Antihistamines

Antihistamines

Between 15% and 25% of the population around the world suffers from periodic allergic rhinitis. It can be occasionally annoying or severe enough to affect the quality of life. Antihistamines are the primary medication used to treat this and other forms of allergy.1

The older types of these medications, the first-generation antihistamines, are sedating. For that reason, they tend to be used more often as sleeping pills. Indeed, some 12% of those over age 65 take such medications for insomnia. This is concerning since over-the-counter sleep medications with the antihistamines diphenhydramine (Benadryl) and doxylamine (Unisom) are on the Beers List – medications to be avoided in those over age 65 because they can cause difficulty with thinking, problems with coordination, can worsen kidney or liver insufficiency, and lead to dizziness and falls. They are a common source of drug interactions including with some antidepressants and cardiac medications.2

Antihistamines are one of the most commonly prescribed drugs for children. Per a Cochrane Review (medical studies that are well-known for their scientific analysis and for thoroughness), the effectiveness of antihistamines for treating nonspecific cough in children is not certain. Also, children are more susceptible to antihistamine adverse effects, including sedation as well as paradoxical agitation and excitability.3   Topical antihistamines should be avoided in children

Some people also take antihistamines for their cold symptoms. While the older, first generation antihistamines may dry secretions, they can thicken the mucus excessively so that it is harder to cough them up.3

     Antihistamines are effective in the treatment of allergic rhinitis and chronic urticaria. For chronic allergy symptoms, regular use of an antihistamine is probably more effective than taking them only as needed. Allergic conjunctivitis is probably better treated with antihistamine eye medications. Antihistamine effects vary from person to person so if one type doesn’t help, another may. 4, 5

First generation antihistamines are not recommended because they can cause sedation as well as difficulty thinking. These medications should be avoided not only in those over 65 years of age, but also those with glaucoma, constipation, dementia, or benign prostate enlargement. Second generation antihistamines are much less likely to cause sleepiness but it can have this effect in some, especially in higher doses.5

Because many types of antihistamines are sold without a prescription, it is essential to discuss any use of them with your pharmacist so that they can determine if there are any interactions with your prescriptions. And remember, it is far superior to try to determine what is causing an allergic reaction and make every effort to eliminate exposure to such.

This article is not intended to replace your health care provider. The intent is to make important information about medications available.

References

1D. Passali, et al, “The International Study of the Allergic Rhinitis Survey:  outcomes from 4 geographic regions,” Asia Pacific Allergy, January, 2018; 8 (1): e7.

2O. Abraham, et al, “Over-the-Counter medications containing diphenhydramine and doxylamine used by older adults to improve sleep.” International Journal of Clinical Pharmacy 297; 39(4) 808-817.

3J. Van Schoor, Antihistamines:  A brief review, Professional Nursing Today, 2012: 16(5).

4Dr. Koop’s Self-Care Advisor. Time Life Medical Books, 1996.

5The Merck Manual, 19th edition. Whitehouse, New Jersey:  Merck, Sharp and Dohme, 2011.

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Garlic and Onions and Leeks, Oh my!

Garlic and Onions and Leeks, Oh my!

It isn’t fair to stereotype these wonderful foods as doing nothing more that causing bad breath. There is so much more to these foods than that. Oh, there are more beautiful and more tasty foods out there, but do they really deliver the nutrients as well as this root-based vegetable family? With 1,200 onion varieties in the world, I guess it isn’t such a small family.

Onions are especially valued for their quercetin. This is a powerful antioxidant, rendering harmful compounds unable to cause their damage to human cells. This is why they help our body fight cancer. Quercetin has also been found helpful in lessening allergy symptoms. Onions possess other nutrients such as vitamin C, B6, potassium and manganese.

Research has also uncovered that onions may help alleviate the symptoms of upper respiratory infections. Lowering the risk of osteoporosis is another possible benefit from onions. If the strong flavor of onions decreases your intake of onions, you’ll be relieved to learn that cooking does not affect the flavonoid (including quercetin) or phenol compounds in these wonderful vegetables.

Leeks are related to onions and wonderful too. They are also high in the flavonoids quercetin and kaempferol, making them good antioxidant additions to the diet. They are also high in vitamin C and K, as well as manganese.

Garlic is just plain a superstar. It too is high in manganese, and a good source of vitamin C and vitamin B6. It also contains phytochemicals (chemicals that come from plants) and some of the benefits aren’t available until the garlic is crushed and allowed to sit for ten minutes before being eaten. Garlic also has strong antimicrobial properties, helping to kill bacteria, viruses and even fungi and parasites! Its anti-inflammatory effect makes it a potential aid in treating asthma and allergies. As if that isn’t enough, it can help lower blood pressure and decrease blood clot formation.

All three of these root vegetables (or are they herbs?) have been linked to cholesterol lowering as well. If you add that to the other vitamins in them, and consider their very low calorie content, surely they’ll start to look pretty beautiful. If you like to garden, all three are easy to grow as well. Enjoy these white roots and add all three to your diet on a regular basis.

References:  Tonia Reinhard, Super Foods, the Healthiest Foods on the Planet, 2nd edition. New York:  Firefly Books, 2014.

Dr. Don Colbert, Eat this and Live!  Lake Mary, FL:  Siloam, A Strang Company, 2009.

This information is not intended to replace the care of your Primary Care Provider.