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Hay fever

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Mad Professor
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Hay fever

Post by Mad Professor » Fri Apr 28, 2017 10:25 pm

dr_john wrote: Fri Apr 28, 2017 3:29 pm I'll look into Piriton then, thanks for the tip.

Strange that a couple of you have found relief with age, just the opposite with me.
If youre going to take piriton [chlorphenamine ] then my advice is def dont drive as its one of the older 1st gen sedative type antihistamines and only has a short duration of action cf to the 2nd gen non sedating drugs like cetirizine ,loratadine and fexofenadine
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Hay fever

Post by NickDE » Fri Apr 28, 2017 10:37 pm

Mad Professor wrote: Fri Apr 28, 2017 10:23 pm actually on relfection you'll always look cool in the Z .
My Z is a coupe so relatively hayfever free zone. You're right though, it is hard not to feel cool in a Z4C, that is until you try to get out and end up on hands and knees trying to make a graceful exit !
My E30 convertible though is very hayfever inducing. No pollen filters etc, and a lot of turbulence with the roof down. Hence it is equipped with wraparounds and a pack of loratadine in the glovebox
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Hay fever

Post by dr_john » Fri Apr 28, 2017 11:16 pm

As the OP must say thanks Mad Professor for a great in depth reply.

A bit late at night to take it all in, and I'm feeling not too bad at present after some Lorotadine this morning and Otrivine spray this afternoon.

A couple of pints down the local this evening seemed to have helped as well :thumbsup:
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Hay fever

Post by MrPT » Sat Apr 29, 2017 12:46 am

Great info from the Prof!

Never thought you could be off work with hay fever until the summer of 2005, when I was sent home in bits by my boss. Dr asked me to systematically try everything, and in the end it was fexofenadine that sorted me out. Completely... I mean, I think that once I'd found something that worked I was actually a bit better off than colleagues with mild symptoms.

Right now, cetirizine seems to working ok, but every year is an adventure!
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Mad Professor
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Hay fever

Post by Mad Professor » Sat Apr 29, 2017 2:14 pm

dr_john wrote: Fri Apr 28, 2017 11:16 pm As the OP must say thanks Mad Professor for a great in depth reply.

A bit late at night to take it all in, and I'm feeling not too bad at present after some Lorotadine this morning and Otrivine spray this afternoon.

A couple of pints down the local this evening seemed to have helped as well :thumbsup:
Need to be careful with otrvine which works by constricting the blood vessels -because if taken on a regualr basis ,tolerance rapidly developes and you also get rebound congestion in the nose -which can makes things worse -this tolerance and rebound with regular otrivine use can be overcome by also taking with a nasal steroid . Also if you are going take otrivine regularly then take otrivine first ,wait 5 min for the nose to decongest and take the steroid spray second .This way you decongest the turbinates allowing better pentration of the steroid spray to where it needs to act . I usually tell my patients when i start them both together to stop the otrivine after 1-2 weeks once the steroid spray has kicked in .Also never use the otrivine more than once a day -i tend to use it at before bedtime so that the nasal airway remains open allowing to breathe through the nose while sleeping .The nose is there to humidify and warm the air delivered downstream to the bronchial tree .
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Hay fever

Post by DPG » Sat Apr 29, 2017 5:19 pm

Kenalog

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Hay fever

Post by AlfaScozzesi » Sat Apr 29, 2017 6:12 pm

I get by usually with Cetirizine but sometimes this isn't enough! Today is one of those days :cry:

Also as someone said above the Zed is usually a bit of a safe haven for me being a coupe with always at every service a new filter!

Wondered if the Prof knew of what the next steps should be with someone who has cold urticaria as my other half has started with in the last two years to become very affected by this and all anti histimine medication given (ranitidine) is proving not to work.

Thanks in advance although I realise not strictly hayfever. :)

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Hay fever

Post by NickDE » Sat Apr 29, 2017 10:15 pm

Mad Professor wrote: Sat Apr 29, 2017 2:14 pm This way you decongest the turbinates allowing better pentration of the steroid spray to where it needs to act .
It's a shame we are talking about hayfever, and not engine modifications. Just imagine a N52 fitted with twin turbinates and steroid injection :D
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Hay fever

Post by Mad Professor » Sat Apr 29, 2017 10:26 pm

AlfaScozzesi wrote: Sat Apr 29, 2017 6:12 pm I get by usually with Cetirizine but sometimes this isn't enough! Today is one of those days :cry:

Also as someone said above the Zed is usually a bit of a safe haven for me being a coupe with always at every service a new filter!

Wondered if the Prof knew of what the next steps should be with someone who has cold urticaria as my other half has started with in the last two years to become very affected by this and all anti histimine medication given (ranitidine) is proving not to work.

Thanks in advance although I realise not strictly hayfever. :)
So for urticaria the next step is a higher dose of oral fexfenadine ie 180mg twice daily and then add in oral montelukast 10mg daily - low dose tricyclic antidepressants like amitriptyline or doxepin sometimes works especially at night as they also have sedative effects .
Failing that we're talking stepping up to the S54 variant of therapy like anti-IgE [xolair] injections monthly which are highly effective but hideously expensive ,so really last resort -i would suggest you get her referred to a dermatologist for a proper opinion in the first instance .
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Hay fever

Post by Molinites » Sun Apr 30, 2017 6:12 pm

Mad Prof (bet you wish you never joined in this!!) what is the nasal spray equivalent of Benadryl Plus please? Normal Benadryl doesn't work but whatever is in Plus does work! Many many thanks

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Hay fever

Post by AlfaScozzesi » Sun Apr 30, 2017 6:24 pm

Mad Professor wrote: Sat Apr 29, 2017 10:26 pm
AlfaScozzesi wrote: Sat Apr 29, 2017 6:12 pm I get by usually with Cetirizine but sometimes this isn't enough! Today is one of those days :cry:

Also as someone said above the Zed is usually a bit of a safe haven for me being a coupe with always at every service a new filter!

Wondered if the Prof knew of what the next steps should be with someone who has cold urticaria as my other half has started with in the last two years to become very affected by this and all anti histimine medication given (ranitidine) is proving not to work.

Thanks in advance although I realise not strictly hayfever. :)
So for urticaria the next step is a higher dose of oral fexfenadine ie 180mg twice daily and then add in oral montelukast 10mg daily - low dose tricyclic antidepressants like amitriptyline or doxepin sometimes works especially at night as they also have sedative effects .
Failing that we're talking stepping up to the S54 variant of therapy like anti-IgE [xolair] injections monthly which are highly effective but hideously expensive ,so really last resort -i would suggest you get her referred to a dermatologist for a proper opinion in the first instance .
Thanks for this prof (bet nobody thought your were a real prof before this :D )

Above and beyond :thumbsup:

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Hay fever

Post by Mad Professor » Sun Apr 30, 2017 7:27 pm

Molinites wrote: Sun Apr 30, 2017 6:12 pm Mad Prof (bet you wish you never joined in this!!) what is the nasal spray equivalent of Benadryl Plus please? Normal Benadryl doesn't work but whatever is in Plus does work! Many many thanks
Benadryl is acrivastine a sedative old school short duration 1st gen oral antihistamine -ie an antiallergy drug -think of that if you will as being like a 1600 xflow -not even a flowed /ported xflow with cast iron pistons and crank and no verniers .Benadryl plus also has a decongestant oral pseudoephedrine which shrinks the blood vessels in the nasal mucosa -not a good idea to take on a regular basis as like nasal otrivine spray you rapidly become tolerant to it and then also develop rebound worsening of congestion .Also if you have high blood pressure taking pseudoephedrine isnt a smart idea as it will put up your blood pressure by constricting blood vessels eslewhere -not something i would ever use . Think of oral pseudoephedrine as an SU carb rather than multipoint fuel injection if you will .
So the reason that benadryl plus works for you is clearly the decongenstant -that ok to take occasionally for relief but not on a regualr basis IMHO .The equivalent nasal spray would be otrivine which works on the same alpha1 receptor as psueodephedrine to constrict the blood vessels in the nose .However if you take otrivine on its own on a regular basis after a few days you develope the same tolerance and rebound as you get with pseudoehedrine -this is becasue the body is clever and rapidly adapts by reducing the number of available alpha receptors .
However what our published research has shown is that if you take the otrivine with a nasal steroid spray like beclometasone [Beconase ] it mitigates the tolerance as it has synergistic effect on the alpha 1 receptor . So the equivalent for you would be to take otrivine spray 1 squirt first ,wait 5-10 min for the decongenstant effect to kick in and then follow that by taking the Beconase spray as a chaser -but only take the combination once a day -that could be increased to 2 squirts of each once daily if required .That would ok to take on a regular basis -although i usually tell my patients to stop the otrivine after 1-2 weeks and then continue on the Beconase alone -ie it takes that long for the beconase to fully kick in .
Hope that helps
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Hay fever

Post by Mad Professor » Sun Apr 30, 2017 7:28 pm

NickDE wrote: Sat Apr 29, 2017 10:15 pm
Mad Professor wrote: Sat Apr 29, 2017 2:14 pm This way you decongest the turbinates allowing better pentration of the steroid spray to where it needs to act .
It's a shame we are talking about hayfever, and not engine modifications. Just imagine a N52 fitted with twin turbinates and steroid injection :D
v funny :D
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Hay fever

Post by 85genius » Sun Apr 30, 2017 7:49 pm

I found desloratadine works better than loratadine citerezine or fexofenedine with the others I still get symptoms but desloratadine has my allergies controlled, I do also take montelukast
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Hay fever

Post by Molinites » Sun Apr 30, 2017 9:11 pm

Thank you so much for your advice, explanation and time, as put beautifully by another - above and beyond. I have tried Boots own pseudoephedrine and Beconase Nasal Spray without the success of Benadryl Plus, I will definitely try Otrivine and Beconase and follow your advice. Thanks :thumbsup:

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