Anti Inflammatory Medications - The Changing World Of Allergy Treatments: Allergies

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Anti-inflammatory medications

Anti-inflammatory medications

Painful tissue swelling due to inflammation is a major allergy symptom that causes allergy sufferers much misery. Left unchecked, the consequences of long-term inflammation can lead to permanent tissue damage. Anti-inflammatory medications, of which there are several kinds, are an essential component of successful allergy treatment.

Corticosteroids

Corticosteroids (steroids) are anti-inflammatory medications that dampen the inflammatory response that accompanies chronic allergic conditions. Steroids come in many forms — as sprays, inhalants, pills, topical creams and ointments, and injections. Long the mainstay of allergic rhinitis and asthma treatment, steroids are used on a daily basis to prevent or treat chronic allergic diseases.

Like antihistamines, steroids have been revamped. The newer nasal and inhaled steroids are more potent and less likely to be absorbed systemically. For example, it is estimated that only around 5% of mometasone (Nasonex) and 25% of fluticasone (Flonase) is absorbed by the body. In general, these types of steroids are effective and safe in the doses commonly prescribed.

By contrast, regular use of oral steroids — prednisone (Cortan, Deltasone, others) or methylprednisolone (Medrol), for example — can have potentially serious side effects, including thinning of the bones (osteoporosis), bruising, cataracts, diabetes, and suppression of normal adrenal function. Talk with your doctor about medications such as alendronate sodium (Fosamax) and risedronate sodium (Actonel), which can be taken to protect against bone loss.

Mast cell stabilizers

Mast cell stabilizers, such as cromolyn (Intal), nedocromil (Tilade), and lodoxamide (Alomide), are another type of anti-inflammatory medication. This class of medications is thought to interfere with the release of inflammatory chemicals from mast cells. Not as powerful as steroids, but lacking their side effects, mast cell stabilizers help in the treatment of mild allergic rhinitis or mild asthma when used on a regular basis. They can also help prevent acute allergic reactions — for example, when a cat-allergic person visits someone who has cats.

Bronchodilators

Beta-agonist bronchodilators: Used primarily to treat asthma, beta-agonist bronchodilators help relax the bronchial tube muscles to make breathing easier. They can be short-acting, such as albuterol (Proventil, Ventolin), or longer-acting, such as salmeterol (Serevent) and formoterol (Foradil). Short-acting beta-agonists provide quick relief of asthma symptoms. Long-acting beta-agonists should be used only with anti-inflammatory medicines, such as steroids, to prevent asthma attacks. Beta-agonist bronchodilators come as inhalants, pills, liquids, or injectables.

Theophylline: Theophylline is a bronchodilator primarily used in the treatment of asthma and chronic obstructive pulmonary disease (COPD). Because it is toxic in high doses, and because certain other medicines can increase its levels in the blood, patients taking theophylline should be monitored closely.

Anticholinergics: Anticholinergics, such as atropine, ipratropium (Atrovent), and the newer tiotropium (Spiriva), help alleviate smooth muscle contractions in COPD. However, they are generally not very effective for the treatment of asthma. Ipratropium is available as a nasal spray that can be helpful in treating non-allergic rhinitis.

Last updated:	August 21, 2006
Reviewed By:	Faculty of Harvard Medical School