Anti-inflammatories are “controller” medications that inhibit allergic reactions and reduce nasal swelling. They often are prescribed as a nasal spray when used to treat allergies. Some of the more popularly prescribed anti-inflammatories are corticosteroids, cromolyn sodium (a mast cell stabilizer) and nonsteroidal anti-inflammatory drugs (NSAIDs).

Corticosteroids are used to treat the most severe forms of allergic rhinitis, especially if antihistamines fail to provide relief. Corticosteroids decrease inflammation in nasal passages during an allergic reaction. These drugs are not the same as the anabolic steroids used by some athletes to enhance muscle size and strength.

Physicians are often reluctant to prescribe corticosteroids to children, for a number of reasons, including:

• Children and teenagers who take corticosteroids can experience slowed growth, particularly if the medication has been taken for a long period of time. This is due to the medications interference with the function of the adrenal gland.
  
  
• Corticosteroids have a range of side effects that tend to be more pronounced in children than in adults. These are rare, but may include:
• • Memory problems
  • Anxiety and depression
  • Hallucinations
    
    
• Children who are using corticosteroid drugs and contract certain infections (e.g., measles, chickenpox) may experience more severe infections. To avoid this, a physician may recommend vaccinations for some types of infection or suggest an alternative treatment, if appropriate.

Children may receive corticosteroids in nasal spray or inhaler form, but only when absolutely necessary. An injection of corticosteroids is often given to young children who have a hard time swallowing the foul-tasting liquid form of the medication. Some children vomit after taking the liquid form. The effectiveness of a corticosteroid injection is comparable to the liquid form. Examples of corticosteroids given to children include:

Patients who are nearing the end of systemic corticosteroid therapies must gradually taper off the drug to allow the adrenal glands to resume their normal rate of cortisol (a steroid hormone) production. Symptoms that can occur during this transition period include fatigue, weakness, depression and muscle and joint pain.

Cromolyn sodium is a type of mast cell stabilizer commonly prescribed in nasal spray, oral or inhaled forms for the treatment of allergies and asthma. These medications prevent mast cells from bursting and releasing histamine and other chemicals that cause the symptoms of an allergic reaction. Cromolyn sodium is not as effective as corticosteroids in treating severe allergies. However, it is considered extremely safe. It is often prescribed to treat less severe allergies in children as young as 2 because it has very few side effects.

Some forms of cromolyn sodium and their safe age of use include:

• Cromolyn (inhalation) solution has been safely tested in children as young as 2, and the cromolyn inhalation aerosol has been tested in children as young as 5.
  
  
• Cromolyn (nasal spray) has been safely tested in children as young as 6.
  
  
• Cromolyn (oral) has not been thoroughly tested in young children, though it is frequently used in children as young as 2, and can be used to treat children younger than 2 in severe cases.

Depending on the judgment of the physician, mast cell stabilizers can be prescribed to children younger than the ages indicated. This class of drugs is often more suited to use in young patients because of the mild and relatively low number of side effects associated with their use. Cromolyn sodium medications include:

Non-steroidal anti-inflammatory drugs (NSAIDs) are medications commonly used to reduce pain and inflammation. While these drugs are often the first choice for treating pain and inflammation, they should be used with caution for people with asthma, since they can trigger an asthma attack in susceptible individuals.