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By JAN JARVIS

jjarvis@star-telegram.com

That annoying itching and sneezing that signals the arrival of spring allergies is back - and it’s only going to get worse.

Fort Worth and Dallas were the two worst cities in the country for allergies Tuesday, with pollen counts nearly off the charts, according to data at www.pollen.com.

All the recent rain has brought nothing but bad news for anyone who is sensitive to pollen from trees, grasses and mold.

“Certainly it is going to be a bad season, and it’s going to get much worse,” said Dr. John Fling, a Fort Worth allergist and associate professor at the University of North Texas Health Science Center at Fort Worth. “April and May will be just terrible for allergies because of the rain.”

The biggest offender is mold, but trees and grasses aren’t far behind. Even if the recent rains have helped clear the air, the wind is sending the pollen flying and causing plenty of sneezes.

Trees and grass pollen peak in April or May and typically overlap each other, creating a double whammy for those who are sensitive.

It’s hard to predict the allergy season. Normally it starts off gradually and picks up, but this year is different, said Dr. David Khan, professor of internal medicine at the University of Texas Southwestern Medical Center at Dallas.

“It’s hitting more aggressively and all at once, so a lot of people are suffering,” he said. “People who are allergic to trees and grasses are in big trouble.”

Plenty of people are already miserable.

“I’ll wake up at 2 in the morning, and the roof of my mouth is itching really, really bad,” said Arthur Autrey of Watauga. “I can feel my nasal cavity swelling, and pretty soon it completely shuts up like a steel trap.

“That’s when I go grab some Benadryl.”

The antihistamine, along with a slew of other medications, will likely be in high demand.

If Claritin, Zyrtec and other over-the-counter medications don’t do the trick, allergy sufferers should consult a doctor.

Nasal steroid sprays such as Flonase are the mainstay for allergies, but they must be started before the season begins, Fling said. Still, it’s not too late.

For children, over-the-counter medications can be a good option for allergies if they’re age-appropriate, said Dr. Jason Terk, a Keller pediatrician. Right now, he’s seeing more viruses than allergies in his patients. But if that stuffy nose is caused by a virus, over-the-counter cough and cold medications aren’t very effective, he said. In young children, they can have an adverse effect.

Old-fashioned interventions such as saline irrigation and humidifiers tend to be the best choice in those cases, Terk said.

In the future, pills could one day be used much like allergy shots to desensitize the individual. The pills are already being tested in Europe but have not been approved for use in the United States.

The biggest obstacle: Most people in Texas have multiple allergies and would probably need a different pill for each one, Fling said.

For now, allergy sufferers can brace for a rough spring and possibly an even worse fall, especially if there’s a lot more rain, as predicted.

“We’ve had so much rain, it’s going to really be a bad ragweed season,” Fling said.

JAN JARVIS, 817-390-7664

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FDA Announces New Restrictions on LABA

The U.S. Food and Drug Administration (FDA) yesterday announced a label change for products for asthma containing long acting Beta2 adrenergic agonist (LABA) drugs to include:

1. The use of LABAs is contraindicated without the use of an asthma controller medication such as inhaled corticosteroid, with the exception of exercise induced asthma.

2. LABAs should only be used long-term in patients whose asthma cannot be adequately controlled on asthma controller medications.

3. LABAs should be used for the shortest duration of time required to achieve control of asthma symptoms and discontinued, if possible, once asthma control is achieved. Patients should then be maintained on an asthma controller medication.

AAAAI and ACAAI leadership agree with this proviso: “We recommend considering discussing with patients an action plan for ’step up’ therapy and where appropriate, a ’step down’ approach to treatment.” This may mean a more frequent monitoring of asthma patients requiring these LABAs by specialists.

LABAs are approved to treat both people with asthma or with chronic obstructive pulmonary disease (COPD). The new recommendations only apply to the use of LABAs in the treatment of asthma. The FDA is actively seeking to reduce the use of LABA in both children and adults. They will be monitoring the sales of single LABA use and dual therapy before and after this announcement.

For the full release click here FDA Announces New Restictions on LABA.

Here are the source documents:

LABA Information -

http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm199565.htm

Q&As -

http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm200719.htm

Drug Safety Communication -
http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm200776.htm

Sami L. Bahna, MD, DrPH, FACAAI, FAAAAI
President, American College of
Allergy, Asthma & Immunology
Paul A. Greenberger, MD, FAAAAI, FACAAI
President, American Academy of
Allergy, Asthma & Immunology

FDA Announces New Restrictions on LABA

The U.S. Food and Drug Administration (FDA) yesterday announced a label change for products for asthma containing long acting Beta2 adrenergic agonist (LABA) drugs to include:

1. The use of LABAs is contraindicated without the use of an asthma controller medication such as inhaled corticosteroid, with the exception of exercise induced asthma.

2. LABAs should only be used long-term in patients whose asthma cannot be adequately controlled on asthma controller medications.

3. LABAs should be used for the shortest duration of time required to achieve control of asthma symptoms and discontinued, if possible, once asthma control is achieved. Patients should then be maintained on an asthma controller medication.

AAAAI and ACAAI leadership agree with this proviso: “We recommend considering discussing with patients an action plan for ’step up’ therapy and where appropriate, a ’step down’ approach to treatment.” This may mean a more frequent monitoring of asthma patients requiring these LABAs by specialists.

LABAs are approved to treat both people with asthma or with chronic obstructive pulmonary disease (COPD). The new recommendations only apply to the use of LABAs in the treatment of asthma. The FDA is actively seeking to reduce the use of LABA in both children and adults. They will be monitoring the sales of single LABA use and dual therapy before and after this announcement.

For the full release click here FDA Announces New Restictions on LABA.

Here are the source documents:

LABA Information -

http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm199565.htm

Q&As -

http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm200719.htm

Drug Safety Communication -
http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm200776.htm

Sami L. Bahna, MD, DrPH, FACAAI, FAAAAI
President, American College of
Allergy, Asthma & Immunology
Paul A. Greenberger, MD, FAAAAI, FACAAI
President, American Academy of
Allergy, Asthma & Immunology

http://www.tarrantcounty.com/ehealth/cwp/view.asp?A=763&Q=471978

For information on vaccination sites and target group information.