People who experience allergies regularly buy antihistamines and know what it is.
Timely taken pills save from a debilitating cough, swelling, rash, itching and redness of the skin. The pharmaceutical industry has been releasing similar drugs for many years, and each new batch is formulated as a separate generation.
Today we will talk about the latest generation of antihistamines and consider the most effective of them.
General concept of antihistamines
To everyone who wants to understand in depth the question of what it is - antihistamines, doctors explain that these drugs are designed to counter histamine - an allergic mediator.
When the human body comes into contact with an irritant, specific substances are produced, among which histamine exhibits increased activity. In a healthy person, it is located in mast cells and remains inactive. Under the influence of an allergen, histamine enters the active phase and provokes allergy symptoms.
To stop negative reactions at different times, medicines were invented that could lower the amount of histamine and neutralize its harmful effects on humans. Thus, antihistamines is a general definition of all drugs that have the indicated efficacy. To date, their classification has 4 generations.
The advantages of the drugs under consideration are a gentle effect on the body, in particular, on the cardiovascular system, rapid relief of symptoms and a prolonged effect.
Review of new generation antihistamines
Antihistamines are also called H1 receptor blockers. They are quite safe for the body, but still have some contraindications. For example, during pregnancy and in childhood, the doctor has the right not to prescribe allergy pills if these conditions are listed among the contraindications in their instructions.
All new generation antihistamines - list of new drugs:
- Erius.
- Ksizal.
- Bamipin.
- Cetirizine.
- Ebastine.
- Fenspiride.
- Levocetirizine.
- Fexofenadine.
- Desloratadine.
It is difficult to single out the most effective 4th generation antihistamines from this list, because some of them have appeared relatively recently and have not yet managed to prove themselves 100%. Fenoxofenadine is a popular allergy treatment option. Taking tablets containing this substance does not have a hypnotic and cardiotoxic effect on the patient.
Medications with cetirizine well remove skin manifestations of allergies. One tablet brings significant relief after 2 hours from the moment of use. The result is stored for a long time.
The drug Erius is an improved analogue of Loratadine. But its efficiency is about 2.5 times higher. Erius is suitable for children over the age of 1 who are prone to allergies. They are given the drug in liquid form with a dosage of 2.5 ml 1 time per day. From the age of 5, the dosage of Erius is increased to 5 ml. From the age of 12, the child is given 10 ml of medication per day.
The drug Ksizal is also in high demand today. It prevents the release of inflammatory mediators. Effectiveness is determined by the reliable elimination of allergic reactions.
Feksadin (Allegra, Telfast)
The drug with fexofenadine reduces the production of histamine and completely blocks histamine receptors. Suitable for the treatment of seasonal allergies and chronic urticaria. The tool is not addictive. The body is affected for 24 hours.
Feksadin should not be taken during pregnancy, breastfeeding and children under 12 years of age.
Zodak (Cetrin, Zyrtec, Cetirizine)
The effectiveness of the taken pill is felt after 20 minutes, and after the drug is discontinued, it remains for another 72 hours. Zodak and its synonyms are used for the treatment and prevention of allergies. Long-term use is allowed. The release form is not only tablets, but also syrup and drops.
In pediatrics, Zodak drops have been used since 6 months. After 1 year, syrup is prescribed. Children can take tablets from the age of 6. Dosages for each type of medication are selected individually.
Cetirizine should not be taken by pregnant women. If there is a need to treat allergies during lactation, the baby is temporarily weaned.
Xyzal (Suprastinex, Levocetirizine)
Drops and tablets Ksizal work 40 minutes after ingestion.
The drug is indicated for the treatment of urticaria, allergies, pruritus. For children, fourth-generation antihistamines for allergies called Ksizal are prescribed from the age of 2 and 6 (drops and tablets, respectively). The pediatrician calculates the dosage according to the age and weight of the child.
Xyzal is prohibited during pregnancy. But it can be taken in the process breastfeeding.
Suprastinex helps well with seasonal allergies, when the body reacts to the pollen of flowering plants. As the main drug, it is used in the treatment of conjunctivitis and allergic rhinitis. Take Suprastinex with food.
Desloratadine (Erius, Lordestin, Desal)
Desloratadine and its synonyms have antihistamine and anti-inflammatory properties.
They quickly treat seasonal allergies and recurrent hives, but sometimes cause side effects such as headache and dry mouth. Desloratadine is sold in the form of tablets and syrup.
For children 2 to 6 years old, doctors prescribe syrup. Tablets are allowed to be used only from 6 years. Pregnant and lactating women Desloratadine is completely contraindicated. But with Quincke's edema and bronchospasm, a specialist can choose a gentle option for using this medication.
Antihistamines for toddlers
Newborns are not recommended to take antihistamines. But sometimes there are situations when it is impossible to do without drugs, for example, if the baby was stung by an insect. From 1 month of life, a child can be given Fenistil in drops.
Diphenhydramine, which was previously given to children in different occasions, pediatricians today prescribe only from the 7th month of life.
The most gentle option for the smallest is Suprastin. It quickly exhibits healing properties without causing the slightest harm to the body. Also, children are prescribed Fenkarol and Tavegil. For urticaria, drug dermatosis and food allergies It is better for a child to give Tavegil. Tablets relieve puffiness, restore skin color and work as an antipruritic agent.
Analogues of Tavegil are Donormil, Dimedrol, Bravegil and Clemastin. Their child takes in the presence of contraindications to the use of Tavegil.
From 2 to 5 years of age, the child's body gradually strengthens and can normally tolerate stronger drugs. When itching skin, the names of antihistamines for this age group of patients, the specialist will consider the following:
Erius was mentioned above, now we will focus on Tsetrin. These tablets can be used to prevent allergies in children prone to negative reactions. With individual intolerance to the constituent components, Cetrin is replaced by analogues - Letizen, Cetirinax, Zodak, Zetrinal. After 2 years, the child can take Astemizol.
From the age of 6, the list of antihistamines is being expanded, since drugs of different generations are suitable for such children - from 1 to 4. junior schoolchildren can drink tablets Zyrtec, Terfenadin, Clemastine, Glenset, Suprastinex, Caesera.
What Komarovsky says
The famous pediatrician E.O. Komarovsky does not advise parents to give antihistamines to young children without emergency and medical prescriptions. If a pediatrician or an allergist has deemed it necessary to prescribe an antiallergic agent to a child, it can be taken for no more than 7 days.
Evgeny Olegovich also forbids combining antihistamines with antibiotics and says that it is not at all necessary to give a child an antihistamine tablet on the eve of vaccination or after vaccination.
Some parents, based on their own considerations, try to give their child Suprastin to drink before DTP, but Komarovsky does not see any point in this. The children's doctor explains that the reaction of the body to the vaccine has nothing to do with the manifestations of allergies.
Allergic women planning to have offspring are always interested in what antihistamines can be taken during pregnancy and preferably during lactation, or is it worth enduring the inconvenience associated with hay fever, rash and swelling. Doctors say that during the gestation period, it is better for women not to take any medications, because they are potentially dangerous for the mother and fetus.
Currently, more than 85% of the total population of the entire planet is subject to various manifestations of allergies, and in the past few decades, a pronounced increase in the number of allergic people has been observed. This is probably due to the development of an industry that produces chemical products, which in themselves are frequent allergens or create conditions for the formation of an allergic reaction, due to dysfunction of the endocrine and nervous systems.
It is also possible the influence of hygiene (excessive use of antibacterial and other potent agents), depriving the human body of contact with the multitude, which weakens the immune system (especially in childhood).
It should be remembered that allergy is an extremely individual disease with inadequate reactions of the body to a variety of allergens that cause various painful symptoms at different times for different people. Allergic reactions underlie quite serious illnesses, including, and, and may also accompany some infections (infectious allergies).
Causes of Allergy
Allergy itself can be recognized by a sudden onset lacrimation , sneezing, redness of the skin and other unexpected painful manifestations. Most often, such allergic symptoms occur upon direct contact with a specific allergen substance recognized by the human body as the causative agent of the disease, as a result of which counteraction mechanisms are launched in it.
Modern doctors consider allergens as substances that have a direct allergenic effect, as well as agents that can increase the effect of other allergens.
The response of a person to exposure to various allergens largely depends on the genetic individual characteristics of his immune system . Reviews of numerous studies indicate the presence of a hereditary allergic predisposition. So, parents with allergies are much more likely to give birth to a child with a similar pathology than healthy couples.
The main causes of allergies:
- waste products of a domestic tick;
- pollen from various flowering plants;
- foreign protein compounds contained in or;
- exposure to sunlight, cold;
- dust (book, household, street);
- disputes of different fungi or mold ;
- animal hair (mainly characteristic of cats, rabbits, dogs, chinchillas);
- chemical detergents and cleaners;
- medicinal preparations ( , );
- food products, mainly eggs, fruits (oranges, persimmons, lemons), milk, nuts, wheat, seafood, soybeans, berries (viburnum, grapes, strawberries);
- insect/arthropod bites;
- latex;
- cosmetical tools;
- psychological/emotional;
- Unhealthy Lifestyle.
Types and symptoms of allergies
Respiratory Allergy
A form of allergy is characteristic of the influence of allergens that enter the body from the outside during breathing. These substances are collectively known as aeroallergens , which include pollen, the smallest dust, various gases. This can also be attributed to the allergy of the respiratory tract.
Symptoms of such painful conditions are:, pulmonary rales, itching in the nose, severe, sometimes. The main negative symptoms manifest themselves in the form and bronchial asthma .
Dermatosis
A form of skin allergy, accompanied by various skin irritations and rashes. It occurs due to exposure to such allergens as: medicines, aeroallergens, food, household chemicals, cosmetics.
It is manifested by reddening of the skin, severe swelling, itching, blistering, peeling, rashes by type, dry skin.
allergic conjunctivitis
A form of allergy due to exposure to various allergens, in which the organs of vision are mainly affected and negative eye symptoms are noted.
The main symptomatology manifests itself in the form of: skin swelling in the periorbital region, burning in the eyes, increased tearing.
Enteropathy
Anaphylactic shock
The most dangerous form allergies that can develop in a few seconds or up to five hours. The main causes of this condition are insect bites and the use of untested drugs.
External forms (, gel) are used mainly for itching of the skin ( itchy dermatoses ), caused by insect bites, as well as acquired due to itchy eczema, urticaria, contact allergies (to detergents, washing powder, synthetic or coarse clothing, etc.).
These external preparations are ineffective and are rarely used in the treatment of chronic skin allergic forms (for example, with). In combination with a diet, these funds can be recommended at the initial stages of treatment. exudative-catarrhal diathesis moderate nature (when a baby has a rash on the face associated with nutrition).
Local combined agents in the form eye drops (Oftalmol , ), including first-generation antihistamines, are used in the treatment allergic conjunctivitis , as well as accompanied by conjunctivitis.
Such drops quite well relieve such negative symptoms as: redness and swelling of the eyelids, itching and tearing in the eyes, while simultaneously providing antimicrobial action. In turn, nasal drops cope quite well with the manifestations allergic rhinitis in all its forms (including hay fever ).
Side effects
Negative effects are mainly inherent in systemic drugs, however, due to long-term use, they can also be observed when using external / local agents (especially in pediatrics).
Most often, first-generation antihistamines are accompanied by:
- strong sedatives /sleeping pills effects;
- decreased muscle tone;
- psychomotor agitation (especially in children and adults with prolonged use);
- potentiation (multiplication) of the effects of alcohol, sleeping pills and analgesic funds;
- /headaches;
- local anesthetic action;
- lowering blood pressure;
- anticholinergic effects (tremor of the fingers, dry mouth, constipation, palpitations, visual disturbances);
- nausea, vomiting, pain in a stomach;
- addictive .
Due to the hypnotic effect, drugs of this generation are not recommended for pupils, students, drivers and people involved in potentially hazardous activities.
All such drugs cause a specific reaction. tachyphylaxis (addiction), which is expressed by a noticeable decrease in effectiveness during long-term use and requiring the replacement of the active ingredient of the drug with another substance every 20 days.
Advantages
In certain cases, doctors have learned to use some of the above disadvantages of 1st generation drugs for good.
For example, sedative /hypnotic the action of these therapeutic agents will be useful in allergic diseases with parallel intolerable skin itching ( atopic dermatitis during an exacerbation), bringing long-awaited sleep to the patient's life.
Anticholinergic effects , including dry mucous membranes, useful in therapy bronchitis (for allergic cough) and rhinitis (from the coryza), accompanied by a profuse liquid secretion.
All first-generation drugs, even those produced abroad, are quite inexpensive, and domestic manufacturers produce even cheaper analogues.
Flaws
Due to the pronounced negative systemic effects and the body's addiction to the active ingredient of the drug, 1st generation drugs are not suitable for long-term therapy.
Drowsiness and sedative effect seriously limits the number of patients who can be prescribed these drugs.
List of 1st generation antihistamines, table
| Active Ingredient | Trade names of drugs | Release form | |
|
|
|
|
| external gel | 0 months | ||
|
eye drops |
|
|
| Chloropyramine |
|
|
1 month |
| clemastine |
|
|
|
|
|
2 months | |
| Pheniramine | Avil |
|
|
|
|
||
| (combined) |
|
|
|
| Cyproheptadine |
|
|
|
| Mebhydrolin |
|
|
|
| Hifenadine | tablets | 3 years |
2nd generation drugs
As in the previous case, the list of second-generation antihistamine allergy drugs is mainly represented by oral dosage forms.
Tablets ( , Histalong , ), syrups ( , ) drops ( , Parlazin , cetirizine ) capsules ( Semprex ) and suspensions ( , ) are used for almost all types of allergic manifestations, both for the treatment of adult patients and for the treatment of children.
Also on the pharmaceutical market there are eye drops of this generation of antihistamines - which are used for therapy allergic conjunctivitis in any form. These drops relieve the negative symptoms of rhinitis after 20 minutes, are not characterized by serious side effects, and help to improve mucociliary clearance.
Second-generation antihistamines have a number of advantages over their predecessors:
- prolonged action (high efficiency is maintained for 24 hours, which allows the patient to drink the recommended dose of the drug shown to him only 1 time per day);
- all therapeutic agents of this generation are not adsorbed by the gastrointestinal tract with food;
- minimal impact sedative /sleeping pills effect, due to the impossibility of passing the active ingredients of therapeutic agents through the blood-brain barrier;
- in the course of therapy, physical activity and mental activity of the patient practically do not suffer;
- anticholinergic action (tremor of the fingers, dry mouth, constipation, palpitations, visual disturbances) is very rare;
- all second-generation drugs are not addictive and can be used for a sufficiently long time (3-12 months) without changing the active substance (for example, throughout seasonal allergies as long as it takes until the allergen disappears);
- when treatment is stopped, therapeutic efficacy persists for another week.
Side effects
Among the negative effects of 2nd generation antihistamines, the most serious is cardiotoxic effect , which manifests itself in varying degrees of severity and requires control over the patient's cardiac activity during therapy.
Cardiotoxic action becomes possible due to the ability of drugs of this generation to act on the potassium channels of the heart, blocking them. The risk of such an effect is increased with impaired hepatic function, parallel reception antifungal agents, antidepressants , macrolides and the use of grapefruit juice. Naturally, elderly patients and patients with disorders in the field of cardiovascular vascular system such drugs are contraindicated.
Other most common side effects:
- impaired hepatic function;
- fast fatiguability;
- nausea;
- puffiness ;
- asthenia;
- phenomena;
- nervous irritability and sedation (in children).
Advantages
Due to the minimal negative systemic action and effect tachyphylaxis (addiction), 2nd generation drugs are the best suited for long-term use and have proven themselves well in the treatment of allergic seasonal rhinoconjunctivitis and rhinitis , hay fever, atopic dermatitis (in complex therapy in the subacute stage) and bronchial asthma .
These therapeutic agents can be prescribed to schoolchildren and students during educational process because they do not reduce their concentration.
Prolonged effectiveness, observed for 24 hours (which allows you not to do unnecessary tricks, but to limit them to 1 time per day).
Flaws
Due to the relatively short practice of use, all possible positive / negative effects of second-generation drugs have not been studied as well as in the case of their predecessors. In particular, for this reason, most of them, according to the instructions for use, are contraindicated up to 2 years, and the rest should not be given to children under six months.
List of 2nd generation antihistamines, table
| Active Ingredient | Trade names of drugs | Release form | Age restrictions for use |
| Loratadine |
|
|
|
| cetirizine | Alerza | tablets | 6 years |
|
|
|
|
|
|
||
|
|
||
| Akrivastine | Semprex | capsules | 12 years old |
| Terfenadil |
|
tablets | 3 years |
| Terfenadine |
|
3 years | |
| ebastine |
|
tablets | 6 years |
|
|
||
| Astemizol |
|
tablets | 2 years |
| Hismanal |
|
2 years |
3rd generation drugs
The entire list of anti-allergy drugs of the new generation (third) can, in principle, be attributed to previous therapeutic agents, because the active ingredients of these drugs are pharmacologically active metabolites of some of the already known main ingredients of the last generation (second) described above.
However, new generation antiallergic drugs have entered the market. pharmaceutical market the last and many sources position them as 3rd and even 4th generation antihistamines.
The range of positive effects of this generation of drugs covers almost all currently known allergic manifestations. Tablets ( , ), syrups ( Eden , ), oral drops and solutions ( , ) can be used for therapy hay fever , allergic rhinitis , dermatological reactions and other allergic manifestations.
Antihistamines of the new generation, in comparison with their predecessors, are characterized by the greatest selectivity (selectivity) of their action exclusively aimed at peripheral H1 receptors. It is precisely because of this that their high antiallergic effectiveness can be traced along with the absence of side effects inherent in 1st and 2nd generation drugs.
Distinctive characteristics of such drugs are:
- rapid absorption in the gastrointestinal tract along with high bioavailability, which contribute to the leveling of allergic reactions in as soon as possible;
- drops, syrups and tablets do not cause, and only when taking excessive doses can lead to the development sedative actions;
- the patient's performance and response remain at a high level;
- missing cardiotoxic effects that will allow prescribing drugs of this generation to elderly patients;
- there is no addiction effect, which makes it possible to use these drugs for a long period of time;
- there is practically no interaction with concurrently taken drugs from other pharmaceutical groups;
- absorption of therapeutic agents does not depend on the time of the meal;
- active ingredients are excreted in unchanged form, relieving the burden on the kidneys and liver.
Side effects
In rare cases, development is possible:
- nausea;
- prolongation of the QT interval ;
- headaches/dizziness;
- increased appetite;
- skin hyperemia;
- dryness of mucous membranes.
Advantages
Prolonged and rapid action, the practical absence of negative side effects (manifested in the form of anticholinergic action and suppression of the nervous system), a single daily intake.
Flaws
As with all relatively new drugs, the lack of these drugs in incomplete clinical data regarding the safety of their use (especially in pediatrics). The price of drugs of this generation can be several times higher than the cost of their predecessors.
List of antihistamines 3-4 generations, table
| Active Ingredient | Trade names of drugs | Release form | Age restrictions for use |
| Desloratadine |
|
tablets | 12 years old |
|
|
|
|
|
|
|
|
| Levocetirizine |
|
|
|
|
tablets | 6 years | |
|
tablets | 6 years |
Modern pediatrics in its practice of treating allergies in children uses antihistamine antiallergic drugs for children of all three generations. In the younger age group, the most used oral dosage forms are children's drops and syrups, tablets are prescribed to children already at a more conscious age, most often from the age of 6.
Some allergy nasal and eye drops for children can be used from birth.
- In the countries of the post-Soviet space, especially in acute period allergies, pediatricians often prefer to use 1st generation antihistamines for children under one year old. Such drugs are characterized by rapid efficacy and rapid elimination. They have been used in pediatrics for a long time, their positive and negative effects are well studied, most of them are considered relatively safe (if taken as prescribed by a doctor, without overestimating the recommended doses), many drugs in this group can be used for newborns. When liquids are not available dosage forms it is allowed for children up to a year to take medicines in the form of tablets, previously divided into parts recommended by the doctor and crushed. The most popular and effective drugs for systemic action of first-generation antihistamines are recognized:,.
- Antihistamines 2 generations characterized by a longer duration of action, due to which they can be used once every 24 hours. Such drugs are more suitable for long-term therapy. They rarely lead to sleeping pills /sedative effect and other side effects inherent in 1st generation medicinal products. Such medicines are prescribed for children from 1 year old (rarely from 6 months old), since their effect on the body of infants has not been studied enough. In this generation, pediatricians most often use drugs:, Zyrtec , .
- 3rd generation antihistamines differs in very high efficiency and even smaller manifestation of side effects. Liquid preparations of this generation (syrups, drops), due to their novelty, are used to treat chronic allergic processes in children only when they reach the age of 12 months. Of the third generation children's medicines, we can distinguish:, Eden , Desal .
Parents should remember that it is strictly forbidden to give your child antiallergic drugs on their own. As Dr. Komarovsky wrote in his article: “ ... antihistamines can only be prescribed by a doctor and used in strict accordance with his instructions«.
Antihistamines during pregnancy
Naturally, allergic women who plan to become pregnant or are already carrying a child under their hearts are extremely interested in which allergy pills can be taken with and in the future, and is it possible to take such drugs during these periods in principle?
Let's start with the fact that pregnancy it is better for a woman to avoid taking any medical preparations, since their action can be dangerous for both pregnant women and their future offspring. It is strictly forbidden to take antihistamine pills for allergies during pregnancy in the 1st trimester, with the exception of extreme ones, life threatening expectant mother, cases. In the 2nd and 3rd trimester, the use of antihistamines is also allowed with huge restrictions, since none of the existing therapeutic antiallergic drugs is 100% safe.
Allergic women suffering from seasonal allergies , you can recommend to plan in advance the time of your pregnancy when specific allergens are least active. For the rest, it is also best to avoid contact with substances that cause them allergic reactions. If it is impossible to fulfill such recommendations, the severity of some allergic manifestations can be reduced by taking natural antihistamines (, and, zinc, pantothenic , and oleic acids) and then only after consulting a doctor.
Membrane mast cell stabilizers
For the treatment of certain allergic reactions, mainly initial and
Allergy is the scourge of the XXI century. A disease whose prevalence has been growing rapidly in recent decades, especially in developed countries world, still remains incurable. World statistics showing the number of people suffering from various manifestations allergic reaction, strikes even the wildest imagination. Judge for yourself: 20% of the population annually suffer from allergic rhinitis, 6% are forced to diet and take allergy pills, about 20% of the world's inhabitants experience symptoms of atopic dermatitis. No less impressive are the numbers that reflect the number of people suffering from even more severe pathologies that have allergic origin. Depending on the country of residence, about 1-18% of people cannot breathe normally due to asthma attacks. Approximately 0.05-2% of the population experience or have experienced in the past a life-threatening anaphylactic shock.
Thus, at least half of the population faces allergic manifestations, and it is concentrated just for the most part in countries with developed industry, and, therefore, in the Russian Federation. At the same time, the help of allergists, alas, does not cover all Russians in need, which, of course, aggravates the situation and contributes to the further progression of the disease. The obviously insufficient control over the release of prescription antiallergic drugs in domestic pharmacies also contributes to the not very favorable state of affairs with the treatment of allergies in Russia. This trend contributes to aggressive self-treatment, including with the help of hormonal allergy medications, which can sometimes lead patients into a blind corner and bring the development of severe stages of the disease closer.
We have drawn such an unsightly picture not to frighten the reader. We just want every person who has encountered an allergy to understand both the severity of the disease and the prognosis in case of unsuccessful treatment, and not to rush to buy the first pills “peeped” in the commercial. We, in turn, will devote to the description of allergies detailed article, which, we hope, will help to understand the features of the disease, its therapy and the features of various drugs used for this purpose. Understand and continue to be treated only correctly.
What is an allergy?
And we will start with the basics, without which it is impossible to understand how allergy pills work. Allergy is defined as a range of conditions caused by hypersensitivity of the immune system to a substance. At the same time, most people perceive these same substances as safe and do not react to them at all. Now let's try to describe this process in a more popular way.
Imagine an army guarding the borders of a state. She is well armed and always ready for battle. Every day, enemies try to storm the carefully controlled border, but invariably receive a worthy rebuff. One fine day, confusion occurs in the ranks of our army for unknown reasons. Her experienced and courageous warriors suddenly make a serious mistake, mistaking a friendly delegation, which has always crossed the border unhindered, for an enemy. And by this, unwittingly, they cause irreparable damage to their country.
Approximately the same events develop during an allergic reaction.
The immune system of the body, which every day is on its defense against hundreds of bacteria and viruses, suddenly begins to perceive harmless substances as mortal enemies. As a result, a military operation begins, which is too expensive for the organism itself.
How does an allergic reaction develop?
First, the body begins to produce special antibodies that are not synthesized normally - class E immunoglobulins. Looking ahead, let's say that a blood test for the presence of IgE allows you to reliably establish that a person suffers from allergies and needs medicines for it. The task of immunoglobulins E is to bind a substance that is mistaken for an aggressive toxin - an allergen. As a result, a stable antigen-antibody complex is formed, which should neutralize the enemy. However, unfortunately, it is impossible to “neutralize” without consequences in case of an allergic reaction.
The formed antigen-antibody combination settles on the receptors of special cells of the immune system called mast cells.
An antigen is a molecule that is capable of binding to an antibody.
They are located in the connective tissue. There are especially many mast cells under the skin, in the region of the lymph nodes and blood vessels. Various substances are located inside the cells, including histamine, which regulates many physiological processes in the body. However, along with a positive role, histamine can also play a negative one - it is he who is a mediator, that is, a substance that triggers allergic reactions. As long as histamine is inside the mast cells, it does not pose a danger to the body. But if an antigen-antibody complex is attached to the receptors located on the surface, the mast cell wall is destroyed. Accordingly, all the contents come out, including histamine. And then his finest hour comes, and hitherto unaware of the complex processes taking place in their bodies, citizens seriously think about what kind of pills they should buy for allergies. But there is no need to rush - you should first find out what kind of allergic reaction will take on.
What is an allergy?
And there may be several options depending on the allergen and individual sensitivity. Most often, allergies develop on the pollen of grasses and flowers. In this case, they talk about hay fever, or hay fever. Symptoms that indicate a disease and require the appointment of tablets or allergy sprays include:
- manifestations of allergic rhinitis - runny nose, sneezing, itching in the nose, rhinorrhea;
- manifestations of allergic conjunctivitis - lacrimation, itching in the eyes, redness of the sclera;
Much less often, treatment with tablets or ointments for allergies requires dermatitis that is allergic in nature. These include a number of diseases, including:
- atopic dermatitis, characterized by excessive dryness and irritation skin;
- contact dermatitis develops as a reaction to contact with materials, causing allergies. Most often it is latex (latex gloves), less often - metal products and jewelry;
- urticaria, may appear due to reactions to various foods.
Severe chronic disease of allergic nature - bronchial asthma. Even more dangerous conditions associated with a risk to life are Quincke's edema and anaphylactic shock. They are immediate allergic reactions, have a fulminant onset and require immediate medical attention. Well, now let's start describing the drugs that are used to treat various types of allergies.
Antihistamines as Allergy Drugs: Popular and Economical
Means of this group are among the most well-known and commonly used drugs for the treatment of food, seasonal allergies, various dermatitis, less often - urgent conditions.
The mechanism of action of antihistamines is to block the receptors to which the main mediator of allergy, histamine, binds. They are called H1-histamine receptors, and drugs that inhibit them, respectively, blockers of H1-histamine receptors, or H1-antihistamines.
To date, three generations of antihistamines are known, used both for the treatment of allergies and for some other conditions.
Here is a list of the most famous antihistamines that are used against allergies.
Table 1. Three generations of antihistamine antiallergic drugs
First generation antihistamines
They have been used for several decades and, nevertheless, still have not lost their relevance. Distinctive features these drugs are:
- sedative, that is, a sedative effect. It is due to the fact that drugs of this generation can bind to H1 receptors located in the brain. Some drugs, such as Diphenhydramine, are much better known for their sedative than antiallergic properties. Other pills that could theoretically be prescribed for allergies have found use as a safe sleeping pill. We are talking about doxylamine (Donormil, Somnol);
- anxiolytic (mild tranquilizing) action. It is associated with the ability of certain drugs to suppress activity in certain areas of the central nervous system. As a safe tranquilizer, the first generation antihistamine tablets hydroxyzine, known under the trade name Atarax, are used;
- anti-sickness and antiemetic action. It is manifested, in particular, by diphenhydramine (Dramina, Aviamarin), which, along with the H-histamine blocking effect, also inhibits m-cholinergic receptors, which reduces the sensitivity of the vestibular apparatus.
One more hallmark antihistamine pills for allergies of the first generation is a quick, but short-term anti-allergic effect. In addition, the first generation drugs are the only antihistamines that are available in injectable form, that is, in the form of injection solutions (Diphenhydramine, Suprastin and Tavegil). And if the solution (and tablets, by the way, too) of Dimedrol has a rather weak anti-allergic effect, then the injection of Suprastin and Tavegil allows you to quickly provide first aid for an immediate type of allergy.
In case of an allergic reaction to insect bites, urticaria, Quincke's edema, intramuscular or intravenous Suprastin or Tavegil are used along with injections of a glucocorticosteroid drug, most often Dexamethasone, as a powerful antiallergic agent.
Second generation antihistamines
Preparations of this series can be called modern new-generation allergy pills that do not cause drowsiness. Their names often appear in TV commercials and media brochures. They are characterized by several properties that distinguish among other H1-histamine blockers and antiallergic drugs in general, including:
- rapid onset of antiallergic effect;
- duration of action;
- minimal or complete absence of a sedative effect;
- lack of injection forms;
- ability to provide Negative influence to the heart muscle. By the way, we can dwell on this effect in more detail.
Do allergy pills work on the heart?
Yes, indeed, some antihistamines can adversely affect the functioning of the heart. This is due to blockage of the potassium channels of the heart muscle, leading to a prolongation of the QT interval on the electrocardiogram and a violation heart rate.
The likelihood of developing a similar effect increases when second-generation antihistamines are combined with a number of other drugs, in particular:
- the antifungals ketoconazole (Nizoral) and itraconazole (Orungal);
- macrolide antibiotics erythromycin and clarithromycin (Klacid);
- antidepressants fluoxetine, sertraline, paroxetine.
In addition, the risk of a negative effect of second-generation antihistamines on the heart increases if allergy pills are combined with the use of grapefruit juice, as well as in patients suffering from liver diseases.
Among the wide range of second-generation antiallergic drugs, several drugs should be distinguished that are considered relatively safe for the heart. First of all, it is dimethindene (Fenistil), which can be used for children from 1 month of age, as well as cheap pills Loratadine is also widely used for allergy therapy in pediatric practice.
third generation antihistamine
And finally, we come to the smallest, latest generation of drugs prescribed for allergies, from the group of H1-histamine blockers. They fundamentally differ from other drugs in the absence of a negative effect on the heart muscle against the background of a powerful anti-allergic effect, fast and prolonged action.
The drugs in this group include Cetirizine (Zyrtec), as well as Fexofenadine (trade name Telfast).
About metabolites and isomers
In recent years, two new H1-histamine blockers, which are close "relatives" of already well-known drugs of the same group, have gained popularity. We are talking about desloratadine (trade names Erius, analogues Lordestin, Ezlor, Edem, Eliza, Nalorius) and levocetirizine, which belong to a new generation of antihistamines and are used to treat allergies of various origins.
Desloratadine is the primary active metabolite of loratadine. Just like its predecessor, desloratadine tablets are prescribed once a day, preferably in the morning for allergic rhinitis (both seasonal and year-round) and chronic urticaria for the treatment of adults and children over one year old.
Levocetirizine (Xyzal, Suprastinex, Glenset, Zodak Express, Cezera) is a levorotatory isomer of cetirizine, used for allergies of various origins and types, including those accompanied by itching and rashes (dermatoses, urticaria). The drug is also used in pediatric practice for the treatment of children older than 2 years.
It should be noted that the appearance of these two drugs on the market was enthusiastically received. Many experts believed that levocetirizine and desloratadine would finally help to effectively solve the problem of insufficient response to traditional antihistamine therapy, including severe allergy symptoms. However, in fact, expectations, alas, did not materialize. The effectiveness of these drugs did not exceed the effectiveness of other H1-histamine blockers, which, by the way, is almost identical.
The choice of antihistamine is often based on the patient's tolerance and price preferences, as well as ease of use (ideally, the drug should be used once a day, such as Loratadine).
When are antihistamines used for allergies?
It should be noted that antihistamines are distinguished by a rather large variety of active substances and dosage forms. They can be produced in the form of tablets, solutions for intramuscular and intravenous injections and external forms - ointments and gels, and all are used for various types of allergies. Let's figure out in which cases the advantage is given to one or another medicine.
Hay fever, or polynosis, food allergy
The drugs of choice for allergic rhinitis (inflammation of the nasal mucosa of an allergic nature) are allergy pills of the II or last, III generation (the full list is given in Table 1). When it comes to allergies in a small child, dimethindene (Fenistil in drops), as well as Loratadine, Cetirizine in children's syrups or solutions are often prescribed.
Skin manifestations of allergies (food, various types of dermatitis, insect bites)
In such cases, it all depends on the severity of the manifestations. With mild irritation and a small area of lesion, external forms can be limited, in particular, Psilo-balm gel preparations (Dimedrol is included) or Fenistil gel (external emulsion). If the allergic reaction in an adult or child is strong enough, accompanied by severe itching and / or a significant area of the skin is affected, tablets (syrups) for allergies of the H1-histamine blockers group can be prescribed in addition to local drugs.
allergic conjunctivitis
With inflammation of the mucous membrane of the eye of an allergic nature, eye drops are prescribed and, with insufficient effect, tablets. The only eye drops today that contain exactly the antihistamine component are Opatanol. They contain the substance olapatadin, which provides a local anti-allergic effect.
Mast Cell Membrane Stabilizers: Allergy Pills Are Not for Everyone
Another group of allergy drugs acts by preventing calcium ions from entering mast cells and thus inhibiting the destruction of cell walls. Thanks to this, it is possible to prevent the release of histamine into the tissues, as well as some other substances involved in the development of an allergic and inflammatory reaction.
On modern Russian market Only a few allergy remedies for this group have been registered. Among them:
- ketotifen, an allergy drug in tablets;
- cromoglycic acid and sodium cromoglycate;
- lodoxamide.
All preparations containing cromoglycic acid and sodium cromoglycate are conditionally called cromoglycates in pharmacology. Both active ingredients have similar properties. Let's consider them.
cromoglycates
These drugs are available in several forms of release, which, in turn, are indicated for various types of allergies.
Dosed nasal spray (Kromoheksal) is prescribed for seasonal or year-round allergic rhinitis. It is prescribed for adults and children over five years of age.
It should be noted that the noticeable effect of the use of cromoglycates in the spray occurs after one week of continuous use, reaching a peak by four weeks of continuous treatment.
Inhalations are used to prevent asthma attacks. An example of inhalation agents against allergies, which was complicated by bronchial asthma, are Intal, KromoGeksal, Kromogen Easy Breathing. The mechanism of action of drugs in such cases is aimed at interrupting the allergic reaction, which is a "trigger" in the pathogenesis of bronchial asthma.
Capsules of cromoglycic acid (KromoGeksal, Cromolyn) are prescribed for food allergies and some other diseases, one way or another associated with allergies.
Eye drops with cromoglycates (Allergo-Komod, Ifiral, Dipolkrom, Lekrolin) are the most prescribed anti-allergic drugs for conjunctivitis caused by sensitivity to plant pollen.
Ketotifen
A tableted remedy for allergies, from the group of mast cell stabilizers. Just like cromoglycates, it prevents or at least slows down the release of histamine and other biologically active substances that provoke inflammation and allergies from mast cells.
It has a fairly low price. In the Russian Federation, several preparations containing ketotifen are registered, and one of the highest quality is the French Zaditen. By the way, it is available in the form of tablets, as well as syrup for children and eye drops, which are prescribed for allergies of various origins and types.
It should be borne in mind that Ketotifen is a drug that exhibits a cumulative effect. With its constant use, the result develops only after 6-8 weeks. Therefore, Ketotifen is prescribed preventively, for the prevention of allergies in bronchial asthma, allergic bronchitis. In some cases, cheap Ketotifen tablets are used to prevent the development of seasonal allergic rhinitis, as indicated in the instructions for the drug. However, it is important to start taking the medication in advance, ideally at least 8 weeks before the expected start of the allergen bloom, and, of course, not stop the course of therapy until the season is over.
lodoxamide
This active substance is produced as part of eye drops, which are prescribed for allergic conjunctivitis, Alomida.
Glucocorticosteroids in tablets and injections in the treatment of allergies
The most important group of drugs that are used to relieve the symptoms of allergies are steroid hormones. Conventionally, they can be divided into two large subgroups: local funds, which are used for irrigation of the nasal cavity, tablets and injections for oral administration. There are also eye and ear drops with corticosteroids, which are used for ENT pathologies of various origins, including allergic conjunctivitis and otitis media, as well as ointments and gels sometimes used to treat allergic dermatitis. However, in the treatment of these diseases, corticosteroids are far from the first place: rather, they are prescribed as a means of temporary relief, for the rapid relief of symptoms, after which they switch to therapy with other antiallergic drugs. Means for local (nasal sprays) and internal use (tablets), on the contrary, are used quite widely for the treatment of various diseases of an allergic nature, and it is worth talking about them in more detail.
The difference between these categories of drugs, first of all, is tolerability. If local and external preparations have bioavailability close to zero and are practically not absorbed into the systemic circulation, exerting only an effect at the site of application (application), then injection and tablet preparations, on the contrary, penetrate into the blood in the shortest possible time, and, therefore, exhibit systemic effects. Therefore, the safety profile of the first and second is fundamentally different.
Despite such significant differences in the characteristics of absorption and distribution, the mechanism of action of both local and internal glucocorticosteroids is the same. Let's talk in more detail, due to which tablets, sprays or ointments containing hormones have a therapeutic effect in case of allergies.
Hormonal steroids: mechanism of action
Corticosteroids, glucocorticosteroids, steroids - all these names describe a category of steroid hormones that are synthesized by the adrenal cortex. They exhibit a very powerful triple healing effect:
Due to these abilities, corticosteroids are indispensable drugs used for a wide variety of indications in different fields of medicine. Among the diseases in which corticosteroid preparations are prescribed are not only allergies, regardless of origin and type, but also rheumatoid arthritis, osteoarthritis (with a pronounced inflammatory process), eczema, glomerulonephritis, viral hepatitis, acute pancreatitis, as well as shock, including anaphylactic.
However, unfortunately, despite the severity and variety of therapeutic effects, not all glucocorticosteroids are equally safe.
Side effects of hormonal steroids
It was not for nothing that we immediately made a reservation about the different safety profile of glucocorticosteroids for internal and local (external) use.
Oral and injectable hormonal preparations have many side effects, including serious ones, sometimes requiring drug withdrawal. We list the most common of them:
- headache, dizziness, blurred vision;
- hypertension, chronic heart failure, thrombosis;
- nausea, vomiting, peptic ulcer stomach ( duodenum), pancreatitis, loss of appetite (both improvement and deterioration);
- decreased function of the adrenal cortex, diabetes, menstrual disorders, growth retardation (in childhood);
- muscle weakness and/or pain, osteoporosis;
- acne disease.
“Good,” the reader will ask. “Why are you describing all these terrible side effects?” Just so that a person who is going to treat allergies with the same Diprospan thinks about the consequences of such a “treatment”. Although this should be discussed in more detail.
Diprospan for allergies: a hidden danger!
Many experienced allergy sufferers know that the introduction of one (two or even more) ampoules of Diprospan or its analogue, for example, Flosteron or Celeston, saves from severe symptoms seasonal allergies. They advise this magical remedy» to acquaintances and friends who are desperate to find a way out of the allergic vicious circle. And they do them oh what a disservice. “Well, why bearish? - the skeptic will ask. “It’s getting easier, and fast.” Yes, it does, but at what cost!
The active substance of Disprospan ampoules, which are often used to relieve allergy symptoms, including without a doctor's prescription, is a classic glucocorticosteroid betamethasone.
It exhibits a powerful and rapid anti-allergic, anti-inflammatory and antipruritic effect, indeed in a short time alleviating the condition with allergies of various origins. What happens next?
The further scenario largely depends on the severity of the allergic reaction. The fact is that the effects of Diprospan cannot be called long-term. They can last for several days, after which their severity weakens and finally disappears. A person who has already managed to feel a significant relief of allergy symptoms naturally tries to continue the “treatment” with another Diprospan ampoule. He does not know or does not think about the fact that the likelihood and severity of side effects of glucocorticosteroids depend on their dose and frequency of use, and, therefore, the more often Diprospan or its analogues are administered to correct allergy manifestations, the higher the risk of experiencing the full force of its side effects. actions.
There is another extremely negative side of the use of glucocorticosteroids for internal use in seasonal allergies, which most patients have no idea about - a gradual decrease in the effect of classic antiallergic tablets or sprays. Applying Diprospan, especially from year to year, regularly during the manifestation of allergies, the patient literally leaves no alternative for himself: against the background of a strong, powerful effect shown by an injectable glucocorticosteroid, the effectiveness of antihistamine tablets and, moreover, mast cell membrane stabilizers, decreases catastrophically. The same picture persists after the end of the action of steroids.
Thus, a patient who uses Diprospan or its analogues to alleviate allergy symptoms practically dooms himself to constant hormone therapy with all its side effects.
That is why doctors are categorical: self-medication with injectable steroids is dangerous. "Passion" for drugs of this series is fraught not only with resistance to therapy with safe drugs, but also with the need for a constant increase in the dose of hormones to achieve an adequate effect. However, in some cases, treatment with corticosteroids is still necessary.
When are steroid pills or injections used to treat allergies?
First of all, tablets or injections of Dexamethasone (less often, Prednisolone or other glucocorticosteroids) are used to stop an acute allergic reaction. Yes, at anaphylactic shock or Quincke's edema, it is advisable to administer the hormone intravenously, in less urgent cases - intramuscularly or orally. In this case, the doses of the drug can be high, approaching the highest daily or even exceeding it. Such a tactic justifies itself with a single use of drugs, one or two times, which, as a rule, is sufficient to obtain the desired effect. In such cases, you should not be afraid of the notorious side effects, because they begin to manifest themselves in full force only against the background of a course or regular administration.
There is another important indication for the use of hormones in tablets or injections as drugs for the treatment of allergies. This severe stages or types of disease, for example, bronchial asthma in the acute stage, severe allergies that are not amenable to standard therapy.
Hormone therapy for allergic diseases can only be prescribed by a doctor who is able to evaluate both the benefits and risks of treatment. He carefully calculates the dose, controls the patient's condition, side effects. Only under the vigilant supervision of a doctor, corticosteroid therapy will bring real results and will not harm the patient. Self-medication with hormones for oral administration or injection is strictly unacceptable!
When should you not be afraid of hormones?
As dangerous as glucocorticosteroids can be for systemic use, steroids intended for injection into the nasal cavity are just as innocent drugs. Their field of activity is limited exclusively to the mucous membrane of the nasal cavity, where they, in fact, should work in the case of allergic rhinitis.
“However, some of the medicine can be accidentally swallowed!” - the meticulous reader will say. Yes, this possibility is not excluded. But in the gastrointestinal tract, the absorption of intranasal steroids (absorption) is minimal. Most of the hormones are completely "neutralized" when passing through the liver.
Having an anti-inflammatory and powerful anti-allergic effect, nasal corticosteroids quickly stop the symptoms of allergies, stopping the pathological reaction.
The effect of intranasal steroids appears 4-5 days after the start of therapy. The peak effectiveness of this group of drugs for allergies is achieved after a few weeks of continuous use.
Today, there are only two hormonal corticosteroids on the domestic market, which are available in the form of intranasal sprays:
- Beclomethasone (trade names Aldecin, Nasobek, Beconase)
- Mometasone (trade name Nasonex).
Beclomethasone preparations are prescribed for the treatment of mild to moderate allergies. medium degree gravity. They are approved for use by children over 6 years of age and adults. As a rule, beclomethasone is well tolerated and does not cause side effects. However, in some (fortunately extremely rare) cases, especially with long-term treatment, damage (ulceration) of the nasal septum is possible. To minimize its risk, it is necessary, when irrigating the nasal mucosa, not to direct the jet of the drug to the nasal septum, but to spray the medicine on the wings.
Occasionally, the use of beclomethasone spray can lead to minor nosebleeds, which is not dangerous and does not require discontinuation of the drug.
"Heavy artillery"
The next representative of hormonal corticosteroids would like to pay Special attention. Mometasone is recognized as the most powerful drug for the treatment of allergies, which, along with very high efficacy, has an extremely favorable safety profile. Mometasone, the original Nasonex spray, has a powerful anti-inflammatory and anti-allergic effect, practically not absorbed into the blood: its systemic bioavailability does not exceed 0.1% of the dosage.
The safety of Nasonex is so high that in some countries of the world it is approved for use in pregnant women. In the Russian Federation, mometasone is officially contraindicated during pregnancy due to the lack of clinical studies studying its use in this category of patients.
It should be noted that not a single tablet or spray that is used to treat allergies in a wide range of patients is approved for use during pregnancy - expectant mothers suffering from hay fever or other types of allergies are advised to avoid the action of the allergen, for example, leaving for another climatic zone at the time of flowering. And on frequently asked question: which allergy pills can be taken during pregnancy there is only one correct answer - none, during this crucial period you will have to do without medication. But the nursing ones were more fortunate. For allergies while breastfeeding, you can take some pills, but before starting treatment, it is better to consult a doctor.
But the drug is widely used in pediatric practice for the treatment and prevention of allergies in children over the age of 2 years.
Mometasone begins to act 1-2 days after the start of treatment, and its maximum effect is achieved after 2-4 weeks of continuous use. The drug is prescribed for the prevention of seasonal allergies, starting to irrigate the nasal mucosa a few weeks before the expected period of pollination. And, of course, mometasone is one of the most "favorite" and frequently prescribed drugs for the treatment of allergies. As a rule, treatment with them is not accompanied by side effects, only in rare cases, dryness of the nasal mucosa and the occurrence of minor nosebleeds may occur.
Allergy treatment with pills and more: a stepwise approach
As you can see, there are quite a lot of drugs with anti-allergic properties. Most often, patients select pills for the treatment of allergies, based on the reviews of friends, advertising statements that sound on TV screens and pour from the pages of magazines and newspapers. And, of course, it is quite difficult to get in this way “with a finger in the sky”. This leads to the fact that a person suffering from allergies seems to be treated by taking pills or a spray, but does not see the result and continues to suffer from a runny nose and other symptoms of the disease, complaining that the medicines do not help. In fact, there are quite strict rules of treatment, the observance of which largely depends on the effectiveness.
First of all, the treatment regimen for allergies (we will speak on the example of its most common form, allergic rhinitis) is based on an assessment of the severity of the disease. There are three levels of severity: mild, moderate and severe. What drugs are used for each of them?
- Step one.
Treatment of mild allergies.
As a rule, therapy begins with the appointment of an antihistamine of the II or III generation. Most often, Loratadine (Claritin, Lorano) or Cetirizine (Cetrin, Zodak) tablets are used as first-line drugs for allergies. They are quite inexpensive and easy to use: they are prescribed only once a day. In the absence of a clinical effect or an insufficient result, they proceed to the second stage of allergy therapy. - Step two.
Treatment of moderate allergies.
An intranasal corticosteroid (Baconase or Nasonex) is added to the antihistamine.
If symptoms of allergic conjunctivitis remain during treatment, antiallergic eye drops are prescribed. Insufficient effect on the combined treatment regimen is the basis for more thorough diagnosis and therapy, which should be dealt with by an allergist. - Step three.
Treatment of severe allergies.
The treatment regimen may include additional drugs, for example, leukotriene receptor inhibitors (Montelukast). They block the receptors to which inflammatory mediators bind, thus reducing the severity inflammatory process. The target indication for their appointment is bronchial asthma, as well as allergic rhinitis. In a very severe cases systemic glucocorticosteroids are introduced into the therapy regimen. If even then the result is not achieved, a decision is made on the need for allergen-specific immunotherapy and other methods of treatment. Only an experienced doctor should prescribe treatment. The lack of medical care in such situations can lead to uncontrolled progression of allergies and the development of its extremely severe form, bronchial asthma.
Thus, the selection of tablets, sprays and other anti-allergy products is not as easy as it seems after watching the next commercial. To choose the right scheme, it is better to use the help of a doctor or at least an experienced pharmacist, and not rely on the opinion of a neighbor or girlfriend. Remember: with allergies, as with most other diseases, the doctor's experience, individual approach and thoughtful solutions are important. Under these conditions, you will be able to breathe easily and freely. all year round, forgetting about the endless runny nose and other allergic "joys".
Question: Can antiallergic antihistamines harm a person if taken on a regular basis?
Answer: It is better to pass tests for allergens on the machine "IMEDIS Expert", and further exclude contacts with identified bioresonance test allergens. Also, if possible, is treated by a bioresonance therapist and long years take homeopathic and bioresonance preparations prescribed during the treatment of bioresonance therapy, as well as during exacerbations or during the allergic season, take new-generation antihistamine medicines selected by the bioresonance test or pendulum.
You need to drink new generation antihistamines 1 time per day until the allergy symptoms disappear. If contact with the allergen cannot be avoided, then you will have to take an antihistamine (anti-allergic drug) daily, there is nowhere to go from this, alas. When exposed to an allergen without an antiallergic drug, a severe allergic reaction can develop, which in turn can lead to death, coma, and allergies can also turn into asthma.
There are people who sit on new generations of antihistamines during their lifetime and nothing.
Of course, pills are no sweetie, and antihistamines are no exception. In a state of reaction, do not try to do without them. Allergens will need to be removed from the field of the body on time, and then it may be too late.
Antihistamines
Antihistamines are a group of drugs whose principle of action is based on the fact that they block H1 and H2-histamine receptors. This blocking helps to reduce the reaction of the human body with a special mediator histamine. What are these medicines for? Doctors prescribe them during allergic reactions. Possessing good antipruritic, antispastic, antiserotonin and local anesthetic effects, antihistamines perfectly help with allergies, and also effectively prevent bronchospasm caused by histamine.
In accordance with the time of invention and release on sale, the whole variety of allergy remedies is classified into several levels. Antihistamines are classified into first, second, third and fourth generation drugs. The medicines included in each generation have their own specific features and properties. Their classification is based on the duration of the antihistamine effect, the existing contraindications and side effects. The medicine necessary for treatment must be selected based on the characteristics of each specific case of the disease.
Generations of antihistamines
First generation antihistamines
Preparations of the 1st (first) generation include sedatives. They work at the level of H-1 receptors. The duration of their action is four to five hours, after this period it will be necessary to take a new dose of the drug, and the dose should be large enough. Sedative antihistamines, despite their strong effect, have a number of disadvantages. For example, they can provoke dry mouth, dilated pupils, blurred vision.
Drowsiness and a decrease in tone may occur, which means it is impossible to take these drugs while driving a car and other activities that require a high concentration of attention. They also enhance the effect of taking other sedatives, sleeping pills and pain medications. The effect on the body of alcohol mixed with sedatives also intensifies. Most first generation antihistamines are interchangeable.
Their use is advisable in the event of problems of an allergic nature with respiratory system such as coughing or nasal congestion. It is worth paying attention to the fact that first-generation antihistamines fight cough well. This makes it appropriate to use them in bronchitis.
They will also be useful for those people who suffer from chronic diseases associated with difficulty breathing. Their use is quite effective in bronchial asthma. They can also have a fairly good effect in the treatment of acute allergic reactions. So, for example, their use will be appropriate for urticaria. The most common among them are:
suprastin
diphenhydramine
diazolin
tavegil
Also often on sale you can find peritol, pipolfen and fenkarol.
Second generation antihistamines
Preparations of the 2nd (second) generation are called non-sedative. They do not have such a large list of side effects as the drugs that make up the first generation of antihistamines. These are drugs that do not cause drowsiness and do not reduce brain activity, and also do not have cholinergic effects. good effect gives their use for itching of the skin and allergic rashes.
However, their significant drawback is the cardiotoxic effect that these drugs can cause. Therefore, non-sedative drugs are prescribed only in outpatient settings. In no case should they be taken by people suffering from diseases of the cardiovascular system. Names of the most common non-sedative drugs:
trexil
histalong
zodak
semprex
fenistil
claritin
Third generation antihistamines
Antihistamines of the 3rd (third) generation are also otherwise called active metabolites. They have strong antihistamine properties and have virtually no contraindications. The standard set of these drugs includes:
cetrin
zyrtec
telfast
These drugs do not have a cardiotoxic effect, unlike second-generation drugs. Their application gives positive effect with asthma and acute allergic reactions. They are also effective in the treatment dermatological diseases. Quite often, third-generation antihistamines are prescribed by doctors for psoriasis.
New generation drugs are the most effective and harmless antihistamines. They are non-addictive, safe for the cardiovascular system, and also have a long period of action. They belong to the fourth generation of antihistamines.
Fourth generation antihistamines
Preparations of the 4th (fourth) generation have a small list of contraindications, which are mainly pregnancy and childhood, but, nevertheless, it is worth reading the instructions and consulting with a specialist before starting treatment. The list of these drugs includes:
levocetirizine
desloratadine
fexofenadine
Based on them, a larger number of drugs are produced, which, if necessary, can be purchased at a pharmacy. These include erius, xizal, lordestin, and telfast.
Forms of release of antihistamines
There are several forms of release of drugs that block histamine receptors. In most cases, their most convenient type to use are tablets and capsules. However, on the shelves of pharmacies you can also find antihistamines in ampoules, suppositories, drops and even syrups. The action of each of them is unique, so only a doctor can help you choose the most appropriate form of taking the medicine.
Treatment of children antihistamines
As you know, children are more prone to allergic diseases than adults. A qualified allergist should select and prescribe drugs for children. Many of them in the list of their contraindications are of children's age, therefore, if necessary, from the application to the preparation of a course of treatment, it is necessary to be especially careful. Children's organisms can react quite sharply to the effects of the drug, so the child's well-being during the period of their use must be monitored very carefully. In case of side effects, the drug should be stopped immediately and consult a doctor.
For the treatment of children, both somewhat outdated medicines and more modern ones are suitable. The drugs that make up the first generation are mainly used to urgently relieve acute allergy symptoms. During long-term use more modern means are usually used.
Antihistamines are not usually available in special "children's" forms. For the treatment of children, the same drugs are used as for adults, but in smaller doses. Drugs such as zyrtec and ketotifen are usually prescribed from the moment the child reaches the age of six months, all others - from two years. Do not forget that taking medicines by a child should be under the supervision of an adult.
In the case of an illness of a small child, the selection of antihistamines is much more complicated. For newborns, medications that have a slight sedative effect, that is, first-generation drugs. The most commonly used in the treatment of very young children is suprastin. It is safe for both babies and older children, as well as for nursing mothers and pregnant women. Depending on the disease and the condition of the child's body, the doctor may prescribe him tavegil or Phencarol, and in the case of an allergic skin reaction, an antihistamine cream. For infants, the same drugs are suitable as for newborns.
Antihistamines during pregnancy and lactation
Due to the increased production of cortisol in the body of a woman, allergies during the childbearing period are quite rare, but, nevertheless, some women still face this problem. During pregnancy, the intake of absolutely all medications must be agreed with the doctor. This also applies to allergy remedies, which have a fairly wide range of side effects and can harm the child. The use of antihistamines is strictly prohibited in the first trimester of pregnancy; in the second and third trimesters they can be used, observing, however, necessary measures precautions.
Unintentional ingestion of the drug into the child's body is possible not only during pregnancy, but also during breastfeeding. During lactation, the use of antihistamines is highly undesirable and is prescribed only in the most urgent cases. The question of which remedy a nursing woman will use can only be decided by a doctor. Even the newest and modern medicines can cause irreparable harm, so in no case do not self-medicate by feeding the baby with your milk.
Side effects of antihistamines
As mentioned earlier, the body of each person is individual, and only a specialist can choose the right remedy for treatment. Taking the wrong medicine for a person and violating the dosage can seriously harm health. The harm of antihistamines can manifest itself in addition to their usual side effects such as drowsiness, runny nose and cough in violation of the timing of ovulation in women, the occurrence of allergic edema and asthma. Therefore, be sure to consult your doctor before you start drinking the medicine, and strictly follow the recommendations for taking it.
Drug treatment of allergies, antihistamines
How antihistamines work
Antihistamines of the "old" and "new" generations
What is the difference between 1st, 2nd and 3rd generation antihistamines
Fundamentals of drug therapy
There is such a substance - histamine. It is released during an allergic reaction and is responsible for the development of bad symptoms, from skin manifestations to very severe life-threatening reactions, such as anaphylactic shock. That's why antiallergic drugs are called ANTIhistamines.
They block histamine receptors and thus stop the development of allergy symptoms.
Depending on the type of reaction, antihistamines are prescribed by injection (for severe forms) and orally (for milder ones). It is understandable: if we inject the drug with the help of an intramuscular or intravenous injection, it instantly enters the bloodstream and is included in the work. And if we drink this medicine, time must pass before the active substance is absorbed into the blood from the gastrointestinal tract.
All anti-allergy drugs can be divided into several groups:
1. Symptomatic drugs.
2. Medicines for the treatment of chronic allergic inflammation in the affected organ.
3. Medicines for local therapy.
Symptomatic drugs are intended to alleviate the course of allergic diseases. The leading place among them belongs to drugs called antihistamines.
These agents counteract the damaging effects of the main mediator of allergic reactions, histamine. Today, doctors are armed with three generations of antihistamines that differ in their characteristics.
The selection of antihistamines is carried out individually, taking into account the nature of food allergies, the age of the child and the nature of concomitant diseases. Symptomatic drugs also, for example, include bronchodilators. They are used for asthma attacks.
Antihistamines for the treatment of chronic allergic inflammation in the affected organ are divided into non-hormonal and hormonal. The latter drugs are more powerful and effective.
The appointment of drugs in this group is carried out depending on the clinical manifestations of food allergies, the severity of the disease, the age of the child. It must be remembered that these drugs are generally effective only with long-term regular use.
It must be remembered that drug therapy food allergies - a long process, you need to patiently and persistently follow medical recommendations.
We must also remember that some treatments for food allergies are absolutely contraindicated and can harm the child. So, with food allergies, treatment with herbs and many means is contraindicated. traditional medicine, and psychotherapy and reflexology, except for bioresonance treatment, almost do not give a significant effect.
Treatment with herbs and preparations based on them increases the risk of developing an allergy to plant pollen in the future. The same "service" can be provided biologically active additives which often contain plant components.
Antihistamines are standard therapy for atopic dermatitis. They are used as an additional remedy for external treatment with severe itching and associated rashes.
Antihistamines are divided into three generations:
means of the 1st "old" generation;
means of the 2nd and 3rd generations ("new" generation).
Antihistamine drugs of the 1st "old" generation
Antihistamines of the 1st generation are more often used to treat acute reactions, in the treatment of itchy allergic dermatoses. Most of them are available in solutions in ampoules, but there are forms in tablets, syrups and powders.
Antihistamines of the 1st "old" generation (forms for oral administration)
Chloropyramine, Clemastine, Dimetindene, Quifenadine, Hifenadine, Mebhydrolin, Ketotifen.
Disadvantages of older generation antihistamines:
Incomplete connection with H1 receptors, as a result of which relatively high doses are required;
Short-term action - taking several times a day
The development of addiction - it is necessary to alternate drugs different groups every 10-14 days
Sedative and hypnotic effect
Antihistamine drugs of the 2nd and 3rd "new" generations
Loratodin, cyterizine, fexofenadine, desloratadine.
Currently, in the treatment of atopic dermatitis, antihistamine drugs of the “new”, that is, the 2nd and 3rd generations, are widely used.
Antihistamine drugs of the 2nd and 3rd generations are used for basic and anti-relapse therapy.
Antihistamines of the "new" generation do not have sedative and hypnotic effects. They render selective action, causing blockade of only H1-histamine receptors. The duration of their action is up to 24 hours, so most of these drugs are prescribed once a day.
After taking most antihistamines, their residual effect may last for one week after withdrawal (this circumstance must be taken into account when conducting an allergy examination). A significant difference between the antihistamine drugs of the "new" generation is that they have not only H1-blocking action, but also anti-allergic and anti-inflammatory effects.
If long-term use is necessary, only antihistamines of the “new” generation are used.
The absence of undesirable side effects characteristic of the first antihistamines allows to significantly expand the list of indications for the appointment of modern H1-antagonists.
Benefits of 2nd generation antihistamines over 1st generation:
Rapid onset of action (from 30 minutes - acute cases);
Possibility of taking at any time of the day (including in the first half of the day) Good absorption from the digestive tract Possibility of use in children early age long duration of the antihistamine effect (up to 24 hours), which allows you to take the drug once a day.
No blockade of other types of receptors
Lack of penetration through the blood-brain barrier at therapeutic doses
Lack of connection with food intake
Non-addictive, even with long-term use (3 to 6 months)
The almost complete absence of side effects associated with exposure to the nervous and cardiovascular systems.
The use of antihistamine drugs in the treatment of children with atopic dermatitis.
Children after a year, as a rule, are prescribed drugs of a new generation.
The "new" generation drugs that are approved for use in children from 6 months of age are antihistamine drugs based on cetirizine (generic active ingredient).
VACCINATION
Since allergy is an immune disorder, allergic rhinitis and bronchial asthma can be treated with vaccines from allergens to which the child is hypersensitive. Indications for vaccination are determined based on the results of skin tests with allergens.
The vaccine is administered under a special scheme subcutaneously or buried under the tongue. Such treatment is applicable only in children over 5 years of age and should be carried out by an allergist.
And finally the most interest Ask: Do Allergy Medications Cause Allergies? Yes! We will not go into the technical details of the flow complex mechanisms that could lead to such a development.
Let's just say that an allergy to antihistamines is extremely rare, but it happens. There is only one way out - to change the drug.
Antihistamines are a group of drugs that perform a competitive blockade of histamine receptors in the body, which leads to inhibition of the effects mediated by it.
Histamine is a neurotransmitter that can affect the respiratory tract (causing swelling of the nasal mucosa, bronchospasm), skin (itching, blistering-hyperemic reaction), gastrointestinal tract (intestinal colic, stimulation of gastric secretion), cardiovascular system (expansion of capillary vessels, increased vascular permeability, hypotension, cardiac arrhythmias), smooth muscles.
Strengthening its influence cause allergic reactions, so antihistamines are used to combat the manifestations of allergies. Another area of their application is symptomatic therapy / elimination of symptoms in colds.
Currently, there are three groups of drugs (according to the receptors they block):
H1 blockers - used in the treatment of allergic diseases.
H2-blockers - used in the treatment of diseases of the stomach (help reduce gastric secretion).
H3 blockers are used in the treatment of neurological diseases.
Among them, cetrin (cetirizine), phencarol (chifenadine), diphenhydramine, clemastine, suprastin stop the emission (for example, cromoglycic acid) or the action (like diphenhydramine) of histamines.
Produced in the form of tablets, nasal spray, drops, including eye drops, solution in ampoules for intramuscular injection(usually for emergency therapy).
There are several generations of antihistamines. With each generation, the number and strength of side effects and the likelihood of addiction decrease, the duration of action increases.
First generation
Before buying a medicine - paracetamol, ibuprofen, antiallergic (antihistamine) drugs, cold and cold remedies, you need to know:
Paracetamol
Pain reliever, antipyretic, anti-inflammatory agent. active ingredient is paraacetaminophenol, on the basis of which many other similar drugs are produced in different countries, such as acetaminophen, panadol, efferalgan, myalgin, paramol, pilaren, etc.
Benefit. In its action, paracetamol is in many ways close to aspirin, but has less pronounced side effects. It does not reduce blood viscosity, so it is safe to use in preparation for and after surgery.
It is less likely than aspirin to cause allergic reactions and is less irritating to the stomach. Paracetamol is part of many combined preparations in combination with aspirin, analgin, caffeine, etc. It is available in the form of tablets, capsules, mixtures, syrup, "effervescent" powders (panadol, panadon).
Possible harm. When combined with alcohol, it can damage and even destroy the liver. Therefore, it, like aspirin, is dangerous for people who regularly drink alcohol. Paracetamol has a negative effect on the liver and in case of violation of the norm of its intake (in case of overdose).
Exit. Take no more than 2 g per day (4 tablets of 500 mg) - People who drink alcohol daily should stop taking paracetamol.
Ibuprofen
It has an analgesic and anti-inflammatory effect. Ibuprofen is the active ingredient in drugs such as Brufen, Arthryl, Advil, Naproxen, etc. These drugs are chemically identical, but differ in the duration of the therapeutic effect.
Benefit. Help with fever, muscle and joint pain (rheumatoid arthritis, arthrosis, etc.)
Possible harm. If the body is severely dehydrated as a result of severe physical work, heat or taking diuretics (diuretics), then ibuprofen can adversely affect the kidneys. The risk of kidney damage increases with regular use of ibuprofen.
Long-term use of ibuprofen is dangerous for the stomach. In people who constantly drink alcohol, taking ibuprofen can affect the liver.
Exit. Try to avoid dehydration. When taking ibuprofen, it is necessary to monitor the work of the kidneys. In no case should you exceed the allowable daily intake (6 tablets of ibuprofen 200 mg or 2 tablets of naproxen 220 mg).
Antiallergic (antihistamine) drugs
The drugs in this group are intended for people suffering from pollinosis (hay fever), asthma, hives or other allergic diseases.
Benefit. They relieve runny nose, sneezing, sore throat, coughing and suffocation, unbearable itching and other symptoms of these diseases.
Possible harm. Most common drugs in this group, such as suprastin, tavegil, diphenhydramine, zaditen, peritol, etc., have a sedative effect, that is, they cause drowsiness, inhibition of reactions, and general weakness. Therefore, it is dangerous to take them to car drivers, pilots, operators, dispatchers, etc., that is, people who require constant attention and quick reaction in difficult situations.
Exit. To avoid the risk, you should take a new generation of antihistamines that do not cause drowsiness and inhibition of reactions, such as claritin, kestin, which act for 12-24 hours. Sedative antihistamines are best taken in the afternoon and at night.
Remedies for the common cold
The action of drugs such as sanorin, naphthyzin, galazolin, otrivin, etc., is that they narrow blood vessels in the swollen mucous membrane of the nasal passages, as a result of which the nasal passages themselves expand.
Benefit. With a cold, the runny nose is weakened or stops, breathing through the nose is restored, and the headache disappears.
Possible harm. When taking these drugs, blood vessels are narrowed not only in the nose, as a result of which blood pressure may increase in patients with hypertension.
This is especially dangerous for hypertensive patients, since they are taken to reduce blood pressure medicines will be ineffective. In addition, drugs in this group are dangerous for those who take antidepressants such as pyrazidol, pirlindol, nialamide.
Exit. For people suffering from hypertension, common cold remedies can only be taken under control. blood pressure. In the event of an increase in pressure, the dosage of antihypertensive drugs should be increased.
Patients with depression who take the listed antidepressants or the like, drugs in this group are contraindicated.
Complex preparations for colds used with antihistamines
Among the complex anti-cold drugs, such as askofen, citramon, sedalgin, alkaseltzer plus, bicarmint, etc. are especially known.
Benefit. They help to get rid of various symptoms of the disease at the same time: cough, runny nose, pain, fever, allergic manifestations.
Possible harm. When taking complex drugs, the so-called "unforeseen overdose" is quite often allowed.
This is what happens when bad cold or headache, in order to increase the effectiveness of treatment, add to the intake of aspirin also a complex preparation for colds containing aspirin. As a result, peptic ulcer disease may worsen or even gastric bleeding occurs.
If, with an allergic rhinitis, in addition to suprastin, you also take a complex preparation containing an antihistamine, then everything together will act as a strong sleeping pill. Sometimes liver disorders are associated with a similar overdose of paracetamol or ibuprofen.
Exit. Before taking complex drug from a cold, you must carefully read its composition indicated on the package or in the insert, and do not take separately those medicines that are included in it.
Antiallergic drugs for children: characteristics, principle of action, benefits and harms
Diazolin (mebhydrolin);
Peritol (cyproheptadine).
In principle, the effectiveness of the above drugs has been confirmed by many years of experience, but this same experience indicates a whole bunch of side effects:
All these drugs to a greater or lesser extent affect the central nervous system, providing sedative and hypnotic effects.
Classical antihistamines dry out the mucous membranes. Dry mouth, sputum viscosity in the lungs (which is especially dangerous in acute respiratory viral infections, as it seriously increases the risk of developing pneumonia) - does not affect the child's condition in the best way.
The simultaneous use of first-generation antiallergic drugs with other drugs enhances the effect of the use of the latter. Thus, antipyretic, analgesic, hypnotic effects are enhanced. Especially dangerous is the combination of antihistamines with other drugs that actively affect the functioning of the central nervous system. In this case, the development of side effects up to fainting is possible. The combination with alcoholic beverages is highly undesirable.
The action of such drugs, although effective, is limited to 2-3 hours (some last up to 6 hours).
Of course, it does not come without advantages. Firstly, first-generation antihistamines are relatively affordable, and secondly, they are great for short-term treatment of allergies. That is, if, for example, a child ate an excessive amount of chocolate and a short-term intake of an antihistamine is required, you can safely use the same Tavegil or Fenkarol.
Most first-generation allergy remedies are forbidden to be taken orally by nursing mothers; only their local forms can be used - ointment, cream, spray. The exception is Suprastin and Fenkarol (from three months of pregnancy). Each drug has its own salient feature, which is important to consider when drawing up a treatment regimen. So, it is not advisable for a baby prone to constipation to use Tavegil; a child suffering from gastrointestinal diseases is prohibited from taking Suprastin; and children with impaired liver function need to be careful with the use of Phencarol.
For babies under one year old, taking first-generation antiallergic drugs is undesirable. For the little ones, there are more modern drugs are practically safe and very effective.
The principles of action of antihistamines, the second generation on the children's body
The undoubted advantage of antiallergic drugs of the second and third generation is the absence or minimization of the sedative, hypnotic, CNS inhibitory effect.
In addition, they have a number of other advantages: they do not penetrate the fetoplacental barrier (that is, such drugs can be used during pregnancy);
do not dry mucous membranes;
do not affect the mental and physical activity of the child;
have a quick and long-lasting (up to 24 hours) therapeutic effect - one tablet is enough to forget about allergy symptoms for the whole day;
in addition to antiallergic, they have antiemetic, antiulcer and other actions (some drugs); do not reduce their effectiveness with long-term use.
Perhaps the only drawback of second-generation antiallergic drugs is their ability to have a negative impact on the children's cardiovascular system. Due to the possible cardiotoxic effect, the use of such drugs is not recommended for children with various pathologies heart and blood vessels.
Among the most prominent representatives of the second generation:
Claritin (loratidin);
Allergy treatment, antihistamines
Diazolin dragee 50mg №20
Diazolin tab. 100mg #10
Suprastin (chloropyramine) is one of the most widely used sedative antihistamines. It has significant antihistamine activity, peripheral anticholinergic and moderate antispasmodic action.
Effective in most cases for the treatment of seasonal and year-round allergic rhinoconjunctivitis, angioedema, urticaria, atopic dermatitis, eczema, itching of various etiologies; in parenteral form - for the treatment of acute allergic conditions requiring emergency care. It does not accumulate in the blood serum, so it does not cause an overdose with prolonged use. The effect comes on quickly, but is short-lived; to increase its duration, it is combined with non-sedating H1-blockers.
Suprastin injection 2% 1ml amp. No. 5 (Egis, Hungary)
Suprastin tab. 25mg №20 (Egis, Hungary)
Chloropyramine g / x tab. 25mg #40
Tavegil (clemastine) is a highly effective antihistamine drug similar in action to diphenhydramine. It has a high anticholinergic activity, but penetrates the blood-brain barrier to a lesser extent.
In an injectable form, which can be used as an additional remedy for anaphylactic shock and angioedema, for the prevention and treatment of allergic and pseudo-allergic reactions. However, there is an allergy to tavegil.
Peritol (cyproheptadine), along with antihistamine, has a significant antiserotonin effect. It is often used in some forms of migraine to increase appetite.
Peritol syrup 2mg/5ml 100ml (Egis, Hungary)
Peritol tab. 4mg №20 (Egis, Hungary)
Pipolfen (promethazine) - a pronounced effect on the central nervous system, is used as an antiemetic and to potentiate anesthesia.
Pipolphen other 25mg №20 (Egis, Hungary)
Pipolfen solution for injections 50mg 2ml amp. №10 (Egis, Hungary)
Diprazine tab. 25mg #20
Phencarol (quifenadine) - has less antihistamine activity than diphenhydramine, but is also characterized by less penetration through the blood-brain barrier, which determines the lower severity of its sedative properties. In addition, fenkarol not only blocks histamine H1 receptors, but also reduces the content of histamine in tissues. Can be used in the development of addiction to other sedative antihistamines.
Fenkarol tab. 25mg №20 (Latvia)
Second generation antihistamines (non-sedating).
Unlike the first generation, they have almost no sedative and anticholinergic effects, do not penetrate the blood-brain barrier, do not reduce mental and physical activity, are not adsorbed with food in the gastrointestinal tract, have a high affinity for H1 receptors, and have a rapid therapeutic effect. . However, for them varying degrees marked cardiotoxic effect; when they are taken, constant monitoring of cardiac activity is required (appointed on an outpatient basis). They should not be taken by patients with disorders of the cardiovascular system, elderly patients.
The effect comes on quickly and for a longer time (delayed elimination).
When using drugs in therapeutic doses, a minimal sedative effect is observed. Some particularly sensitive individuals may experience moderate drowsiness, which does not require discontinuation of the drug.
The absence of tachyphylaxis (decrease in antihistamine activity) with prolonged use.
The cardiotoxic effect occurs due to the ability to block the potassium channels of the heart muscle, the risk of a cardiotoxic effect increases when antihistamines are combined with antifungals (ketoconazole and itraconazole), macrolides (erythromycin and clarithromycin), antidepressants (fluoxetine, sertraline and paroxetine), when drinking grapefruit juice as well as in patients with severe violations liver function.
There are no parenteral forms, only enteral and local dosage forms.
The most common second-generation antihistamines are:
Trexil (terfenadine) is the first second-generation antihistamine drug that does not have an inhibitory effect on the central nervous system, but with a significant cardiotoxic effect and an increased ability to cause fatal arrhythmias.
Trexil tab. 60mg №100 (Ranbaxi, India)
Gistalong (astemizole) is one of the longest acting drugs of the group (up to 20 days). It is characterized by irreversible binding to H1 receptors. Virtually no sedative effect, does not interact with alcohol.
Effective in chronic allergic diseases, with an acute process, its use is impractical. But the risk of developing serious violations heart rate, sometimes fatal. Due to these dangerous side effects, the sale of astemizole in the United States and some other countries has been suspended.
Astemizole tab. 10mg #10
Histalong tab. 10mg №20 (India)
Semprex (acrivastine) is a drug with high antihistamine activity with a minimally pronounced sedative and anticholinergic effect. The therapeutic effect is achieved quickly, but for a short time.
Semprex caps. 8mg №24 (GlaxoWellcome, UK)
Fenistil (dimetendene) is closest to first-generation antihistamines, but differs from them in a significantly lesser sedative effect, higher antiallergic activity and duration of action than first-generation drugs. There is a gel for external use.
Claritin (loratadine) is one of the best-selling second-generation drugs. Its antihistamine activity is higher than that of astemizole and terfenadine, due to the greater strength of binding to peripheral H1 receptors.
There is no sedative effect, it does not potentiate the effect of alcohol. Virtually no interaction with others medicines and has no cardiotoxic effect. It can be taken by drivers, children from 1 year old.
Claritin syrup 5mg/5ml 120ml (Schering-Plough, USA)
Claritin tab. 10mg №10 (Schering-Plough, USA)
Loratadine tab. 10mg #10
Agistam tab. 10mg #12
Third generation antihistamines (metabolites).
They are active metabolites of second-generation antihistamines. They do not have a sedative and cardiotoxic effect. In this regard, the drugs are approved for use by persons whose activities require increased attention.
Zyrtec, cetrin (cetirizine) is a highly selective blocker of peripheral H1 receptors. Cetirizine is almost not metabolized in the body, the rate of its excretion depends on the function of the kidneys. It penetrates well into the skin, and is effective in skin manifestations of allergies.
The effect appears 2 hours after ingestion and lasts 24 hours. Do not have a sedative and cardiotoxic effect in therapeutic doses. Be wary appoint in violation of kidney function.
Cetrin tab. 10mg No. 20 (Dr. Reddy's Laboratories, India)
Telfast (fexofenadine) is a metabolite of terfenadine. Does not metabolize in the body, does not interact with drugs, does not have a sedative effect and does not affect psychomotor activity. An effective and safest drug among antihistamines.
Telfast tab. 120mg №10 (Hoechst Marion Roussel)
Telfast tab. 180mg №10 (Hoechst Marion Roussel)
Allergy is pathological process, which occurs when the body reacts inadequately to various substances (foreign agents). The development of civilization and the abundance of chemicals in products and the surrounding world provokes the widespread spread of the disease. AT recent times people are increasingly exposed to or the sun, which is basically unnatural for humans.
Doctors do not yet know exactly what are the deep causes of the body's inadequate response to stimuli, so allergy medications can only relieve symptoms, and not completely cure the patient. Particular attention should be paid to children who suffer from allergic reactions. After all, this disease disrupts the immune system and can lead to failure in other organs and systems.
Allergy medications help relieve skin rashes, itching, runny nose and relieve cough. There are a number of drugs that are used to treat allergic reactions, but you should start taking them only after consulting a doctor.
What can cause allergies?
Before deciding what to drink for allergies, you need to seek the advice of a doctor. He will be able to determine the factor that caused the development of the disease, and, based on this information and the main symptoms, he will prescribe the correct treatment.
An allergic reaction can be caused by the following factors:
- Medications, especially if taken too often or for too long
- Dust, including house dust, in which dust mites live
- Pollen of plants during the flowering period causes hay fever (a separate type of allergy)
- Sudden temperature changes (cold and)
- Animal hair, especially cats, dogs, rodents and rabbits, as well as bird feathers
- Stings of bees, wasps and mosquitoes
- mold mushrooms
- Household chemicals, perfumes and cosmetics due to the abundance of chemical components can cause allergic reaction not only in children, but also in adults
- Food products. Food allergies are most common in children, but can also occur in adults. The most common is an inappropriate reaction to cow's milk, citrus fruits, red fruits and vegetables, seafood, grains, and nuts.
Allergy medications are included complex treatment, which is often prescribed to alleviate the patient's condition:
- First of all, they try to minimize or completely eliminate contact with the allergen. If this is not possible, then the patient has to constantly take antihistamine tablets.
- Allergy medications quickly relieve the symptoms of the disease: itching, skin rashes, sneezing, rhinitis and allergic cough.
- It is also recommended to carry out immunotherapy, which promotes the production of blocking antibodies to external stimuli.
- With severe and prolonged allergies, drugs with corticosteroids are used. But this last resort, since such medicines can only be taken in limited quantities and not long time and treatment should be discontinued gradually. Medications with corticosteroids are used only if there is no other way to eliminate the signs of an allergy.
- The body of the patient seeks to cleanse as much as possible of toxins. For this, sorbent preparations are prescribed, such as Activated carbon, Enterosgel, Polysorb and Polyphepan.
- Less often, blood purification is used, for example, such invasive methods as plasmapheresis.
Best Allergy Remedies
Allergy symptoms entail the production of large amounts of histamine. Therefore, in order to overcome inflammation of the eyes, skin and respiratory organs, antihistamines are prescribed. There are currently three generations of these medicines.
Below we will provide data on the drugs that exist on the modern pharmacological market, consider their positive and negative sides. It should be noted that the information provided in this article is purely informative in nature, and only a qualified doctor can prescribe the intake of this or that remedy.
At the moment the most effective tool antihistamines of the 3rd generation (metabolites) are considered against allergies. They quickly eliminate signs of an allergic reaction, do not cause drowsiness, cardiotoxic or sedative effects. In addition, they do not disrupt the functioning of the central nervous system, so they can be given to children from two years old and adults who work with mechanisms and need constant concentration.
In rare cases, the use of metabolites may cause drowsiness. But this effect is observed only in people with hypersensitivity or in those who suffer from chronic fatigue. Therefore, this symptom is not a reason to stop taking medication.
New generation allergy drugs include Cetirizine, Loratadine, Ebastine, Acelastine, Astemizol, Akrivastine and others. Cetirizine () and Loratadine are considered the most effective for oral administration. As an external agent, Acelastin is most often used in the form of a nasal spray and eye drops.
The main advantage of metabolites is that they can be taken for a long time, for example, to treat long-term allergic manifestations:
- Allergic contact dermatitis
- perennial allergic rhinitis
- and adults
- Urticaria
- Allergic conjunctivitis
The advantages of 3rd generation antihistamines are obvious:
- They do not affect the reaction rate and do not have sedative properties. Also, these medicines do not interfere with mental and physical activity. You can take them regardless of the meal, and the improvement comes fairly quickly. The effect of the drug lasts for two days, and the activity of the drug does not change even with prolonged use.
- Some drugs may cause side effects. For example, Terfenadine and Astemizol should not be taken simultaneously with antibiotics and antimycotic drugs. Also, you can not drink them with citrus juices. This can cause cardiotoxic effects and disrupt liver function. Therefore, these funds are not prescribed for the elderly and patients with diseases of the liver and the cardiovascular system. For such patients, Loratadine and Cetrin are considered more acceptable.
- For local treatment, the drug Acelastin is used, which begins to act within 20 minutes after administration and has no side effects.
Overview of the most effective drugs
Here is a list of the most effective medicines of the 3rd generation, their main properties and analogues:
cetirizine
It is considered the most effective medicine for allergies. The product is practically not absorbed by the body, but at the same time it quickly removes the manifestations of allergies on the skin. The drug is often prescribed to children to combat early atopic syndrome, since taking Cetirizine significantly reduces the risk of recurrence of the disease in the future.
Relief occurs within two hours after ingestion, and the effect lasts quite a long time. Therefore, it is often enough to take 1 tablet per day, and at the initial stage of allergy, Cetirizine is taken every other day or even twice a week.
Cetirizine has a slight sedative effect, so it is rarely given to people with kidney problems. The tool is also suitable for the treatment of children older than two years (in the form of syrup or suspension).
The table below shows a list of analogues with their approximate price and form of release.
Tablets of analogue drugs are cheaper. Drops and syrups are allowed for children and are more expensive drugs.
Loratadine
At the moment, it is the most popular 3rd generation drug for the treatment of allergies. It is suitable for everyone age categories and has virtually no side effects. Loratadine does not have a sedative effect, does not affect the functioning of the heart and nervous system. Most patients tolerate the drug well, as it interacts well with other drugs.
Loratadine can be taken by children older than one year. The table below shows a list of analogues. Erius is considered the most powerful of them. It should not be used during pregnancy and for the treatment of children under one year old.
| Name | approximate price | Form of the drug |
| Erius | 450-700 rubles | Tablets for adults and syrup for children |
| Loratadine | 20 rubles | Tablets |
| Lomilan | 100-130 rubles | Tablets, suspension |
| Claricens | 30-60 rubles | Tablets and syrup |
| Lorahexal | 50 rubles | Tablets |
| Claritin | 220-205 rubles | Tablets and syrup |
| Desloratadine Teva | 360 rubles | Tablets |
| Desal | 160 rubles | Tablets |
| Lordestin | 210 rubles | Tablets |
| Clarotadine | 110-130 rubles | Tablets and syrup |
Fexofenadine
A metabolite drug that does not affect metabolic processes, does not cause drowsiness, interacts well with other drugs and does not affect the functioning of the nervous system. Although the drug is considered one of the safest, it should not be taken by children under six years of age.
Analogue drugs are Telfast (average price 450 rubles), Fexofast (200 rubles) and Feksadin (160 rubles). All of them are available only in tablets.
Dimetinden
By its properties, it resembles antihistamines of the 1st generation, but has a longer effect. A feature of the drug is that it can be used both for internal use and as an external agent for relieving inflammation on the skin. Fenistil drops, gel and emulsion are considered analogues of Dimetinden, the cost of which ranges from 280 to 350 rubles, depending on the form of release.
Acrivastine, Astemizole, Terfenadine and their analogues (Semprex, Gistalong and Trexil, respectively) have cardiotoxic effects and other side effects, as well as short-term effects. Therefore, now they are practically not used to treat allergies.
The choice of drugs depending on the patient
Depending on the age and the presence of other diseases in the patient, a certain type of anti-allergy medication is prescribed:
- Children from 1 to 4 years old can use Loratadine and Cetrinisin.
- Patients under 12 years of age are prescribed Cetirizine, Loratadine and Dimetinden, as well as their analogues Cetrin, Zirtek, Claritin and Fenistil.
- During pregnancy, you can use Loratadine and Fexofenadine, and during breastfeeding, the only drug that can overcome an allergic reaction is Clemastin.
- In case of violations of the liver, patients are recommended to take Loratadine, Fexofenadine and Cetirizine, and for people with renal insufficiency, in addition to Loratadine, Astemizol and Terfenadine are also suitable.
Description of 1st generation antihistamines
Such agents are now rarely used because of their shortcomings, which are completely absent in metabolites:
- Reduce muscle tone
- Cause drowsiness and sedation
- The action of the drug occurs quickly, but lasts no more than five hours.
- Children may experience psychomotor agitation. This effect can also appear in adults with prolonged use and non-compliance with dosages.
- You can not use 1st generation antihistamines for people whose work is related to concentration: drivers, students and people who work with various mechanisms.
- Enhance action sleeping pills, analgesics and alcohol.
- In most countries, these drugs are not produced due to their serious side effects: urinary retention, constipation, dry mouth, tachycardia, and decreased visual acuity.
An approximate list of 1st generation drugs that are best replaced with metabolite agents is given below:
- Tavegil is still used because of the relatively long duration of the drug (up to 8 hours). However, recently, cases of allergies to Tavegil itself have begun to be recorded.
- Diphenhydramine is not recommended for use, as it can have an unpredictable effect on the nervous system.
- Suprastin and Chloropyramine are popular because they do not cause cardiotoxic effects. And its ability not to accumulate in the blood allows the use of the drug for a long time. Most often, funds are used to treat urticaria, to relieve itching and. The only drawbacks are a slight sedative effect and a short duration of action.
- Peritol is used to treat migraines, but may cause an increase in appetite.
- Diazolin is not used due to the fact that the agent causes irritation of the mucous membrane of the digestive organs, inhibits mental and physical reactions, causes drowsiness, urinary retention and dizziness.
- Fencarol is similar in its properties to diphenhydramine, but has a less sedative effect. This tool is used mainly after getting used to other drugs of the 1st generation.
- Pipolfen and Diprazine are used to relieve the gag reflex, but the funds must be used with caution due to their adverse effects on the nervous system.
Allergy medicines for children
Allergy tablets for children are used only in older children, and for small patients, drops, syrups or suspensions are mainly used.
Children suffering from allergies are prescribed only certain types drugs. Among antihistamines babies older than a year can use Lomilan, Loratadin, Claritin, Clarisens and Clarotadin. After two years, Tsetrin, Zodak and Parlazin are allowed to be taken, but only in the form of drops or syrup.
To strengthen the mast cell membrane, Ketotifen syrup, Kromoglin and Kromoheksal sprays, as well as Intal are used. These drugs prevent the destruction of mast cell membranes, increasing the protection of the immune system and preventing excessive production of histamine. However, all these drugs can only be used in children older than a year.
Corticosteroids are used very rarely, as they can cause irreparable harm to the child's body. The danger of taking such drugs lies in the fact that the negative effect may appear long after the completion of the course of treatment. Reception of prednisone, betamethasone, hydrocortisone and other hormonal tablets, drops, sprays and others should be carried out under the supervision of a pediatrician and only if other drugs could not cope with the manifestations of allergies.
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