Tips For Seasonal Allergy Management

EBP Guidelines, Immunology, Podcast, Pulmonology 2

Asthma and Allergy Awareness Month

Click play above to hear this 21 minute audio podcast.

What Are Allergies?

Allergies occur when the body’s immune system identifies exposure to a substance as harmful. The immune system produces an allergic response releasing histamine and inflammatory mediators from mast cells within the body. There are many different types of allergies, depending upon the trigger and time of year: drug allergies, food allergies, latex allergies, insect allergies, skin and eye allergies, and lastly indoor and outdoor allergies. Indoor and outdoor allergies are also referred to as hay fever, seasonal, perennial or nasal allergies.

Allergy Symptoms

Symptoms of allergies vary with each individual’s genetics and allergen exposure, but almost always includes itching. Symptoms can include:

Allergic Conjunctivitis – causing the eyes to itch, become red, produce clear tearing
Allergic Rhinitis – nasal and/or sinus itching, sneezing, nasal congestion, and rhinorrhea (runny nose)
Urticaria – skin itching and red patches (hives)
Asthma – coughing, wheezing and difficulty breathing

The Nurse Practitioner Show Podcast Episode 013 Seasonal Allergy Management | Learn Tips For Dealing With Seasonal Allergies with Dr Rachel Silva DNP of Accessible Healthcare Institute LLC
Access Your Free 11 Page Resource Guide for Managing Seasonal Allergies

Strategies to Prevent and Manage Indoor and Outdoor Allergies

1. USE PREVENTION STRATEGIES

✓ Avoid Outdoor Allergen Triggers

  • Pollen from trees, grass, weeds
  • Mold
  • Pet dander from animals
  • Keep windows and doors closed during allergy season to prevent entrance of allergens into the home

   ✓ Avoid Indoor Allergen Triggers

  • Prioritize maintaining bedroom allergen-free, as much as possible
  • Indoor humidity should be less than 40%
  • Keep windows and doors closed during allergy season to prevent entrance of allergens into the home
  • Change air conditioner and vacuum filters
  • Weekly vacuuming and dusting
  • Utilize allergen-impermeable covers for mattress and pillows
  •  Dry clothes via clothes dryer rather than drying outside in the air exposed to allergens
  • Wear long-sleeves and mask when outside performing yard work
  • May need to remove carpeting in home with severe symptoms
  • Once home, immediately bathe and change clothes to reduce exposure to allergens

   ✓ Be Informed of Pollen Counts

✓ Preventive Pharmacological Therapy

  • Intranasal Corticoteroid (see below)
  • Leukotriene Modifier
    • Montelukast (Singulair) or zafirlukast (Accolate)
  • Mast Cell Stabilizer
    • Intranasal and optic cromolyn (NasalCrom)
2. THERAPEUTIC MODALITIES FOR SEASONAL ALLERGY MANAGEMENT

✓ Use preservative-free artificial tears
✓ Sunglasses for photosensitivity
✓ Rescue Pharmacological Therapy:

☞ First line therapeutic options-

  • Intranasal corticosteroids (most effective) notes: slow onset of therapeutic benefit, warn patients they may not see effects for 2 weeks, but is most effective choice.
    • Fluticasone propionate (Flonase)
    • Mometasone furoate (Nasonex)
    • Triamcinolone (Nasacort AQ)
    • Beclomethasone (Beconase AQ)
  • Second generation oral antihistamines
    • Cetirizine (Zyrtec) notes: children may take as recommended by their healthcare provider, may need to give a night due to sedation side effect, can interact with alcohol and other central nervous system depressants, causes dry mouth
    • Desloratadine (Clarinex)
    • Fexofenadine (Allegra) notes: avoid aluminum or magnesium-containing antacids
    • Loratadine (Claritin)
  • Intranasal antihistamines or anticholinergic sprays (not recommend for children less than 6 years of age)tominimize nasal discharge
    • Azelastine (Astelin) antihistamine
    • Olopatadine (Patanase) antihistamine
    • Ipratropium bromide (Atrovent) anticholinergic

☞ Decongestants (avoid in patient with cardiac, hypertension, stroke, bladder neck obstruction, glaucoma and
hyperthyroidism) to minimize nasal congestion

  1. Oral Pseudoephedrine (Sudafed) or phenylephrine (Sudafed PE)
  2. Intranasal Afrin should not be used more than 3 days to prevent rebound congestion

☞✗ First generation antihistamines are not first line options due to sedation side effects: diphenhydramine
(Benadryl), chlorpheniramine (Chlor-Trimeton), and hydroxyzine (Atarax)

3. DISCOVER HELPFUL RESOURCES

✓ Our resource page at Accessible Healthcare Institute’s Library
American Academy of Allergy, Asthma and Immunology (National Allergy Bureau)
Asthma and Allergy Foundation of America

4. FOLLOW-UP WITH YOUR HEALTHCARE PROVIDER

Follow up with your healthcare provider to determine the best controller therapy and rescue therapy options for you. Healthcare providers can refer to the American Academy of Family Physicians and the ARIA Classification and Guidelines. I highly recommend Dr. Margaret Fitzgerald’s book Nurse Practitioner: Certification Examination and Practice Preparation, it has excellent samples of guidelines on page 98.

The Nurse Practitioner Show Podcast Episode 013 Seasonal Allergy Management | Learn Tips For Treating Seasonal Allergies with Dr Rachel Silva DNP of Accessible Healthcare Institute LLC
Access Free 11 Page PDF Guide on Managing Seasonal Allergies

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