Managing Seasonal Allergies

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Deeper Dive Horizons

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Jul 08, 2024

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Colorado - Denver Metro

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How Seniors can manage seasonal allergies


  

Seasonal allergies can affect seniors just like people of any age. Older adults may experience symptoms such as sneezing, runny nose, and itchy eyes due to allergens like pollen and dust. While some seniors may experience a decrease in seasonal allergies as they age, others may find their allergies worsening with time. It is important for seniors to manage their allergies effectively to avoid discomfort and potential health concerns. As seniors age, their immune systems may become less effective at fighting off allergic reactions, making them more susceptible to mild symptoms triggered by allergens such as pollen. Here are a few common Over-the-counter medications that you can use to manage seasonal allergies: 


Nasal steroids: These include Flonase (generic is fluticasone), and Nasacort (generic is triamcinolone). These medications are generally considered the first-line treatments for allergies. Doctors and pharmacists prefer these treatments for moderate to severe or persistent allergy symptoms. These treatments are also beneficial for itchy, irritated or watery eyes as well as nasal congestion.

2ndgeneration Antihistamines: These medications which include Claritin (generic is loratadine), Allegra (generic is fexofenadine) and Zyrtec (generic is cetirizine) are good for milder allergy symptoms, or those symptoms that occur occasionally. It is very important that seniors stick with the 2nd generation antihistamines and AVOID Benadryl (generic is diphenhydramine) or Chlor-Trimeton (generic is chlorpheniramine). Antihistamines such as Benadryl can cause excessive sedation, worsen glaucoma, and promote increased fall risk in elderly patients. Therefore, it is best to avoid Benadryland Chlor-Trimeton when you get older.


Nasal Antihistamines: These include brands Astepro and Astelin, and these medications are considered add-ons to nasal steroids. If you are still suffering from allergy symptoms while on a nasal steroid, these may provide additional help.


Ophthalmic antihistamines: For those with watery or itchy eyes, in which nasal steroids are not quite enough, medications such as Zaditor (generic ketotifen) or Pataday (generic olopatadine) are eye drops that can provide additional benefit.


Lastly for uncontrolled nasal congestion one can consider nasal decongestant medications such as Afrin (generic is oxymetazoline). Realize there are some warnings with these medications. They can cause rebound nasal congestion if used for 3 days or more. Reserve this medication for nasal congestion that does not respond to nasal steroids, or for the occasional nasal stuffiness. If you have uncontrolled high blood pressure, avoid this medication.


The management of seasonal allergies includes nonpharmacologic and pharmacologic approaches. Nonpharmacologic measures include nasal irrigation and allergen avoidance (e.g., keeping windows closed, using window screen filters and air conditioning, limiting outdoor time during peak allergen season, showering after outdoor exposure). Choose a medication based on severity of symptoms, patient age, other medical conditions, and preferences.  Immunotherapy (subcutaneous or sublingual) can be considered if other management is not adequate or if the patient has seasonal allergies in combination with asthma. Alternative therapies (e.g., supplements, homeopathy, and acupuncture) have been used and promoted for seasonal allergies; however, there are insufficient data to recommend these therapies.

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Seniors can help manage their seasonal allergies by incorporating an immunity-boosting diet that includes foods like apples, strawberries, ginger, leafy vegetables, walnuts, and fatty fish. It is crucial for caregivers of seniors to be aware of how seasonal allergies can impact older adults and provide the necessary care and support.If you are a senior or a caregiver of a senior experiencing seasonal allergies, it is recommended to seek guidance from healthcare professionals on how to effectively manage and alleviate allergy symptoms. Implementing strategies to minimize exposure to allergens and incorporating healthy lifestyle habits can significantly improve the quality of life for seniors dealing with seasonal allergies.

As we grow older, our body changes and so does our immune system. Just as we no longer run as fast as we once did, we may lose our tolerance to potential allergens, from pollen to dog hair. And, on the flip side, we may build immunities to the things that once bothered us, research shows.

  

Nasal antihistamines

See a comparison of nasal sprays for allergic rhinitis later in the document.

Add-on therapy with nasal steroids, if needed (especially for nasal congestion).1,3,8

Under two years (Astepro [US]) or under five   years (Astelin [US]).9

Under six years (olopatadine).9

Neither available as single-ingredient nasal sprays in Canada.

 

Ophthalmic antihistamines

Add-on therapy for eye symptoms with nasal steroids, if needed.1

Under three years (ketotifen, olopatadine [Canada]).9,15,16

Under two years (olopatadine [US]).9

 

Decongestants (intranasal, oral)

Inadequate response from a nasal steroid for nasal   congestion.2

Use in combination with an oral antihistamine  (intranasal).3

Intermittent nasal congestion.2


Hypertension, arrhythmia, coronary heart disease, hyperthyroidism, glaucoma, diabetes, and benign prostatic hypertrophy (oral).2

Prolonged use (more than three to five days) (intranasal).2,3

With monoamine oxidase inhibitors.6Monotherapy (intranasal).6

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