ALLERGY DRUGS: PUTTING DRUGS IN THEIR PLACE
For the pregnant woman or nursing mother, drugs for allergy symptoms must be used with special caution, and never for relief of minor allergic symptoms. In a review article for Annals of Allergy, Dr Wallace R. Pratt says that present knowledge of the safety of drugs used during pregnancy or breastfeeding is incomplete. Doctors know that some drugs - including iodides commonly found in expectorants - cause problems in the developing foetus when taken during pregnancy. Other information suggests that epinephrine, brompheniramine, promethazine, diphenhydramine, hydroxyzine and phenylpropanolamine also present some risks to the foetus. While epinephrine should not be withheld in the event of a life-threatening attack, Dr Pratt emphasizes that the limited and uncertain safety of many drugs during pregnancy and breastfeeding calls for prudence in prescribing allergy drugs for expectant and nursing mothers (Annals of Allergy).
While most of the precautions demanded by allergy drugs apply to classic conditions such as asthma, hives and hay fever, use of drugs for any allergic symptoms should not be pursued casually, whether you're pregnant or not.
Because of the potential risks of drug therapy, it behooves doctors to take two things into consideration when prescribing allergy medication:
1. Does the allergy persist in spite of earnest attempts to avoid the offending food or inhalants?We'd be the last to deny a life-giving drug to an asthmatic. But at the same time, the individual (or parent) should make every effort to control allergic asthma non-medically - getting rid of the dog, installing an air filter, controlling diet, breathing correctly, learning to relax - to prevent emergencies from arising.
'Certainly, the answer is to find the cause rather than just take pills,' says Dr Falliers. 'If you get a headache every time you eat a certain type of fruit, instead of running for aspirin, try to find out: Is it the fruit? Is it the way it was sprayed?'
2. Is the risk of not taking the drug higher than the risk of potential side effects?Intermittent use of bronchodilators in asthma that's acute, chronic and resistant to all other forms of therapy is preferred over the risk of permanent lung damage from uncontrolled asthma. And, of course, if an individual lapses into anaphylactic shock - loss of consciousness, extreme drop in blood pressure and respiratory arrest with the threat of death - drugs may be the only way to prevent these problems.
'Drugs require the proper attitude,' says Dr Falliers. 'Some families are totally dependent on drugs. Their houses look like a pharmacy, and they take one drug after another. Others are so afraid of drugs they don't take their medicine even when they really need it.'
It all boils down to one excellent piece of advice: do all you can to control your allergies before you turn to drugs.
'Not waiting until the damage is done, but preventing it - that will be the secret of success for allergy treatment,' says Dr Falliers. 'And if it will put us allergists out of a job, that's just fine.'