Test Your Knowledge

There are many different nasal sprays that can be used to treat various symptoms related to nasal allergies. These include:

• Antihistamine nasal sprays. These medications prevent histamine from attaching to special receptors on cells, thus short-circuiting an allergic reaction. Antihistamines can be used to treat symptoms of sneezing, and runny and itchy nose. They are also effective in treating some eye symptoms. Antihistamine nasal sprays include:
  
• • Azelastine hydrochloride (Astelin) – Prescription reliever
    
    

  

  
  
• Anticholinergic nasal sprays. These block the effects of the chemical acetylcholine, which the body uses to signal the mucous glands to produce mucus. This makes anticholinergic sprays a good treatment for a persistent runny nose. Traditionally prescribed in pill form, anticholinergic nasal sprays are now available. Anticholinergic nasal sprays include:
  
• • Ipratropium bromide (Atrovent Nasal Spray) – Prescription reliever
    
    
• Decongestant nasal sprays. These reduce nasal congestion by narrowing the blood vessels in the membranes lining the nose. This causes a corresponding drop in swelling, inflammation and mucus production. Patients should not use these drugs for more than three to five consecutive days. Use of nasal sprays for longer periods can result in “rebound congestion,” which causes symptoms to get worse instead of better. Decongestants include:
  
• • Oxymetazoline (Afrin 12 Hour, Nostrilla) – Over-the-counter (OTC) reliever
    
    
  • Phenylephrine (Neo-Synephrine, Vicks Sinex 12 Hour) – OTC reliever
    
    
  • Tetrahydrolazine (Tyzine) – Prescription reliever
    
    
• Corticosteroid nasal sprays. Over the past two decades, these anti-inflammatory medications have become an important tool in preventing seasonal and perennial allergic rhinitis (hay fever). They mimic the body’s hormones, boosting the level of steroids in the body. This helps shrink inflamed tissue and reduce mucus flow.
  
  The latest versions of corticosteroids work best when the patient takes them just prior to the start of allergy season, or at the first sign of symptoms. Most are effective when used once daily and display few side effects over long periods of use. However, physicians often are reluctant to prescribe these drugs to children because there is some evidence that they may slow child growth rates, at least temporarily. The medication must be taken even when the patient is not suffering symptoms. Steroid nasal sprays include:
  
• • Beclomethasone dipropionate (Beconase AQ, Vancenase AQ) – Prescription controller
    
    
  • Budesonide (Rhinocort AQUA) - Prescription controller
    
    
  • Ciclesonide (Omnaris) – Prescription controller
    
    
  • Flunisolide (Nasalide and Nasarel) – Prescription controller
    
    
  • Fluticasone (Flonase) – Prescription controller
    
    
  • Mometasone (Nasonex) – Prescription controller
    
    
  • Triamcinolone acetonide (Nasacort AQ) – Prescription controller
    
    
• Cromolyn sodium sprays. These non-steroid drugs stabilize mast cells and prevent them from releasing histamine and other chemicals that trigger hay fever symptoms. The advantage of cromolyn sodium is that it produces almost no side effects and is considered safe for young children and pregnant and breastfeeding women. The disadvantage is that patients must use it four to six times a day beginning one to four weeks before allergy season begins. Examples of cromolyn sodium sprays include:
  
• • NasalCrom – OTC controller and reliever
    
    
• Normal saline. Saline nasal sprays can moisten dry nasal membranes, clear debris from the nasal passageway and improve mucous membrane function. Saline may also be used as a sinus wash or irrigation solution. These solutions are available in pharmacies, or a homemade solution can be made and used by taking the following steps:
  
• • Add ¼ teaspoon of non-iodized salt, ¼ teaspoon baking soda and 8 ounces of warm water (distilled or filtered) and stir thoroughly.
    
    
  • Using a dropper, squirt a half-dropper of the solution into each nostril in the morning and at night.
    
    
  • Repeat daily and wait for one to two weeks before looking for results.