Antihistamine Preparations Research Articles

Possibilities of phytotherapy for allergic dermatitis complicated by pyoderma

It was established that a water extract based on collection in combination with an antibiotic and an antihistamine preparation promotes resorption of a purulent-inflammatory process in experimental dermatitis. Water extract based on collection No. 1 in combination with an antibiotic and an antihistamine drug has a pronounced anti-inflammatory and antibacterial effect and can be used in the treatment of allergic dermatitis with opportunistic infection.

Medical thermography in evaluation of results of skin testing by prick test method in patients with IgE-mediated allergic diseases

Objective — to study the aspects of use of medical thermography to evaluate the results of skin testing with allergen solutions in patients with allergic rhinitis, atopic asthma and acute allergic urticaria.Materials and methods. During our study, 40 patients with bronchial asthma and/or allergic rhinitis and/or acute allergic urticaria were examined using a skin prick-test with solutions of diagnostic allergens, followed by visual and thermographic evaluation. The study was open-ended, comparative. Skin testing was performed by standardized prick-test method with domestic allergens manufactured by ME Immunolog (Vinnytsya, Ukraine). Immediately after the visual assessment, an instrumental evalua­tion was performed using a thermograph with a locked image in the memory of the device for further processing.After the initial admission and testing procedure, the antihistamine preparation of bilastine was administered at an average recommended daily dose of 20 mg one tablet per day. After three days (72 hours), all patients were retested with a prick-test method and its visual and thermographic evaluation was performed to determine the degree of suppression of the skin reaction by an antihistamine drug.Results and discussion. Analyzing the comparison of results of visual and thermographic measurements of papule size, we found a high coefficient of correlation between test scores (r = 0.9), but the difference between papule sizes averaged 1.6 mm. However, when analyzing the results, the coincidence of visual analysis by the allergist and thermographic measu­rement accounted for only 70 % of cases.Conclusions. As a result of the analysis and further statistical processing, it was found that the average diameter of the papules of the positive test during the re-examination after taking bilastine decreased by 55.6 % (95 % CI 0.50—0.59). At the same time, in the vast majority (87.2 %) of patients (95 % CI 0.83—0.91), the positive test disappeared completely.

Антиексудативні властивості рідкого спиртово-водного екстракту листя аїру звичайного (Acorus calamus L.)

Мета дослідження – вивчення антиексудативних властивостей рідкого спиртово-водного екстракту листя аїру звичайного (Acorus calamus L.) (РСВЕЛА). РСВЕЛА був отриманий на кафедрі ботаніки НФаУ під керівництвом професора Т. М. Гонтової. Протизапальні властивості РСВЕЛА досліджені на білих безпородних щурах на моделях карагенінового та гістамінових набряків. Досліджуваний РСВЕЛА (0,5 мл / кг) і препарати порівняння, а саме: диклофенак натрію (у дозі 8 мг / кг), кверцетин (у дозі 11 мг / кг) і лоратадин (у дозі 1 мг / кг), на моделі карагенінового та гістаміновими набряків застосовували в лікувально-профілактичному режимі: внутрішньошлунково одноразово щодня протягом 5 діб до моделювання запалення й за 1 год до ін'єкції флогогену (карагеніну або гістаміну відповідно). Розвиток набряку спостерігали в динаміці за показником об'єму лапи, який визначали за допомогою цифрового плетизмометра. Через 24 год після введення флогогену в тварин визначали кількість лейкоцитів і ШОЕ. Встановлено, що на моделі карагенінового та гістамінового набряку РСВЕЛА чинить протинабрякову дію. Антиексудативна активність РСВЕЛА склала 68,9 % (р < 0,05) на 120 хв запалення та 79,5 % (р < 0,05) на 180 хв у разі карагенінового набряку. На моделі гістамінового набряку антиексудативна дія РСВЕЛА склала 50,8; 27,7 і 50,0 % відповідно на 30, 60 і 90 хв набряку. За виразністю антиексудативної дії, ступенем зниження ШОЕ та показника лейкоцитозу РСВЕЛА не поступається всім трьом препаратам порівняння: диклофенаку натрію, кверцетину і лоратадину. Таким чином, встановлено, що РСВЕЛА має антиексудативну дію, що є обгрунтуванням подальших досліджень з перспективою створення на його основі нових ефективних фітопрепаратів для профілактики та фармакокорекції запальних процесів.

Comparative study of the effectiveness of antihistamine preparations in the treatment of patients with atopic dermatitis

The objective of the study – to determine the comparative effectiveness of І-generation antihistamines and active metabolites of II-generation in treatment of patients with atopic dermatitis. Materials and methods. The study included 40 patients with atopic dermatitis. SCORAD scale was used for the assessment of the disease severity and Ukrainian translation of the Dermatology Life Quality Index – for the quality of life assessment. Patients were randomized into two groups that received I generation antihistamines and active metabolites of the II generation. Student's criterion or Wilcoxon criterion was used for statistical analyses. Normality of data distribution was verified using Shapiro–Wilk criterion. Results. A high ΔSCORAD (%) was observed in patients, who used I generation antihistamines. The significantly higher DLQI was in the group which used active metabolites of the II generation. ΔDLQI (%) was significantly lower in patients from the comparison group compared with individuals from the main group. Significant differences in neuroticism and state anxiety were obtained in patients from main and comparative groups with lower values in patients taking I generation antihistamines. In the group of patients before the start of treatment, the state of subdepression was noted, and in those of the main group there were no depressive symptoms at the end of the course of therapy. Conclusions. First-generation antihistamines are more effective in the treatment of atopic dermatitis compared to the active metabolites of second-generation, as evidenced by significant differences in SCORAD, ΔSCORAD (%), the severity of pruritus between groups of patients after completion of treatment. I-generation antihistamines indirectly have a positive effect on the quality of life, anxiety, depression and neuroticism, which explains the need for their priority choice in the treatment of atopic dermatitis.

PP-2 Ethanol content in registered paediatric preparations: address the excess

Background Ethanol is commonly used in many pe-diatric liquid formulations as a solvent or preservative, with concentrations varying widely between products per formulation design. Therefore, acute or chronic use of certain products in paediatric patients may expose them to excessive amounts of ethanol. Both the U.S. Food and Drug Administration (FDA) and the Europe-an Medicines Agency (EMA) recommend to exclude ethanol from medicinal products intended for use in children whenever possible. If deemed necessary, however, the FDA has set (1995) a maximum quantity of ethanol content in over-the-counter (OTC) pediat-ric formulations for different ages. Recently (2014), the EMA suggested to lower the ethanol content limit set previously (2006). The use of ethanol in paediatric for-mulations is being evaluated these days by the Israeli Drug Registration Department and new regulations regarding limitations of ethanol content in liquid pediatric formulations (both OTC and prescription drugs) are being finalised. The objective of our study was to com-pile a list of oral liquid paediatric formulations registered in Israel that contain ethanol, and identify products whose ethanol concentration may produce dangerous ethanol blood levels in infants, either by taking the recommended dosage or by accidental consumption of large amounts of the preparation. Methods The Israeli Drug Registry was searched using the following keywords: elixir, solution, syrup, suspension, drops, tincture and ethanol, and the results were sent to the Drug Registration Department to provide the exact amounts of ethanol in each product per manufacturer’s data. Thirty-nine registered products were identified, of which 29 are currently registered for paediatric use. The majority of formulations are indicated for the treatment of cold and cough symptoms (n=14). Other formulations include antihistaminic, antiemetic and sedative prepara-tions (n=6); analgesics and antipyretics (n=3); antibiotics and anti-epileptics. Results The preparations were found to differ widely in ethanol content, ranging from Conclusion Ethanol consumption is strongly discour-aged during pregnancy and lactation, whereas children are constantly at risk for exposure to ethanol through routine use of registered medications. Many paediatricians and parents acknowledge the harmful effect of ethanol in this young population, but are unaware of the high potential for exposure. More than half (n=26) of the available products that contain alcohol do not meet the require-ments set by the new Israeli regulations and would be subject to changes accordingly (either in total volume or alcohol content of the formulation).

The effectiveness of the combination of azelastine hydrochloride and mometasone furoate for the intranasal application in the patients presenting with seasonal allergic rhinitis

The objective of the present work was to evaluate the effectiveness of the combination of azelastine hydrochloride and mometasone furoate for the intranasal application to treat the patients presenting with seasonal allergic rhinitis. A total of 60 subjects suffering from seasonal allergic rhinitis were available for the observation. All the patients were allocated to three groups comprised of 20 individuals each. The patients of the first group received the fixed combination of azelastine hydrochloride and mometasone furoate for the intranasal application, those in the second group were given mometasone furoate administered intranasally together with an oral antihistamine preparation of the third generation, and the patients of the third group were treated with intranasal mometasone furoate alone. The effectiveness of the treatment was evaluated on days 7 and 14 after its initiation. It was found that the treatment with the use of the combination of azelastine hydrochloride and mometasone furoate resulted in a more pronounced alleviation of rhinological symptoms and improvement of the quality of life at the early stages of therapy in comparison with mometasone furoate monotherapy. It is concluded that the patients with moderate and severe seasonal allergic rhinitis can be recommended to use the combination of azelastine hydrochloride and mometasone furoate as качестве the initial treatment.

JUSTIFICATION OF DIAZOLINE PERMISSIBLE LEVELS IN OCCUPATIONAL AIR IN CHEMICAL AND PHARMACEUTICAL INDUSTRIES

The toxicological assessment of diazoline, the first- generation antihistaminic preparation, was carried out together with justification of the hygiene standard for permissible content ( (Tentative Safe Exposure LevelTSEL) of occupational air in production premises. It was found out that according to acute oral toxicity criterion, Diazoline refers to low hazardous substances. In the clinical picture of acute and sub-chronic intoxication, CNS involvement prevails. Diazolin has a weak local irritant effect in case of contact with mucous membranes, shows a strong cumulative activity. In case of intracutaneous sensitization, it influences indicators of the cellular and humoral component of innate and acquired immunity. TSEL of diazoline in occupational air is 1.0 mg/m .

The role of antihistamines in chronic actinic dermatitis treatment

Inveterate actinic dermatitis is an immunologically mediated photodermatosis characterized by itchy eczematous dermhelminthiasis exposed to sunlight. The disease proceeds in the same way as the atopic eczema or atopic dermatitis. The treatment of patients with inveterate actinic dermatitis is similar to the treatment of patients with atopic dermatitis and eczema. Administration of the modern antihistaminic preparation desloratadine (Aerius) in the treatment has a positive effect on the skin process relief and on some cellular and humoral immunity factors.

The modern strategies for the treatment of allergic rhinitis

The present literature review had the objective to analyze the published data concerning the effectiveness of intranasal administration of antihistamine preparations and intranasal glucocorticoids for the treatment of allergic rhinitis. Special emphasis is placed on the clinical significance and the further prospects for the application of a fixed combination of these medications including azelastineplusmometasonefuroateas the first choice therapy of moderately severe and severe manifestations of allergic rhinitis.

Could aluminum be a new hidden allergen in type 1 hypersensitivity reactions when used as a drug additive?

Medications usually contain numerous additives and preservatives. Some of these agents have been reported as causative factors in adverse drug reactions, including asthma attacks, urticaria and/or angioedema, and even severe systemic anaphylaxis. Moreover, allergens such as additives and preservatives may be hidden as they are not easily identified during etiological investigations.

Влияние антигистаминных препаратов второго поколения на когнитивные функции детей с поллинозом

Relevance. Allergic pathology in particular, a hay fever, can lead to decrease in cognitive functions at children. Earlier it was established that antihistamine preparations of I generation influence cognitive functions of patients. Т he patients with this nosology receive for a longtime courses of antihistamine preparations of II generation, so the analysis of influence of different AH preparations of II generation on cognitive activity of children with a hay fever is necessary. P urpose . Studying of influence of II generation antihistamine preparations in a complex with the specific allergen immunotherapy on cognitive functions at children with a hay fever. Patients and methods. Using the psychophysiological computer complex «Psihomat» the condition of cognitive functions was established. In total the 81 child with a hey fever were investigated. The persons under consideration were divided on subgroups depending on antihistamine which they received. For the patients in the main group of investigation the cognitive functions have been studied in 3 points. Results. The patients had changes in the attention and psychomotor activity more often, than in other conitive activity. It is not obtained distinct data on characteristic contribution of antihistamine preparations of a second generation in improvement of cognitive activity as a whole at complex treatment of hay fever with specific allergen immunotherapy. Antihistamine preparations (desloratidine and cetirizine) are improved by indexes of visual and space perception at children with a hay fever. From the 3 antihistamine preparations the cetirizine has the most carried out positive effect concerning the psiho-motoric activity in the combined ASIT. Conclusion. Padding express researches in the field are necessary for receiving the definite answers to problem questions.

Hypersensitivity to antihistamines

Antihistamines are the cornerstone of allergy therapy and are not expected to cause hypersensitivity reactions. We describe two cases, one had urticaria to multiple anti-H1-preparations and the other had anaphylaxis to hydroxyzine. We also provide a review of the English literature on reported reactions regarding causative preparations and manifestations. The latter showed a wide range; most commonly urticaria/angioedema, contact dermatitis, anaphylaxis, and fixed drug eruption (FDE). Most reported cases were young to middle age adults, with apparent predilection to female subjects. The onset of reactions varied from a few minutes for anaphylaxis and urticaria/angioedema, several hours for maculopapular rashes, or longer for contact dermatitis and FDE. Almost all antihistamines have been reported as causing reactions; cetirizine was the most common oral preparation followed by its parent drug, hydroxyzine. Doxepin cream was the most commonly implicated topical preparation in causing contact dermatitis. A causal relationship is often difficult to recognize because the reaction may be similar to the disease being treated with that antihistamine preparation. Reactions to one preparation are likely to occur, but not always, to other members of the same class. Diagnosis is based on clinical suspicion and may be verified by challenge testing. Except for patch testing in contact dermatitis or fixed eruption, other tests have not shown optimal reliability. In most cases, challenge testing with multiple preparations would identify one or more preparations that can be tolerated. Although hypersensitivity to antihistamines seems to be very rare, awareness of the problem would reduce its misdiagnosis.

Gustatory itching: an unusual complication following superficial parotidectomy

We report the previously undocumented complication of gustatory itching following superficial parotidectomy. Case report and review of the English literature concerning Frey's syndrome, complications of superficial parotidectomy and the pathophysiology of itching. A 49-year-old woman developed gustatory itching following a superficial parotidectomy. Her symptoms were satisfactorily managed with topical and oral antihistamine preparations. We propose a neurophysiological pathway involving acetylcholine and histamine to explain this phenomenon. To our knowledge, this is the first documented case of gustatory itching following superficial parotidectomy. The use of antihistamine preparations appears to effectively manage this symptom, without the need for invasive procedures.

In vitro antibacterial activity of some systemic and topical antihistaminic preparations

In vitro antibacterial activity of topical and systemic antihistaminic preparations containing different active substrates against the standard strains of two bacteria was evaluated. Four topical and 3 systemic preparations containing pheniramine maleate, chlorophenoxamine hydrochloride, and diphenhydramine hydrochloride were studied. The antibacterial activities of these preparations against strains of S. aureus (American Type Culture Collection, ATCC 29213) and S. epidermidis (ATCC 25212) were tested using the disc diffusion method. In addition, the Minimal Innhibitory Concentration (MIC) and Minimal Bactericidal Concentration (MBC) of parenteral preparations for these two bacteria were determined. Pheniramine maleate-topical and pheniramine maleate-systemic had no activity against bacteria, but the others showed various rates of activity. Chlorophenoxamine hydrochloride-topical and chlorophenoxamine hydrochloride-systemic were the most effective (P < 0.05). Despite the same active substrate content, diphenhydramine hydrochloride-topical-1 and diphenhydramine hydrochloride-topical-2 yielded different results when they were compared with each other or with the other preparations. Diphenhydramine hydrochloride-topical-2 had a relatively higher rate of activity than diphenhydramine hydrochloride-topical-1. Inhibition zone diameters were 16.9+/-1.5 mm 12.3+/-0.5 mm for S .aureus, 17.4+/-1.0 mm 0 mm for S .epidermidis respectively (P < 0.05). MIC values of parenteral preparations were equal to or above 125 ?g/ml. MIC values of parenteral preparations were higher than their blood levels in clinical use. Thus, effects of parenteral preparations may not have been reflected in routine clinical practice. However, topical forms have antibacterial activity due to additive substrates and the use of high concentration levels at the site of application. Therefore, in selection of topical forms for appropriate cases, these effects should also be taken into consideration. The antibacterial activity of topical antihistaminic preparations may be useful in certain dermatological pathology.

Levocetirizine better protects than desloratadine in a nasal provocation with allergen

BackgroundDirect comparisons of antihistamines are rare but very much needed. Newly available antihistamine preparations, levocetirizine, the R-enantiomer of racemate cetirizine, and desloratadine, an active metabolite of loratadine, have been recently released for allergic rhinitis. ObjectiveWe sought to compare levocetirizine and desloratadine in a nasal provocation test (NPT) with grass pollen. MethodsTwenty-four volunteers with grass pollen allergy and a history of rhinitis were enrolled in a double-blind, placebo-controlled, crossover study. Three NPTs were performed in a dose-escalating manner during the out-of-season period 4 hours after a single dose of levocetirizine (5 mg), desloratadine (5 mg), or placebo. ResultsDifferences in the mean allergen dose level (primary end point) necessary to reach the NPT threshold indicated improved protection provided by levocetirizine compared with that provided by desloratadine (P=.02). Sneezing and rhinorrhea were better inhibited by levocetirizine than desloratadine. Nasal congestion, as assessed by using objective methods, was not limited by either active substances or placebo. In nasal lavage fluid, IL-5, IL-8, eotaxin, and eosinophil cationic protein levels increased at 24 hours, without differences between the groups. In contrast, levocetirizine, but not desloratadine, significantly limited albumin extravasation into nasal lavage fluid in the early-phase response. ConclusionsThis study demonstrates a better overall protection of a single dose of levocetirizine compared with desloratadine in an NPT with grass pollen allergen. In contrast to late-phase inflammatory markers, which were unaffected, extravascular leakage of the early-phase marker albumin was significantly limited by levocetirizine.

Bombyx mori – A Review of its Potential as a Medicinal Insect

The importance of various stages of the silkworm, Bombyx mori viz., eggs, larvae, pupae, moths and its products, by-products and waste products as a potential medicinal source has been indicated. Larvae have been identified as a possible source of adipokinetic hormone (AKH), chymotrypsin inhibitors, ß- N -acetylglucosaminidase, sex pheromone bombykol, amino acids, etc., apart from their value as health food especially for cardiac and diabetic patients, bronchial asthma, primary trigeminal neuralgia, vocal nodules and polyps and in the treatment of facial palsy and pain. Pupae are a source of proteins, vitamin B 1, B 2 and E, diapause hormone, amino acids, etc., and form a part of antibacterial and antihistaminic preparations. Male moths are used to treat sterility. Paste chlorophyll, pectin, phytol, carotene and triacontanol, solanesol, etc., extracted from silkworm feces are used in the treatment of various diseases such as hepatitis, acute pancreatitis, chronic nephritis, stomach and gastric disorders, leukocytopenia, blood cholesterol, etc. Phytol is used in the preparation of vitamin E and K while carotene in vitamin A. Pelade obtained from reeled cocoons is read-ily digestible and forms a valuable ingredient of food. It reduces cholesterol and blood sugar. Chrysalises separated from pelade contain palmitic, stearic, oleic and linoleic acids and serve as a food additive and in pharmaceutical preparations.

The comparision of the efficacy of fluticasone propionate with cetirizine in perenneal allergic rhinitis

Allergic rhinitis is an IgE mediated hypersensitivity reaction of the nasal mucosa characterised by nasal discharge, obstruction, and pruritus. In this study, 43 patients with perenneal allergic rhinitis were enrolled in order to compare the efficacy of Fluticasone Propionate (FP), a corticosteroid nasal spray, with Cetirizine, a systemic oral antihistaminic preparation, which is supposed to have nonsteroidal antiinflammatory activity. Cetirizine (10 mg daily as a single dose) was administered to 22 patient for 45 days. On the other hand, FP (400 micrograms/day) was administered into each nostril twice a day in the remaining 21 patients for 45 days. Skin test was obtained from each patient before therapy. Total eosinophil count, eosinophil count in nasal smear, electrorhinomanometric investigation, PGE2 and ratio of LTC4 to LTD4 both in the serum and in the nasal secretions were determined before and after therapy. In addition, percentage of eosinophils, and mast cells count in the biopsy specimens taken from anterior edge of middle choncha were evaluated before and after therapy, and than the results were graded for each patients. When we compared the eosinophil count in nasal smear, eosinophil percentage and total eosinophil parameters between two groups, it was shown that FP was more effective than Cetirizine. On the other hand, when we compared the ratio of LTC4 to LTD4 in serum and nasal smear, level of PGE2 and mast cell and nasal airway resistance measured by ERM, there were non statistical difference between two groups. These results suggest that FP and Cetirizine may be used alternatively in case of an adverse reaction to any of them.

Planning a medical relief mission

Surveillance of drug consumption and disease incidence from medical relief missions in two locations--southeast Asia and eastern Africa--revealed close similarities. Analgesics, antibiotics, antimalarials, antihistamine or decongestant preparations (or both), bronchodilators, and scabicides were the 10 most commonly used drugs. Orthopedic, respiratory, gastrointestinal, dermatologic, and ophthalmic conditions, malaria, sexually transmitted diseases, and parasitic infestations were encountered most frequently. Recognition and early treatment of xerophthalmia, trachoma, and onchocerciasis, which are rare in more developed countries but common at tropical latitudes, can prevent the blindness that results from untreated disease progression. Pulse-temperature relationships and fever patterns may offer diagnostic clues to physicians deprived of laboratory support. Important logistic considerations, disease incidences, and selected topics and idiosyncrasies of humanitarian aid missions to tropical communities are discussed in hopes of aiding providers who are planning future relief missions.

Duration of Effect of Loratadine and Terfenadine Administered Once a Day for One Week on Cutaneous and Inhaled Reactivity to Histamine

The duration of action of several new non-sedative antihistamine preparations as assessed by skin and bronchial reactivity to histamine has still not been well established. The aim of the study was to evaluate the duration of effect of loratadine (10 mg) and terfenadine (120 mg) administered once a day for one week on cutaneous and inhaled reactivity to histamine by comparison with a placebo. Twenty-four adult asthmatic subjects were included in a parallel group study that compared the duration of effect of two antihistamines and a placebo on cutaneous and inhaled reactivity to histamine. Baseline cutaneous and inhaled reactivity (concentration causing a fall of 20 percent in FEV1 [PC20]) to histamine was obtained on three consecutive days. Loratadine (10 mg), terfenadine (120 mg) and a placebo loratadine were administered daily for 1 week to 3 groups of subjects. The PC20 was measured at the end of the medication period, 3 days later, and weekly until PC20 returned to baseline value (upper limit of 2 SD from the mean baseline value). The mean blocking duration on cutaneous reactivity for loratadine was 6.9 days and for terfenadine, 7.2 days. The mean duration of the blocking effect on PC20 histamine was 8.5 days for loratadine and 7.2 days for terfenadine. These figures were significantly longer than for the placebo. These data suggest that terfenadine and loratadine have a comparable blocking effect on reactivity to cutaneous and inhaled histamine. A daily dose taken for one week will result in a mean blocking effect of one week.

Effect of some antihistamine preparations on binding of3H-mepyramine and3H-cimetidine to histamine receptors in rat brain

Effect of some antihistamine preparations on binding of3H-mepyramine and3H-cimetidine to histamine receptors in rat brain