Steroid medications can be divided into those that are derived from testosterone (androgenic steroids) and those that are related to cortisol (glucocorticoids). Androgenic steroids increase the synthesis of muscle tissue and have minimal effects upon inflammation, while glucocorticoids suppress inflammation and lead to the breakdown of muscle and fat tissue.
Systemically administered glucocorticoids, given orally or by injection, have been used since the 1950s to successfully treat inflammatory diseases such as asthma and arthritis. However, even short-term use of these systemic medications, such as prednisolone (Prednisone), leads to significant systemic side effects, including water and salt retention, increased blood pressure, increased blood sugar, cataracts, increased intraocular pressure, reduced bone mineral density, and mood swings.
These adverse effects limit the use of systemic glucocorticoids to patients with very severe disease manifestations. In the 1970s, pharmaceutical companies developed topical intranasal formulations of glucocorticoids to treat allergic rhinitis. In this way, the medication was administered directly to the area of tissue inflammation without causing any systemic effects.
There are a number of intranasal steroids available to treat seasonal and year-round allergic rhinitis in children and adults, and overall these drugs are the most effective known drug therapy for this disease. Nasal steroids are usually started in patients who have moderate to severe persistent allergic rhinitis. These drugs reduce all symptoms of both seasonal as well as year-round rhinitis, including nasal congestion, nasal itching,sneezing, and discharge. In addition, recent studies show that these medications also reduce symptoms of eye itching and watering.
Commonly Used Intranasal Steroids (Generic/Brand Name)
Budesonide/Rhinocort Aqua
Fluticasone propionate/Flonase
Mometasone furoate/Nasonex
Triamcinolone acetonide/Nasacort Aq
Ciclesonide/Omnaris
Fluticasone furoate/Veramyst
Flunisolide/Nasarel
Jack’s comment:
When my allergies started 3 years ago, when I was 28 years old, most of my problems were at night. I was so stuffy that I couldn’t sleep, and I had a bad postnasal drip. I tried some Allovert that I got over the counter, but it didn’t really change the stuffiness. Then I tried a few doses of Benadryl, and it made me feel sleepy most of the day without really get-ting rid of the feeling of nasal blockage. Not only that, but it seemed to really dry me out and made me feel constipated. I finally broke down and saw a doctor, and he gave me a sample of Nasonex. After 2 days, I could start to breathe again, and by 1 week I was pretty much back to normal. That med-icine made a huge difference in my nasal problem.