In addition to the intervention in the allergy-inducing mechanisms, the treatment of pollen allergy in the administration of medication to eliminate or relieve the symptoms. For this purpose, antihistamines, mast cell stabilizers such as disodium cromoglycate (trade name: Intal ) and nedocromil (trade name: Tilade), as well as inhalable and nasal steroids (cortisone) are available.
When administered early, the administration of antihistamines may prevent the onset of allergic asthma as a complication of long-standing hay fever disease.
The best-known antiallergic drugs from this group of antihistamines can be divided into two groups, each of which has a different profile of side effects.
To the first group (medical: Antihistaminika of the 1.Generation, whose development took place at the beginning of the 1960er years) count
However, since these substances are also effective in the brain, they have considerable sedative properties, so that newer drugs have been developed.
Dimetinden and clemastine (trade name: Tavegil) are still used for the treatment of allergic complaints, taking advantage of their local anesthetic (anesthetic) effect to combat severe itching; Doxylamine and diphenhydramine are available without prescription sleep aids (medically: hypnotics).
Diphenhydramine also acts to block the histamine receptors located in the brain's vomiting center and is therefore used as an antiemetic (against nausea).
Examples of newer, barely or not at all sedating or anti-emetic antihistamines (medically: 2nd generation antihistamines) are:
These do not reach the brain via the blood-brain barrier because they are bound to the blood's proteins. As charged particles, they are no longer able to overcome the membranes, which are predominantly made up of fat-soluble, uncharged particles.
The antihistamine fexofenadine (trade name: Telfast) is based on another mechanism for the lack of sedative properties: it enters the brain, but it is immediately detected by an enzyme that due to this very property of transporting different drugs out of the brain again was to be removed.
The enzyme is accordingly called a "multi-drug-resistance" transporter -also as a transport protein responsible for the inefficiency of several drugs (medical name of the enzyme: P -glycoprotein 450).
Undesirable side effects of antihistamines may occur (in addition to the already mentioned, in recent drugs extremely low or no sedation) in the form of loss of appetite, nausea and diarrhea (medical: diarrhea), but are rare.
No less important in the treatment of pollen allergy as the antihistamines to the mast cell stabilizers, since they are both preventive (medical: for prophylaxis) and for long-term therapy
It should be noted, however, that the full effectiveness only occurs with a delay of one to two weeks.
For the mast cell stabilizer disodium chromoglycate, various types of intake are available for local application:
It is available as a nasal spray, as an eye-drop and as an inhalable aerosol. In food allergies, the drug can also be taken as a capsule or as a granular powder (called granules).
Nedocromil is preferred for the treatment of asthmatic complaints as it has anti-inflammatory effects in the large lower respiratory tract (bronchi) and also reduces the tendency of the bronchial tubes, which contract in allergic asthma, to contract in contact with pollen (or other allergens) : Nedocromil causes a reduction of bronchial hyperreactivity).
The side effects of these two mast cell stabilizers are low, as they only act on the spot and enter the systemic circulation only to very small proportions. This is due to their high fat solubility.
Furthermore, topically administered steroids (cortisone), which are taken by inhalation, are of great importance in the treatment of asthma; their mechanism of action lies in the reduction of the formation of new inflammatory messengers and cell-damaging enzymes.
Steroids (cortisone) are among the most effective anti-inflammatory drugs ever; However, the price for this is significantly more unwanted side effects, the strength of which depend on the dose administered, the type of administration and the duration of use.
Although the following side effects are known after long-term use of steroids as a tablet (ie oral) or intravenously, they are virtually never seen with inhalation or with cortisone nasal spray, since the uptake in the systemic circulation is negligible and the steroids only act locally:
Examples of inhaled steroids are:
A common over-the-counter remedy for hay fever is cetirizine. This is used in a variety of allergies. Cetirizine is the active ingredient that can be purchased under different trade names in the pharmacy.
In addition to cetirizine, drugs containing loratadine for the treatment of hay fever can also be used.
Another medicine is azelastine. This is often applied in the form of eye drops.
Cromoglycic acid and levocabastine are also used in various eye or nasal sprays for therapy.
All medications listed in this paragraph belong to the group of antihistamines. Histamine is a messenger in the body that mediates allergic reactions. Antihistamines prevent this. They can be used as tablets, eye or nose sprays.
A prescription drug from the group of antihistamines or antiallergic drugs is
However, medicines that contain glucocorticoids can also cause many side effects. Therefore, these medications are available by prescription. Some sprays combine an antihistamine and a glucocorticoid. These medications are also available by prescription.
For the causal treatment, a specific immunotherapy can be carried out for several years. Here, the controlled administration of the allergen with increasing dosage. Immunotherapy must be supervised or regularly monitored by a physician.
The medicines for hay fever are the group of antihistamines. At the same time, the antihistamines of the second generation, ie the advanced generation, are much less tired than those of the first generation.
However, some people may still be tired when taking it. However, this often disappears during the course of therapy. This is because the second-generation drugs barely cross the blood-brain barrier and thus have very little effect on brain cells.
The second generation antihistamines include drugs with the following active ingredients
Also the prescription drugs
belong to this group and hardly cause fatigue.
Recent developments in the drug treatment of allergies include a protein molecule directed specifically against IgE antibodies (ie, an antibody to IgE antibodies); the omalizumab (trade name: Xolair®). It should already prevent the development of allergies and is used primarily in the treatment of allergic asthma.