The Epidemiology of Allergies

Elsa Sosa

The epidemiology of allergies.

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Since the industrial revolution, there has been increased in allergic responses among individuals globally. For example, more than 7% of the adult population in the United States is a victim of allergies such as allergic rhinitis (Woo & Robison, 2015). Common environmental conditions such as the house dust, mite, grass and cat have created an enabling environment for allegers in various communities. Like the current, being allergic is associated with eczema, fever and asthma and other respiratory complications. Asthma is considered one of the most severe allegoric complications that affect more than ten thousand adults in the United Kingdom, the United States and Wales. As of the year 2012, more than sixteen million people were diagnosed with hay fever, while more than six million children experienced chronic symptoms of hay fever (Woo & Robison, 2015). Research indicates that children with fairer skin are more likely to have experienced hay fever than children with dark skin; thus, the concept of ethnicity and the prevalence of allergies cannot be ruled out. Drug allergy is common, and it is believed to affect one person out of then people worldwide. Some people are also allergic to food, and it is estimated that 3.5-4% of the United States’ population exhibit IgE-mediated food complications.

 

What are your treatment options (consider pharmacoeconomic)?

 

As per the case study, the patient requires oral antihistamines to relieve the effects o itching, watery eyes or a runny nose. Some of the antihistamines are Claritin, Alavert and fexofenadine. Use of decongestants such as pseudoephedrine, is critical in enabling the patient attains temporary relief from nasal stuffiness (Woo & Robison, 2015). Use of Cromolyn sodium nasal spray is critical in easing the allergy symptoms since it is not associated with any side effects. Combination of medications such as antihistamine and decongestant is of great value in alleviating the pain caused by exposure to allergic substances.

 

Compare first and second-generation antihistamines.

 

First-generation antihistamines block the histaminic and muscarinic receptors (Lee et al., 2017). On the other hand, second-generation antihistamine blocks histaminic receptors mainly, and they cannot pass the blood-brain barrier. Second-generation antihistamines offer advantages such as not associated with CNS and cholinergic effects such as the dry mouth. The longer duration of second-generation antihistamines enables the patient-friendly dosing translating to increased patient compliance to drugs (Lee et al., 2017). These advantages are not common in the first-generation antihistamine. First-generation antihistamines are small lipophilic molecules commonly known for adverse health effects due to their ability to cross the brain-blood barrier (Lee et al., 2017). Generally, second-generation antihistamines are highly preferred over first-

generation antihistamines.

 

What education will you provide to the patient?

 

The patient should consider staying indoors on dry and windy days to reduce the chances

of being exposed to pollen grains and other allergic substances. He should consider removing the

clothes worn outside and take a shower to remove allergic substances from the body. If the

patient is engaging in outside chores, it is prudent to wear a pollen mask to prevent coming into

contact with pollen grains. He should delegate lawn mowing and other outside gardening roles

and responsibilities that stir up allergens.

 

 

Lee, Y. M., Song, I., Lee, E. K., & Shin, J. Y. (2017). Comparison of first- and second-

generation antihistamine prescribing in elderly outpatients: A health insurance database study

in 2013. International journal of clinical pharmacology and therapeutics, 55(10), 781–790.

https://doi.org/10.5414/CP203072

Woo, T.M. & Robison, M.V. (2015). Pharmacotherapeutics for Advanced Practice Nurse

Prescribers. Publisher: F.A. Davis Company, 4 th edition. ISBN-13: 978-0803638273

Orestes V. Sacerio Garcia

 

The epidemiology of allergy is related to atopic which is defined as the production of specific IgE in response to exposure to common environmental allergens, such as house dust mite, grass, and cat. Being atopic is strongly associated with allergic disease such as asthma, hay fever, and eczema, but not everyone with atopy develops clinical manifestations of allergy and not everyone with a clinical syndrome compatible with allergic disease can be shown to be atopic when tested for specific IgE to a wide range of environmental allergens.

 

Approximately 20% of Americans suffer from some form of allergic disease. The sequelae of inhalant and food allergies may present in many organ systems. The hygiene hypothesis, which suggests a link between hygienic standards and reduced exposure to microbial substances during childhood, may partially explain this observation. The prevalence of sensitivity to at least one allergen in school-aged children continues to rise and is approaching 50%. There are several different types of allergies that are relevant when discussing the epidemiology of allergies disease. These include allergic rhinitis, drug allergy and food allergies.

When your body comes into contact with whatever your allergy triggers is pollen, ragweed, pet dander, or dust mites, for example it makes chemicals called histamines. They cause the tissue in your nose to swell (making it stuffy), your nose and eyes to run, and your eyes, nose, and sometimes mouth to itch. Sometimes you may also get an itchy rash on your skin, called hives.

 

Histamine is a biologically active substance that potentiates the inflammatory and immune responses of the body, regulates physiological function in the gut, and acts as a neurotransmitter. Antihistamines are drugs that antagonize these effects by blocking or inhibiting histamine receptors (H receptors), and they are categorized as either H1 or H2 according to the type of H receptor targeted. H1 antihistamines are mostly used to treat allergic reactions and mast cell-mediated disorders. This subtype is further divided into two generations. While first-generation H1 antihistamines have a central effect and, thus, are also used as sedatives, second-generation H1 antihistamines have less central effects and are primarily used as antiallergic drugs. H2 antihistamines are indicated primarily for gastric reflux disease because they reduce the production of stomach acid by reversibly blocking the H2 histamine receptors in the parietal cells of the gastric mucosa. Most H1 and H2 antihistamines are contraindicated during pregnancy and childhood. First-generation H1 antihistamines are specifically contraindicated in angle-closure glaucoma and pyloric stenosis.

 

These medicines work well to relieve symptoms of different types of allergies, including seasonal (hay fever), indoor, and food allergies. Between the most used prescription antihistamines include: Azelastine eyedrops (Optivar), Azelastine nasal sprays (Astelin, Astepro), Hydroxyzine (Atarax, Vistaril). The OTC antihistamines include: Cetirizine (Zyrtec), Diphenhydramine (Benadryl), Fexofenadine (Allegra), Loratadine (Alavert, Claritin).

 

The main point of education for this patient is to reduce your exposure to allergy triggers to reduce your exposure to the things that trigger your allergy signs and symptoms (allergens): Stay indoors on dry, windy days. The best time to go outside is after a good rain, which helps clear pollen from the air. Delegate lawn mowing, weed pulling and other gardening chores that stir up allergens. Remove clothes you’ve worn outside and shower to rinse pollen from your skin and hair. Don’t hang laundry outside pollen can stick to sheets and towels. Wear a pollen mask if you do outside chores.

 

References

Allergies – Symptoms and causes. Retrieved 16 June 2020, from https://www.mayoclinic.org/diseases-conditions/allergies/symptoms-causes/syc-20351497

Antihistamines – Knowledge for medical students and physicians. Retrieved 16 June 2020, from https://www.amboss.com/us/knowledge/Antihistamines#:~:text=While%20first%2Dgeneration%

 

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