Allergy IQ: Pet Allergy Triggers
Friday, February 22, 2008 at 07:12PM True or False?
1) It is okay to bring a cat or dog into your home as long as your skin test to them are negative.
2) Dust mite encasements are useless against cat and dog dander that infiltrates mattresses and pillows.
3) There is evidence that weekly cat or dog bathing may be helpful for pet allergy.
4) Hepa filters (High Efficiency Air Filters) are highly effective at reducing indoor allergy triggers including pet dander.
5) There are non-allergic cats and dogs available for allergy sufferers who desire these indoor pets.
Find the answers in the Answer Widget to the left.
Read my recent posting about pets and allergies on MyallergyNetwork.com :
http://www.healthcentral.com/allergy/c/3989/20697/pets-tough-love/
OTC- Zyrtec: A Few Things To Be Aware Of
Sunday, February 17, 2008 at 11:13PM OTC- (Over the Counter) Zyrtec / Zyrtec-D: Buyer Beware
By this time you have probably seen the ads for Zyrtec and Zyrtec-D (antihistamine plus decongestant).
Many of my patients are excited about the ability to get a very capable allergy medication without a prescription. I have mixed feeling about this. The good news is, patients and parents may purchase Zyrtec in its various formulations without the delay sometimes associated with required doctor’s office visits. This of course may also reduce expenses that go along with having to see a doctor for a prescription.
The bad news is, small quantities of Zyrtec tablets in many cases will cost more than before (when co-pays represented the total cost to the consumer). Patients and parents will be required to familiarize themselves with the potential side effects, special dosing information, drug interactions, precautions and contra-indications (situations where the drug should not be used). This means that the package insert should carefully be read.
Be Aware That:
-Zyrtec, unlike Loratadine (Claritin, Alavert, Walatin and others) is not non-sedating. It is considered low sedating which means that more than 10% of people in clinical trials complained of sedation or fatigue. This was much less significant in children.
-People over 65 years of age may be at higher risk of side effects if they have decreased kidney function (more common in the elderly).
-Dry mouth is a potential side effect as with many antihistamines.
-Zrytec-D contains a maximum dose (per 12 hour) of pseudoephedrine. People with high blood pressure or heart conditions should consult their doctor before taking this.
-Zyrtec-D may also impact other disorders such as narrow angle glaucoma, constipation, urinary retention and insomnia. Most of these factors are related to the decongestant component (pseudoephedrine).
-If you are on other prescribed or OTC drugs, or herbs, you should consult your doctor or pharmacist about possible drug interactions. Dangerous side effects may surface if the wrong combination of drugs (including herbs) are taken together or within the same day.
-If you are pregnant or breast feeding, you should consult your doctor about the safety of Zyrtec and its formulations in this setting.
-There are specific dosing recommendations based on age as well as whether a decongestant is a component of the drug. If you have other health problems the dose may need to be adjusted (or perhaps the medication avoided).
Bottom Line:
OTC- Zyrtec and Zyrtec-D is here and will be even more affordable as competitive pricing gets underway. The consumer must remember to read the patient information and ask questions if there are unclear points. Your doctor still plays an important role in managing your health as it relates to medications hence you should inform him or her about any OTC being taken.
Review my comments about the role of antihistamines (for example Zyrtec) and decongestants (example- pseudoephedrine) posted last year (Feb 18th 2007).
Your Quiz question for today:
True or False?
Zyrtec may cause drowsiness in some patients and should cautiously be used if operating heavy machinery or driving.
The answer is in the Answer Widget to the left. Press the link.
The New "HFA" Reliever Inhalers: Things You Should Know
Saturday, February 2, 2008 at 07:30PM Let’s talk about the new HFA inhalers for relieving asthma symptoms.
By now many of you are aware of the arrival of HFA inhalers that represent the new environmental friendly carriers for aerosol inhalers. Three new brands of albuterol are currently available as: ProAir HFA, Proventil HFA, and Ventolin HFA.
Xopenex HFA is a purified form of albuterol that has potentially fewer side effects and in some studies increased effectiveness compared to older brands of albuterol.
All of these inhalers are considered reliever, or rescue, inhalers and are indicated for the relief of asthma symptoms and prevention of exercise induced asthma. These inhalers have the same roles in asthma treatment and similar side effect profiles (although as stated Xopenex HFA may have fewer side effects than the others) but there are some differences between them you should be aware of.
ProAir HFA inhaler requires 3 priming sprays before taking the first puff. It is also recommended that 3 priming sprays be done again if the inhaler has not been used for more than 2 weeks.
The mouthpiece should be cleaned once weekly by running warm water through the top and bottom for 30 seconds (after removing the metal canister) and then shaking vigorously, to remove excess water, followed by air drying over night.
If ProAir HFA is required before drying is complete, you should spray a couple of sprays into the air (away from the face) before inhaling your puffs. Re-washing and drying again is recommended if you have to use it before fully dry.
Proventil HFA has similar patient instructions but 4 priming sprays are recommended. As well, if the inhaler is not used for more than 2 weeks, 4 sprays into the air (just like priming, spray away from the face) are again recommended.
The same washing instructions recommended for ProAir HFA are established for Proventil HFA.
Ventolin HFA requires 4 priming sprays before initial use and if not used for 2 weeks. Additionally, 4 priming sprays are advised if the inhaler is dropped. The makers of Ventolin HFA also recommend that the inhaler be stored with the mouthpiece down at all times.
Cleaning instructions for Ventolin HFA are the same as the above inhalers (once weekly). You are recommended to do 1 re-priming spray if you have to use the inhaler before it is completely dry (then re-wash and allow full drying as previously mentioned).
If you are on Xopenex HFA the above priming and cleaning instructions are similar but 4 sprays into the air for priming are recommended; 4 re-priming sprays are recommended if the inhaler has not been used for more than three days. Cleaning instructions (once weekly) are identical to ProAir HFA and Proventil HFA.
What about Maxair Autohaler?
Maxair Autohaler has a unique breath-actuated mouthpiece which makes it much easier to use. It does not have an available HFA associated brand. The makers of Maxair have been given additional time to adapt their product to an HFA form. The current brand (which is still available) has CFCs (chlorofluorocarbons) which has been associated with contributing to damage of the stratospheric ozone layer.
Maxair Autohaler requires 2 priming sprays when used for the first time and if not used for 48 hrs. The procedure for priming is unique and should be further reviewed in detail by reading the package insert (or going to the Maxair link below).
Cleaning this (Maxair) inhaler is also unique in that the metal canister should never removed. A cotton tipped swab is used to clean around the nozzle while holding the inhaler upside down (see package details or the link below).
All the above inhalers are forms of aerosols which should be shaken vigorously before using and require full exhalation (completely empty lungs first) before inhaling. Proventil HFA, ProAir HFA, Ventolin HFA and Xopenex HFA have 200 doses per canister.
Maxair Autohaler has 400 doses per canister.
Ventolin HFA is the only reliever inhaler that has a dose counter attached to the mouthpiece.
Important Point: The metal canisters in these inhalers should never be submerged in water or allowed to get wet (avoid letting them go through a washer or dryer cycle by being left in your pocket).
The costs of these inhalers vary depending on their own individual wholesale / retail cost and degree of insurance coverage (the latter being most important to the insured patient). No particular brand has any proven superior benefit in asthma treatment over another.
Correct inhalation technique, appropriate use (for relief of asthma symptoms or prevention of exercise induced asthma) and proper care and priming are important for achieving good results.
Remember!: Good asthma control is based on minimal need for reliever inhalers. Consult your doctor if you have increasing need for these inhalers (excluding puffs to prevent exercise related asthma), require them more than a couple of times per week or more than 2 times per month during sleep time.
See my earlier postings: “Are You A Failure With Your Inhaler”- March 1st 07’ & “Generic Albuterol and other Inhalers Soon to be Extinct”- March 8th 07’
www.ventolin.com/howtouse.html