Steven Machtinger, MD


SPRING, 2015

NEW PATIENT PORTAL ON MacPRACTICE

The Patient Portal is up and running. Access to the Portal enables you to:

  • View and Download your Continuity of Care Document (CCD). A CCD is a summary of your health status.
  • Communicate with your allergist via secure, encrypted email

  • Request an appointment

  • Review your personal information and request updates.

Please see Bonnie for information on how to access the Patient Portal and for a personal password.

SUBLINGUAL & RAPID IMMUNOTHERAPY

A new form of immunotherapy not involving shots is available for patients with grass pollen allergy. In sublingual immunotherapy (SLIT) pollen is dissolved under the tongue and then swallowed. Weekly injections are replaced by daily oral dosing at home. To be effective for grass pollen season treatment should begin no later than January 1. Side effects include mouth and throat itching and rare systemic reactions. All SLIT users must have EpiPen or Auvi-Q available. Although not every insurance plan is covering SLIT there are programs to reduce cost.

Rapid Immunotherapy involves receiving more than one allergy injection each visit. The maximum is three injections of each allergy mix per visit. Each injection is greater than the previous one. Using this rapid technique it�s possible to reach the optimal allergen dose in 9-12 weeks. Patients must spend more time in the office for these initial visits but ultimately may save the total time devoted to immunotherapy.

SLIT and rapid immunotherapy are not for everyone and not recommended if your safety might be compromised. If interested please discuss these alternative immunotherapy options with your allergist.

NEWER OTC MEDICATIONS FOR ALLERGY

There are several excellent medications for the treatment of allergic rhinitis & conjunctivitis available over-the-counter (OTC). They were all once prescription medications. Many are as effective and less expensive than equivalent prescription drugs. Generic equivalents are available for some. Using generics can save you a lot of money in the long run. When purchasing OTC medications consider shopping around for the best price.

ANTIHISTAMINES

Claritin, Alavert (loratidine) is a long-acting (one-day), non-drowsy antihistamine effective for all symptoms of nose and eye allergy except for nasal stuffiness. It is approved for use in adult and children older than 24 months coming in various formulations. It sometimes causes headache.

antihistamine effective for all symptoms of nose and eye allergy except for nasal stuffiness. It is approved for use in adult and children older than 6 months of age coming in various formulations. Headache, fever & muscle pain are reported side effects.

Zyrtec, PediaCare Childrens 24 Hour Allergy (cetirizine) is a long-acting (12-24 hour) antihistamine effective for all symptoms of nose and eye allergy except for nasal stuffiness. It is approved for use in adult and children older than 24 months coming in various formulations. Drowsiness, headache, and vomiting are reported side effects. Childrens Zyrtec Hives is the same medication but in liquid form.

EYE DROPS

Zaditor, Alaway, TheraTears Eye Itch Relief, Visine All Day Eye Itch Relief, Zyrtec Itchy Eye Drops (ketotifen). This is a useful medication for itchy, watery eyes due to allergy and may be used in anyone after the third birthday. The dose is one drop each eye twice daily as needed. Do not repeat closer than 8 hours apart. Side effects are pain at the time of application that may be decreased by storing the drug in the refrigerator and administering the drop into the inner corner of the eye. To prevent spreading infection each user in the household should have their own bottle. Visine-A is not the same drug and is not recommended.

NASAL SPRAYS

These three medications have the ability to relieve all symptoms of nasal allergy including nasal congestion. Nasal congestion, or stuffiness, is the most common and often the most bothersome of nasal allergy symptoms.

NasalCrom (cromolyn nasal) is a non-steroidal nasal spray for allergic rhinitis that may be used to prevent and relieve allergy symptoms in anyone older than 24 months. Adverse reactions include sneezing, burning, and nosebleed. This medication works best when used 3-4 times each day.

Nasacort AQ (triamcinolone nasal) is a topical corticosteroid nasal spray that also may be used in anyone 2 years or older. The dose is 1-2 sprays each nostril daily depending on age. Nosebleed and sore throat are the common adverse effects. Discuss with your eye doctor before using if you have glaucoma.

Flonase (fluticasone proprionate nasal) is a topical corticosteroid nasal spray that may be used in anyone 4 years or older. The dose is 1-2 sprays each nostril daily. Nosebleed, nasal ulcer and sore throat are common side effects. Discuss with your eye doctor before using if you have glaucoma.

© 2015 Steven Machtinger, MD. & Associates, Inc.