant for common symptoms including nasal congestion, sneezing, itchy and watery eyes, runny nose, coughing, wheezing, skin rashes or hives, and shortness of breath.
Treatment options
The pharmacological management of allergic rhinitis (AR) focuses on symptomatic relief through various medication classes. Over-the-counter antihistamines, decongestants, and nasal sprays can provide symptomatic relief. Recommend specific medications based on patient history and symptoms.
First-generation antihistamines are no longer recommended due to their central nervous system side effects and potential cardiac toxicity. Newer-generation antihistamines such as cetirizine, loratadine, and desloratadine are preferred due to their improved efficacy and safety profiles. Oral and nasal corticosteroids are used to reduce inflammation and provide relief from nasal congestion and other symptoms. Nasal decongestants provide temporary relief from nasal congestion but should be used cautiously to avoid rebound congestion. Leukotriene receptor antagonists help to block the inflammatory action of leukotrienes, which are substances in the body that contribute to allergic reactions. Intranasal antihistamines such as olopatadine, levocabastine, and azelastine deliver medication directly to the nasal mucosa, providing targeted relief from nasal symptoms.
Combination therapy
The combination of montelukast (a leukotriene receptor antagonist) and levocetirizine (a newer generation antihistamine) has proven to be an effective treatment option for AR. This combination therapy not only provides enhanced symptomatic relief but also significantly improves the quality of life for patients with AR. For persistent or severe symptoms, refer patients to an allergist or immunologist for a comprehensive evaluation and personalised treatment plan. Immunotherapy may be beneficial for patients with severe allergies, helping to desensitise the immune system over time. Verify coverage under medical schemes to manage patient costs effectively.
Conclusion
Managing allergies and sensitivities during seasonal changes requires a proactive and informed approach. Encourage patients to stay informed, implement allergy proofing techniques, and seek professional guidance to improve their quality of life. By understanding potential triggers and employing effective management strategies, physicians can help patients navigate seasonal challenges more comfortably.
References available on request.
