People who experience allergies regularly buy antihistamines and know what they are.
Timely taken tablets save from debilitating cough, swelling, rash, itching and redness of the skin. The pharmaceutical industry has been producing such drugs for many years, and each new batch is drawn up 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 created to resist 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 an 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 effect on humans. Thus, antihistamines are the general definition of all drugs that have a specified efficacy. Today their classification has 4 generations.
The advantages of the drugs in question 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 anti-allergy pills if these conditions are indicated in their instructions among the contraindications.
All new generation antihistamines - a list of new drugs:
- Erius.
- Ksizal.
- Bamipin.
- Cetirizine.
- Ebastin.
- Fenspiride.
- Levocetirizine.
- Fexofenadine.
- Desloratadine.
It is difficult to single out the most effective antihistamines of the 4th generation from this list, since some of them have appeared relatively recently and have not yet had time to prove themselves 100%. Phenoxofenadine is considered a popular treatment option for allergies. Taking tablets containing this substance does not have a hypnotic and cardiotoxic effect on the patient.
Medicines with cetirizine well remove the skin manifestations of allergies. One tablet brings significant relief after 2 hours from the moment of consumption. The result is stored for a long time.
The Erius medicine is an improved analogue of Loratadine. But its efficiency is about 2.5 times higher. Erius is suitable for children from 1 year of age who are prone to allergies. They are given the drug in liquid form with a dosage of 2.5 ml once a 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 medicine per day.
The medicine 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 product is not addictive. The body is affected for 24 hours.
Feksadin should not be taken during pregnancy, hepatitis B and children under 12 years of age.
Zodak (Cetrin, Zyrtec, Cetirizin)
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 are used from 6 months. After 1 year, syrup is prescribed. Children can take tablets from 6 years old. Dosages for each type of medication are selected individually.
Pregnant women should not take cetirizine. If there is a need to treat allergies during lactation, the baby is temporarily weaned.
Ksizal (Suprastinex, Levocetirizine)
Ksizal drops and tablets work 40 minutes after taking.
The medication is indicated for the treatment of urticaria, allergies, itching. For children, antihistamines of the fourth generation for allergies called Ksizal are prescribed from 2 years and 6 (drops and tablets, respectively). The pediatrician calculates the dosage based on the child's age and weight.
Xizal is prohibited during pregnancy. But it can be taken while breastfeeding.
Suprastinex helps well with seasonal allergies, when the body reacts to pollen from flowering plants. As the main drug, it is used in the treatment of conjunctivitis and rhinitis of an allergic nature. Suprastinex is taken with food.
Desloratadin (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 headaches and dry mouth. Desloratadine is sold in the form of tablets and syrup.
Doctors prescribe syrup for children 2 - 6 years old. Tablets are allowed to be used only from 6 years old. Desloratadine is completely contraindicated for pregnant and lactating women. But with Quincke's edema and bronchospasm, a specialist can choose a sparing option for using this medication.
Antihistamines for the little ones
Antihistamines are not recommended for newborns. But sometimes situations arise when it is impossible to do without drugs, for example, if the baby is stung by an insect. From 1 month of age, a child can be given Fenistil in drops.
Diphenhydramine, which used to be given to children in different cases, is now prescribed by pediatricians only from the 7th month of life.
The most gentle option for the smallest is Suprastin. It quickly shows healing properties without causing the slightest harm to the body. Also, children are prescribed Fenkarol and Tavegil. For hives, drug dermatosis and food allergies, it is better for a child to give Tavegil. The tablets relieve swelling, restore skin color and act as an antipruritic agent.
Tavegil's analogs are Donormil, Diphenhydramine, 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 tolerate stronger medications normally. For itchy skin, the names of antihistamines for this age group of patients will be considered by the specialist as follows:
Erius was mentioned above, now we will focus on Tsetrin. These tablets can be used to prevent allergies in children prone to negative reactions. In case of individual intolerance of the constituent components, Cetrin is replaced by analogs - Letizen, Cetirinax, Zodak, Zetrinal. After 2 years, the child can take Astemizole.
From the age of 6, the list of antihistamines is expanded, since medicines of different generations are suitable for such children - from 1 to 4. Younger schoolchildren can drink tablets Zirtek, Terfenadin, Clemastin, Glenzet, Suprastinex, Tsesera.
What Komarovsky says
The famous pediatrician E.O. Komarovsky does not advise parents to give small children antihistamines unless absolutely necessary and medical prescriptions. If the pediatrician or allergist considers it necessary to prescribe an anti-allergic agent for the child, it can be taken for no more than 7 days.
Also, Evgeny Olegovich prohibits combining antihistamines with antibiotics and says that it is not at all necessary to give the child an antihistamine pill on the eve of vaccination or after vaccination.
Some parents, based on their own considerations, try to give Suprastin to drink before the DPT, but Komarovsky does not see any point in this. The children's doctor explains that the body's reaction 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 it is worth enduring the inconveniences associated with hay fever, rash and swelling. Doctors say that during gestation, women are better off not taking any medications, since they are potentially dangerous to the mother and fetus.
Currently, more than 85% of the total population of the entire planet is susceptible to various manifestations of allergies, and in the past few decades, a pronounced increase in the number of people with allergies has been observed. This is probably due to the development of the industry that produces chemical products, which themselves are frequent allergens or create conditions for the formation of allergic reactions, due to dysfunction of the endocrine and nervous systems.
Also, the influence of hygiene (excessive use of antibacterial and other potent agents) is not excluded, which deprives 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 body responses to a variety of allergens that cause different painful symptoms at different times in different people. Allergic reactions underlie quite serious diseases, including, and, and can also accompany some infections (infectious allergies).
Allergy Causes
The allergy itself can be recognized by the sudden appearance lacrimation , sneezing, redness of the skin and other unexpected painful manifestations. Most often, such allergic symptoms occur during 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 triggered in it.
Modern doctors consider as allergens both substances that reveal a direct allergenic effect, and agents that can increase the effect of other allergens.
A person's response to the effects of 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 a healthy married couple.
The main causes of allergies:
- waste products of home ticks;
- pollen of 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 typical for cats, rabbits, dogs, chinchillas);
- chemical detergents and cleaners;
- medicinal preparations (,);
- food products, mainly eggs, fruits (oranges, persimmons, lemons), milk, nuts, wheat, seafood, soy, berries (viburnum, grapes, strawberries);
- insect / arthropod bites;
- latex;
- cosmetical tools;
- psychological / emotional;
- Unhealthy Lifestyle.
Types and symptoms of allergies
Respiratory allergy
The form of allergy is characteristic of the influence of allergens entering the body from the outside during breathing. Such substances are collectively called - aeroallergens , which include pollen, fine dust, various gases. This also includes respiratory allergies.
Symptoms of such painful conditions are:, pulmonary wheezing, itching in the nose, severe, sometimes. The main negative symptoms are manifested 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 allergens such 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 symptoms are manifested in the form of: skin swelling in the periorbital region, burning sensation in the eyes, increased tearing.
Enteropathy
Anaphylactic shock
The most dangerous form of allergy 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 medications.
External forms (, gel) are used mainly for itchy skin ( itchy dermatoses ) caused by insect bites, as well as acquired as a result of itchy eczema, hives, contact allergies (to detergents, washing powder, synthetic or coarse clothing, etc.).
These external drugs are ineffective and are rarely used in the treatment of chronic skin allergic forms (for example, with). In combination with a diet, these remedies can be recommended at the initial stages of treatment. exudative-catarrhal diathesis of a moderate nature (when a baby has a rash on the face associated with nutrition).
Local combination agents in the form of eye drops ( Ophthalmol ,), including first generation antihistamines, are used in the treatment of 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 an antimicrobial effect. In turn, nasal drops cope quite well with manifestations allergic rhinitis in all its forms (including hay fever ).
Side effects
Negative effects are mainly inherent in drugs of systemic action, however, due to prolonged use, they can also be noted when using external / local agents (especially in pediatrics).
Most often, first-generation antihistamines accompany:
- strong sedatives /sleeping pills effects;
- decreased muscle tone;
- psychomotor agitation (especially in children and adults with prolonged use);
- potentiation (augmentation) of the effects of alcohol, sleeping pills and analgesic funds;
- /headache;
- local anesthetic action;
- lowering blood pressure;
- anticholinergic effects (tremor of the fingers, dry mouth, constipation, heart palpitations, visual impairment);
- nausea / vomiting, abdominal pain;
- addictive .
Due to the hypnotic effect, drugs of this generation are not recommended for pupils, students, drivers and people engaged in potentially hazardous activities.
All such drugs cause a specific reaction. tachyphylaxis (addiction), which is expressed by a noticeable decrease in effectiveness during prolonged use and requiring the replacement of the active ingredient of the drug for another substance every 20 days.
Advantages
In certain cases, doctors have learned to use some of the above-described disadvantages of 1st generation drugs for good.
For example, sedative /hypnotic the action of these therapeutic agents will be useful for allergic diseases with parallel unbearable itching of the skin ( atopic dermatitis during an exacerbation), bringing a long-awaited dream into the patient's life.
Anticholinergic effects , including dry mucous membranes, is useful in therapy bronchitis (for allergic cough) and rhinitis (from a cold), accompanied by abundant secretion of fluid.
All first-generation drugs, even those produced abroad, are quite inexpensive, and domestic manufacturers produce even cheaper analogs.
disadvantages
Due to the pronounced negative systemic effects and the body's habituation to the active ingredient of the drug, 1st generation drugs are not suitable for long-term therapy.
Drowsiness and sedation 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 | |
|
|
|
|
| outer gel | 0 months | ||
|
eye drops |
|
|
| Chloropyramine |
|
|
1 month |
| Clemastine |
|
|
|
|
|
2 months | |
| Pheniramine | Avil |
|
|
|
|
||
| (combined) |
|
|
|
| Cyproheptadine |
|
|
|
| Mebhydrolin |
|
|
|
| Hifenadine | pills | 3 years |
2nd generation drugs
As in the previous case, the list of second-generation antihistamines for allergy drugs is mainly represented by oral dosage forms.
Pills ( , 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 persists for 24 hours, which allows the patient to drink the recommended dose of the drug shown to him only 1 time per day);
- all medicinal products 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 medicinal products through the blood-brain barrier;
- in the process of carrying out therapy, physical activity and mental activity of the patient practically do not suffer;
- anticholinergic action (tremor of the fingers, dry mouth, constipation, heart palpitations, visual disturbances) is very rare;
- all second-generation drugs are not addictive and can be used for a long time (3-12 months) without changing the active substance (for example, throughout seasonal allergies as long as it takes until the allergen disappears);
- upon termination of treatment, therapeutic efficacy persists for another week.
Side effects
Among the negative effects of 2nd generation antihistamines, the most serious is considered cardiotoxic effect , manifested in varying degrees of severity and requiring 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 cardiac channels, blocking them. The risk of such an effect increases with impaired hepatic function, concurrent administration of antifungal agents, antidepressants , macrolides as well as drinking grapefruit juice. Naturally, such drugs are contraindicated for elderly patients and patients with disorders of the cardiovascular system.
Other most common negative side effects:
- impaired hepatic function;
- fast fatiguability;
- nausea;
- swelling ;
- asthenia;
- phenomena;
- nervous irritability and sedation (in children).
Advantages
Pop cause of minimal negative systemic action and effect tachyphylaxis (addiction), preparations of the 2nd generation are the best suited for long-term use and have proven themselves well in the treatment of allergic seasonal rhinoconjunctivitis and rhinitis , pollinosis, atopic dermatitis (in complex therapy in the subacute stage) and bronchial asthma .
These therapeutic agents can be prescribed to schoolchildren and students during the educational process, since they do not lower their concentration of attention.
Prolonged effectiveness, observed over 24 hours (which allows you not to do unnecessary receptions, but to limit them to 1 time per day).
disadvantages
Due to the relatively short application practice, 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 for 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 of use |
| Loratadin |
|
|
|
| Cetirizine | Alerza | pills | 6 years |
|
|
|
|
|
|
||
|
|
||
| Acrivastin | Semprex | capsules | 12 years |
| Terfenadil |
|
pills | 3 years |
| Terfenadine |
|
3 years | |
| Ebastin |
|
pills | 6 years |
|
|
||
| Astemizole |
|
pills | 2 years |
| Gismanal |
|
2 years |
3rd generation drugs
The entire list of drugs for allergy of the new generation (third), in principle, can be attributed to the previous therapeutic agents, because the active substances of these drugs are pharmacologically active metabolites of some already known basic ingredients of the above-described last generation (second).
Nevertheless, anti-allergic drugs of the new generation entered the pharmaceutical market last and many sources position them as antihistamines of the 3rd and even 4th generation.
The spectrum of positive action of this generation of drugs covers almost all allergic manifestations known today. 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 highest selectivity (selectivity) of their action exclusively directed at peripheral H1 receptors. It is due to this that their high antiallergic efficacy can be traced along with the absence of side effects inherent in drugs of the 1st and 2nd generation.
The distinctive characteristics of such medicines are:
- rapid absorption in the gastrointestinal tract along with high bioavailability, which contribute to the leveling of allergic reactions in the shortest possible time;
- 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;
- absent cardiotoxic effects that will allow prescribing drugs of this generation to elderly patients;
- there is no addictive effect, which makes it possible to use these drugs for a long period of time;
- there is practically no interaction with drugs taken in parallel from other pharmaceutical groups;
- the absorption of medicinal products does not depend on the time of the meal;
- the active ingredients are excreted unchanged, relieving the burden on the kidneys and liver.
Side effects
In rare cases, development is possible:
- nausea;
- lengthening the QT interval ;
- headaches / dizziness;
- increased appetite;
- hyperemia of the skin;
- dryness of the mucous membranes.
Advantages
Long-term and fast 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.
disadvantages
As with all relatively new drugs, the lack of these drugs in the 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 generation, table
| Active ingredient | Trade names of drugs | Release form | Age restrictions of use |
| Desloratadine |
|
pills | 12 years |
|
|
|
|
|
|
|
|
| Levocetirizine |
|
|
|
|
pills | 6 years | |
|
pills | 6 years |
Modern pediatrics in their practice of treating allergies in children uses antihistamines antiallergic drugs for children of all three generations. In the younger age group, the most used oral dosage forms are baby drops and syrups, tablets are prescribed to children already at a more conscious age, most often from 6 years old.
Some allergy nasal and eye drops for babies can be used from birth.
- In the post-Soviet countries, especially in the acute period of 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 have been well studied, most of them are considered relatively safe (if taken as prescribed by a doctor, without overstating the recommended doses), many drugs in this group can be used for newborns. If liquid dosage forms are unavailable, children under one year old may take drugs in the form of tablets, previously divided into parts recommended by a doctor and crushed. The most popular and effective drugs of systemic action of first generation antihistamines are recognized:,.
- 2nd generation antihistamines are characterized by a longer duration of their 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 medications are prescribed for children from 1 year old (rarely from 6 months), since their effect on the body of infants has not been studied enough. In this generation, most often pediatricians use drugs:, Zyrtec , .
- 3rd generation antihistamines it has a very high efficiency and even fewer 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 of children's medicines, one can distinguish:, Eden , Desal .
Parents should remember that giving their child antiallergic drugs on their own is strictly prohibited. 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, women with allergies who plan to become pregnant or are already carrying a child under their heart are extremely interested in what allergy pills can be drunk with and further, and can such drugs be taken during these periods in principle?
Let's start with the fact that for pregnancy it is better for a woman to avoid taking any medications, since their effect can be dangerous for both pregnant women and their future offspring. Antihistamine tablets for allergies during pregnancy in the 1st trimester are strictly prohibited, with the exception of extreme cases that threaten the life of the expectant mother. 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 planning the time of your pregnancy when specific allergens are least active. For the rest, the best solution will also be 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 acid) and then only after consulting a doctor.
Mast Cell Membrane Stabilizers
For the treatment of certain allergic reactions, mainly initial and
Allergy is the scourge of the 21st century. The disease, the prevalence of which has been growing rapidly in recent decades, especially in the developed countries of the world, still remains incurable. World statistics showing the number of people suffering from various manifestations of an allergic reaction amazes even the most daring imagination. Judge for yourself: 20% of the population suffers from allergic rhinitis every year, 6% are forced to follow a diet and take pills for allergies, about 20% of the world's inhabitants experience symptoms of atopic dermatitis. No less impressive are the numbers reflecting the number of people suffering from even more severe pathologies of allergic origin. Depending on the country of residence, about 1-18% of people cannot breathe normally due to attacks of bronchial asthma. About 0.05-2% of the population experience or have experienced in the past anaphylactic shock associated with a huge risk to life.
Thus, at least half of the population is faced with allergic manifestations, and it is concentrated just for the most part in countries with a 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 clearly insufficient control over the dispensing 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 tendency promotes aggressive self-medication, including with the help of hormonal drugs for allergies, which can sometimes lead patients into a dead corner and bring the development of severe stages of the disease closer.
We did not paint such an unattractive picture 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 "spied" in the commercial. We, in turn, will devote a detailed article to the description of allergies, 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 allergy?
And we will start with the basics, without which it is impossible to understand how allergy pills work. According to the definition, allergy is understood as a number of conditions caused by the hypersensitivity of the immune system to any 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 they invariably get a worthy rebuff. One fine day, confusion occurs in the ranks of our army for unknown reasons. Its experienced and courageous warriors suddenly make a serious mistake, mistaking the friendly delegation, which always crossed the border without hindrance, for the enemy. And by doing so, without wishing it, they inflict irreparable damage on their country.
Roughly the same events develop with an allergic reaction.
The body's immune system, which is protecting it from hundreds of bacteria and viruses from day to day, suddenly begins to perceive harmless substances as deadly enemies. As a result, a military operation begins, which is too expensive for the body itself.
How does an allergic reaction develop?
First, the body begins to develop 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 medications 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 resulting antigen-antibody combination is deposited on the receptors of special cells of the immune system called mast cells.
Antigen is understood to mean molecules that are capable of binding to antibodies.
They are located in the connective tissue. There are especially many mast cells under the skin, in the area 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 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 contents are released outside, 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 to buy for allergies. But there is no need to rush - you should first find out what kind of allergic reaction will take on.
What are allergies?
And there may be several options depending on the allergen and individual sensitivity. Most often, an allergy develops to grass and flower pollen. In this case, they speak of hay fever, or hay fever. Symptoms suggestive of an illness requiring prescription of allergy pills or 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, which is of an allergic nature. These include a number of diseases, including:
- atopic dermatitis, characterized by excessive dryness and irritation of the skin;
- contact dermatitis, develops as a reaction to contact with materials that cause allergies. Most often it is latex (latex gloves), less often - metal products and jewelry;
- hives, may appear as a result of a reaction to various foods.
Severe chronic disease of an allergic nature - bronchial asthma. Quincke's edema and anaphylactic shock are even more dangerous conditions associated with a risk to life. 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 for allergy medications: popular and economical
The funds of this group are among the most famous and frequently used drugs for the treatment of food allergies, seasonal allergies, various dermatitis, and less often emergency conditions.
The mechanism of action of antihistamines is to block receptors with which histamine, the main mediator of allergy, binds. They are called H1-histamine receptors, and drugs that inhibit them, respectively, blockers of H1-histamine receptors, or H1-antihistamines.
Today, 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 well-known antihistamines that are used against allergies.
Table 1. Three generations of antihistamines antiallergic drugs
First generation antihistamines
They have been used for several decades and, nevertheless, have not yet lost their relevance. Distinctive features of these drugs are:
- sedative, that is, 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 properties than anti-allergic properties. Other pills that could theoretically be prescribed for allergies have found use as safe sleeping pills. We are talking about doxylamine (Donormil, Somnol);
- anxiolytic (mild tranquilizing) action. It is associated with the ability of some drugs to suppress activity in certain areas of the central nervous system. Antihistamine tablets of the 1st generation hydroxyzine, known under the trade name Atarax, are used as a safe tranquilizer;
- anti-pumping 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.
Another distinguishing feature of the first generation antihistamine tablets from allergies is the fast, but short-term antiallergic effect. In addition, the first generation drugs are the only antihistamines that are available in injectable form, that is, in the form of injectable solutions (Diphenhydramine, Suprastin and Tavegil). And if the solution (and tablets, by the way, too) of Diphenhydramine has a rather weak antiallergic effect, then the injection of Suprastin and Tavegil allows you to quickly provide first aid for immediate allergies.
In case of an allergic reaction to insect bites, urticaria, Quincke's edema, intramuscular or intravenous Suprastin or Tavegil are used along with injection as a powerful antiallergic agent of a glucocorticosteroid drug, most often Dexamethasone.
Second generation antihistamines
Preparations of this series can be called modern pills for allergies of a new generation, which do not cause drowsiness. Their names often appear in TV commercials and in 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;
- the ability to have a negative effect on the heart muscle. By the way, you can dwell on this effect in more detail.
Do allergy pills work on the heart?
Yes, indeed, some antihistamines can negatively affect the work 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 disturbance in the heart rhythm.
The likelihood of developing a similar effect increases with a combination of second generation antihistamines with a number of other drugs, in particular:
- antifungal ketoconazole (Nizoral) and itraconazole (Orungal);
- antibiotics of the macrolide group erythromycin and clarithromycin (Klacid);
- antidepressants fluoxetine, sertraline, paroxetine.
In addition, the risk of negative effects of second generation antihistamines on the heart increases if you combine allergy pills with grapefruit juice, as well as in patients with liver disease.
Among the wide list of antiallergic drugs of the second generation, several drugs should be distinguished that are considered relatively safe for the heart. First of all, it is dimetindene (Fenistil), which can be used by children from 1 month of age, as well as inexpensive Loratadine tablets, which are also widely used for the treatment of allergies in pediatric practice.
Third generation antihistamines
And finally, we come to the smallest, latest generation of drugs prescribed for allergies, from the group of H1-histamine blockers. They are fundamentally different from other drugs in the absence of a negative effect on the heart muscle against the background of a powerful antiallergic effect, fast and long-lasting 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, analogs of Lordestin, Ezlor, Eden, Elisey, 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 (Ksizal, Suprastinex, Glenzet, Zodak Express, Tsesera) 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 over 2 years of age.
It should be noted that the appearance of these two drugs on the market was met with enthusiasm. Many experts believed that levocetirizine and desloratadine would finally help to effectively solve the problem in case of insufficient response to therapy with traditional antihistamine tablets, including with symptoms of severe allergies. However, in reality, alas, expectations were not met. 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 an antihistamine is often based on the patient's tolerance and price preferences, as well as ease of use (ideally, the drug should be applied once a day, like Loratadine, for example).
When are antihistamines used against allergies?
It should be noted that antihistamines are distinguished by a fairly 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 drug.
Hay fever, or polynosis, food allergy
The drugs of choice for allergic rhinitis (inflammation of the nasal mucosa of an allergic nature) are allergy tablets 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) is often prescribed, as well as Loratadine, Cetirizine in children's syrups or solutions.
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 lesions, you can limit yourself to external forms, in particular, with Psilo-balm gel (diphenhydramine is included in the composition) or Fenistil gel (external emulsion). If the allergic reaction in an adult or a child is strong enough, accompanied by severe itching and / or a significant area of the skin is affected, in addition to local preparations, tablets (syrups) for the allergy of the H1-histamine blockers group may be prescribed.
Allergic conjunctivitis
With inflammation of the mucous membrane of the eye of an allergic nature, eye drops are prescribed and, if the effect is insufficient, tablets. The only eye drops today that contain an antihistamine component are Opatanol. They contain the substance olapatadin, which provides a local antiallergic effect.
Mast cell membrane stabilizers: allergy pills are not for everyone
Another group of drugs for allergies acts by preventing the entry of calcium ions into mast cells and thus inhibiting the processes of destruction of cell walls. Thanks to this, it is possible to prevent the release of histamine into the tissue, as well as some other substances involved in the development of allergic and inflammatory reactions.
On the modern Russian market, only a few allergy remedies of this group have been registered. Among them:
- ketotifen, an allergy medication in tablets;
- cromoglycic acid and sodium cromoglycate;
- lodoxamide.
All preparations containing cromoglyceic acid and sodium cromoglycate are conventionally 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 (KromoGeksal) 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 a noticeable effect from the use of cromoglycates in a spray occurs after one week of constant use, reaching a peak by four weeks of continuous treatment.
Inhalation is used to prevent attacks of bronchial asthma. An example of inhalation agents against allergies, which is complicated by bronchial asthma, are Intal, KromoHeksal, Kromogen Light Breathing. The mechanism of action of drugs in such cases is aimed at interrupting the allergic reaction, which is the "trigger" in the pathogenesis of bronchial asthma.
Capsules of cromoglycic acid (KromoHeksal, Cromolin) are prescribed for food allergies and some other diseases, one way or another associated with allergies.
Eye drops with cromoglycates (Allergo-Komod, Ifiral, Dipolcrom, Lekrolin) are the most prescribed antiallergic drugs for conjunctivitis caused by sensitivity to pollen.
Ketotifen
Allergy tablet formulation 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.
Differs in a rather low price. In the Russian Federation, several drugs containing ketotifen are registered, and one of the highest quality is 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 remedy with 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, which is indicated in the instructions for the drug. However, it is important to start taking the medication well in advance, ideally at least 8 weeks before the expected start of the allergen bloom, and, of course, do not stop the course of therapy until the season is over.
Lodoxamide
This active ingredient is produced as part of eye drops, which are prescribed for allergic conjunctivitis, Alomida.
Glucocorticosteroids in tablets and injections for the treatment of allergies
The most important group of drugs that are used to relieve allergy symptoms are steroid hormones. They can be conditionally divided into two large subgroups: local agents that are used to irrigate 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 widely used to treat 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, lies in the portability. If local and external drugs have close to zero bioavailability and are practically not absorbed into the systemic circulation, exerting only an effect at the site of application (application), then injectable and tableted drugs, on the contrary, quickly penetrate into the bloodstream, and, therefore, exhibit systemic effects. Therefore, the safety profile of the first and the 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 of these names describe a category of steroid hormones that are synthesized by the adrenal cortex. They exhibit a very powerful triple healing effect:
Thanks to these abilities, corticosteroids are indispensable drugs used for a wide variety of indications in various fields of medicine. Among the diseases for 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 hormones have many side effects, including serious ones that sometimes require discontinuation of medication. Let's list the most common ones:
- headache, dizziness, blurred vision;
- hypertension, chronic heart failure, thrombosis;
- nausea, vomiting, gastric ulcer (duodenal ulcer), pancreatitis, impaired appetite (both improvement and deterioration);
- decreased function of the adrenal cortex, diabetes mellitus, menstrual irregularities, growth retardation (in childhood);
- weakness and / or muscle pain, osteoporosis;
- acne disease.
“Okay,” the reader will ask. "Why are you describing all these terrible side effects?" Only so that a person who is going to treat allergies with the help of the same Diprospan thinks about the consequences of such a "treatment". Although this should be discussed in more detail.
The drug Diprospan for allergies: latent danger!
Many experienced allergy sufferers know: the introduction of one (two or even more) ampoules of Diprospan or its analogue, for example, Flosterone or Celeston, saves from severe symptoms of seasonal allergies. They advise this "magic remedy" to friends and acquaintances desperate to find a way out of the allergic vicious circle. And they do them oh what a disservice. “Why bearish? the skeptic will ask. - After all, it becomes easier, and quickly. " Yes, it does, but at what cost!
The active substance of Disprospan ampoules, which are often used to relieve manifestations of allergies, including without a doctor's prescription, is the classic glucocorticosteroid betamethasone.
It exhibits a powerful and fast anti-allergic, anti-inflammatory and antipruritic effect, really in a short time relieving the condition of 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 fades away. A person who has already experienced a significant relief of allergy symptoms naturally tries to continue the "treatment" with another ampoule of Diprospan. He does not know or does not think that the likelihood and severity of side effects of glucocorticosteroids depends on their dose and frequency of use, and, therefore, the more often Diprospan or its analogs are administered to correct the manifestations of allergies, 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 for seasonal allergies, which most patients have no idea about - a gradual decrease in the effect of classic antiallergic pills 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 manifested by an injectable glucocorticosteroid, the effectiveness of antihistamine tablets and, moreover, stabilizers of mast cell membranes, decreases catastrophically. The same picture persists after the end of the steroid action.
Thus, a patient who uses Diprospan or its analogs to relieve 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" with drugs of this series is fraught not only with resistance to therapy with safe drugs, but also with the need to constantly increase the dose of hormones to achieve an adequate effect. However, in some cases, treatment with corticosteroids is still necessary.
When are pills or steroid injections used to treat allergies?
First of all, tablets or injections of Dexamethasone (less often, Prednisolone or other glucocorticosteroids) are used to relieve an acute allergic reaction. So, with anaphylactic shock or Quincke's edema, it is advisable to inject 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 intake or even exceeding it. This tactic justifies itself with a single use of drugs, one or two times, which, as a rule, is sufficient to obtain the desired effect. You should not be afraid of the notorious side effects in such cases, because they begin to manifest themselves in full force only against the background of 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. These are severe stages or types of the disease, for example, bronchial asthma in the acute stage, a severe degree of allergy that does not respond to standard therapy.
Hormone therapy for allergic diseases can only be prescribed by a doctor who is able to assess both the benefits and risks of treatment. He carefully calculates the dose, monitors the patient's condition, side effects. Only under the watchful supervision of a physician, corticosteroid therapy will bring real results and not harm the patient. Self-medication with hormones for oral administration or injections is categorically unacceptable!
When should you not be afraid of hormones?
As dangerous as glucocorticosteroids can be for systemic use, steroids intended for administration into the nasal cavity are just as innocent. Their field of activity is limited exclusively to the mucous membrane of the nasal cavity, where, in fact, they must 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.
Providing anti-inflammatory and powerful anti-allergic action, corticosteroids for nasal use in a short time stop the symptoms of allergy, stopping the pathological reaction.
The effect of intranasal steroids is manifested 4-5 days after the start of therapy. The peak of the effectiveness of drugs in this group for allergies is achieved after several weeks of constant 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 Nazonex).
Beclomethasone drugs are prescribed for the treatment of mild to moderate allergies. They are approved for use by children over 6 years old and adults. In general, 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, while irrigating the nasal mucosa, not to direct the stream of the drug to the nasal septum, but to spray the drug on the wings.
Occasionally, the use of a spray with beclomethasone can lead to minor nosebleeds, which is harmless and does not require discontinuation of the drug.
"Heavy artillery"
I would like to pay special attention to the next representative of hormonal corticosteroids. Mometasone is recognized as the most powerful drug for the treatment of allergies, which, in addition to very high efficacy, has an extremely favorable safety profile. Mometasone, the original Nasonex spray, has a powerful anti-inflammatory and antiallergic effect, practically not being absorbed into the blood: the indicator of 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 examining its use in this category of patients.
It should be noted that not a single pill 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 an allergen, for example, by going to another climatic zone at the time of flowering. And to the frequent question: which pills for allergies 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. Some pills can be taken while breastfeeding for allergies, but it is best to consult your doctor before starting treatment.
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 constant use. The drug is prescribed for the prevention of seasonal allergies, starting to irrigate the nasal mucosa several weeks before the expected pollination period. And, of course, mometasone is one of the most "favorite" and often 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 are possible.
Allergy treatment with pills and more: a stepwise approach
As you can see, there are quite a few drugs with antiallergic 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 pouring from the pages of magazines and newspapers. And, of course, it is quite difficult to get a “finger in the sky” in this way. 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 medications do not help. In fact, there are rather strict treatment rules, on the observance of which the effectiveness largely depends.
First of all, the scheme of allergy therapy (we will talk about the example of its most common form, allergic rhinitis) is based on an assessment of the severity of the disease. There are three degrees 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 a II or III generation antihistamine. Most often, tablets of Loratadine (Claritin, Lorano) or Cetirizine (Tsetrin, Zodak) 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 insufficient result, they switch to the second stage of allergy therapy. - Stage two.
Treatment of moderate allergies.
An intranasal corticosteroid (Beconase or Nasonex) is added to the antihistamine.
If symptoms of allergic conjunctivitis remain on the background of 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. - Stage three.
Treating severe allergies.
Additional drugs, such as leukotriene receptor inhibitors (Montelukast), may be added to the therapy regimen. They block the receptors with which inflammatory mediators bind, thus reducing the severity of the inflammatory process. The target indication for their appointment is bronchial asthma, as well as allergic rhinitis. In 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. Lack of medical care in such situations can lead to uncontrolled progression of allergies and the development of an extremely severe form of it, bronchial asthma.
Thus, the selection of pills, 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 friend. Remember: with allergies, as with most other diseases, the doctor's experience, an individual approach and thoughtful decisions are important. If these conditions are met, you will be able to breathe easily and freely all year round, forgetting about the endless runny nose and other allergic "joys".
Q: Can antiallergic antihistamines be harmful to a person if taken on a consistent basis?
Answer: It is better to pass allergen tests on the machine "Imedis Expert", and further exclude contacts with identified bioresonance test allergens. Also, if possible, he is treated by a bioresonance therapist and for many years to take homeopathic and bioresonance drugs prescribed during the treatment of bioresonance therapy, as well as in case of exacerbations or during the allergic season, take antihistamines of a new generation selected by a bioresonance test or pendulum.
You need to drink new generation antihistamines once a day until the symptoms of allergy disappear. If contact with an allergen cannot be avoided, then you will have to take an antihistamine (antiallergic drug) every day, there is nowhere to go from this, alas. Upon contact with an allergen without an antiallergic drug, a severe allergic reaction can develop, which in turn can lead to death, coma, and the allergy can also turn into asthma.
There are people who live on new generations of antihistamines and nothing else.
Of course, pills are not candy, 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 body on time, and then it may be too late.
Antihistamines
Antihistamines are a group of drugs, the principle of which is based on the fact that they block the H1 and H2-histamine receptors. This blockage helps to reduce the reaction of the human body with a special neurotransmitter histamine. What are these medicines used for? Doctors prescribe them during allergic reactions. Possessing a good antipruritic, antispastic, antiserotonin and local anesthetic effect, antihistamines are excellent help against allergies, and also effectively prevent bronchospasm caused by histamine.
In accordance with the time of the invention and release on the market, the entire variety of allergy products is classified into several levels. Antihistamines are classified into first, second, third and fourth generation drugs. Medicines included in each generation have their own specific characteristics 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
The 1st (first) generation drugs include sedative drugs. They work at the H-1 receptor level. 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 must 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 decreased tone may occur, which means that it is impossible to take these drugs while driving and other activities that require high concentration of attention. They also enhance the effect of other sedatives, sleeping pills, and pain relievers. The effect on the body of alcohol mixed with sedatives is also enhanced. Most first generation antihistamines are interchangeable.
Their use is advisable in case of allergic problems with the respiratory system, for example, when coughing or nasal congestion. It is worth paying attention to the fact that first generation antihistamines are good at fighting coughs. This makes it advisable to use them for bronchitis.
They will also be useful to 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
Peritol, pipolfen and fencarol are also common on the market.
Second generation antihistamines
Drugs of the 2nd (second) generation are called non-sedating. They do not have as many side effects as the first generation antihistamines. These are drugs that do not cause drowsiness or decrease brain activity, and also do not have cholinotic effects. A good effect is given by their use for itchy skin and allergic rashes.
However, their significant drawback is the cardiotoxic effect that these drugs can cause. Therefore, non-sedating drugs are prescribed only on an outpatient basis. In no case should they be taken by people suffering from diseases of the cardiovascular system. The most common non-sedative medications are:
trexil
histalong
zodak
semprex
fenistil
claritin
Third generation antihistamines
Antihistamines of the 3rd (third) generation are also otherwise called active metabolites. They have strong antihistaminic properties and have practically no contraindications. The standard set of these drugs includes:
cetrin
zyrtec
telfast
These drugs do not have cardiotoxic effects, unlike second generation drugs. Their use has a positive effect on asthma and acute allergic reactions. They are also effective in the treatment of 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.
Antihistamines of the fourth generation
Preparations of the 4th (fourth) generation have a small list of contraindications, which mainly consist of pregnancy and childhood, but, nevertheless, it is worth reading the instructions and consulting with a specialist before starting treatment. These drugs include:
levocetirizine
desloratadine
fexofenadine
On their basis, a larger number of drugs are produced, which can, if necessary, be purchased at the 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, tablets and capsules are the most convenient type for use. 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 suitable form of medication.
Treatment of children with antihistamines
As you know, children are more susceptible to allergic diseases than adults. A qualified allergist should select and prescribe drugs for children. Many of them in the list of their contraindications have a child's age, therefore, if necessary, from the application to the preparation of a course of treatment, it is necessary to approach especially carefully. Children's organisms can react quite sharply to the effects of the drug, therefore, the child's well-being during the period of their use must be very carefully monitored. In case of side effects, taking 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 are part of the first generation are mainly used for the urgent relief of acute allergy symptoms. During long-term use, more modern means are usually used.
Antihistamines are usually not available in special “baby” forms. For the treatment of children, the same medicines 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 the age of two. Remember to supervise your child's medication.
In the case of a small child's illness, the selection of antihistamines becomes much more complicated. For newborns, drugs that have a slight sedative effect, that is, drugs of the first generation, may be suitable. The most commonly used in the treatment of very young children is suprastin. It is safe for 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 to take tavegil or Fenkarol, 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 a woman's body, allergies during the period of bearing a child are quite rare, but, nevertheless, some women still face this problem. During pregnancy, taking absolutely all medications must be agreed with your doctor. This also applies to allergy drugs, 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 consumed, nevertheless observing the necessary precautions.
Inadvertent drug ingestion 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 what means a nursing woman will use can only be decided by a doctor. Even the newest and most modern medicines can cause irreparable harm, so in no case do not self-medicate by feeding your 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 a medication that is not suitable for a person and a violation of the dosage can seriously harm health. The harm of antihistamines can manifest itself, in addition to the usual side effects for them, 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 with your doctor before you start drinking the medicine, and strictly follow the recommendations for taking it.
Allergy medication, antihistamines
How antihistamines work
Antihistamines of the "old" and "new" generations
What is the difference between the 1st, 2nd and 3rd generations of 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. This is why antiallergic drugs are called Antihistamines.
They block histamine receptors and thereby stop the development of allergy symptoms.
Depending on the type of reaction, antihistamines are prescribed in injections (for severe forms) and inside (for lighter forms). This is understandable: if we inject a drug using an intramuscular or intravenous injection, it instantly enters the bloodstream and starts working. And if we drink this medicine, time must pass before the active substance is absorbed into the blood from the gastrointestinal tract.
All medicines for allergies can be divided into several groups:
1. Symptomatic medicines.
2. Medicines for the treatment of chronic allergic inflammation in the affected organ.
3. Medicines for local therapy.
Symptomatic medicines 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 histamine, the main mediator of allergic reactions. Today, doctors have 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 medications also include, for example, bronchodilators. They are used for attacks of bronchial asthma.
Antihistamines for the treatment of chronic allergic inflammation in the affected organ are divided between non-hormonal and hormonal. The latter drugs are more powerful and effective.
Prescription of drugs in this group is carried out depending on the clinical manifestations of food allergy, the severity of the disease, the age of the child. It must be remembered that these drugs are generally only effective with long-term regular use.
It must be remembered that drug therapy for food allergies is a long process, you need to patiently and persistently follow medical recommendations.
It must also be remembered that some food allergy treatments are absolutely contraindicated and can be harmful to the child. So, for food allergies, treatment with herbs and many traditional medicine is contraindicated, and psychotherapy and reflexology, in addition to bioresonance treatment, have almost no 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 by biologically active additives, which often contain plant components.
Antihistamines are standard therapy for atopic dermatitis. They are used as an adjunct to external treatment for 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).
Antihistamines of the 1st "old" generation
1st generation antihistamines 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 (oral forms)
Chloropyramine, Clemastine, Dimetinden, Quifenadine, Hifenadine, Mebhydrolin, Ketotifen.
Disadvantages of older generation antihistamines:
Incomplete communication with H1 receptors, as a result of which relatively high doses are required;
Short duration of action - taking several times a day
Development of addiction - it is necessary to alternate drugs of different groups every 10-14 days
Sedative and hypnotic effect
Antihistamines of the 2nd and 3rd "new" generations
Loratodine, Cyterizin, Fexofenadine, Desloratadine.
Currently, in the treatment of atopic dermatitis, antihistamines of the "new", that is, 2nd and 3rd generations, are widely used.
Antihistamines 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 have a selective effect, causing only the blockade of 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 can last for one week after discontinuation (this circumstance must be taken into account when conducting an allergy examination). A significant difference between antihistamines of the "new" generation is that they have not only H1-blocking action, but also antiallergic and anti-inflammatory effects.
If it is necessary to take long-term use antihistamines only of the "new" generation
The absence of undesirable side effects inherent in the first antihistamines makes it possible to significantly expand the list of indications for the appointment of modern H1 antagonists.
Benefits of 2nd generation antihistamines versus 1st generation:
Rapid onset of action (from 30 minutes - acute cases);
The possibility of taking it at any time of the day (including in the morning) good absorption from the digestive tract the possibility of using in young children a long duration of the antihistamine effect (up to 24 hours), which allows you to take the drug once a day.
Lack of blockade of other types of receptors
Lack of penetration through the blood-brain barrier at therapeutic doses
Lack of connection with food intake
No addiction, even with prolonged use (3 to 6 months)
Almost complete absence of side effects associated with effects on the nervous and cardiovascular systems.
The use of antihistamines in the treatment of children with atopic dermatitis.
After a year, children are usually prescribed new generation drugs.
The drugs of the "new" generation, which are approved for use in children from 6 months of age, are antihistamines 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 sensitive. Indications for vaccination are determined based on the results of skin tests with allergens.
The vaccine is administered subcutaneously according to a special scheme or buried under the tongue. This treatment is only applicable to children over 5 years of age and should be administered by an allergist.
And finally, the most interesting question: Do allergy medications cause allergies? Yes! We will not go into the technical details of the complex mechanisms that can lead to such a development of events.
Let's just say that allergy to antihistamines is extremely rare, but it does happen. There is only one way out - to change the drug.
Antihistamines are a group of drugs that competitively block histamine receptors in the body, which leads to inhibition of the effects mediated by them.
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, heart rhythm disturbances), smooth muscles.
Strengthening its effect causes allergic reactions, therefore antihistamines are used to combat the manifestations of allergies. Another area of their application is symptomatic therapy / elimination of symptoms for 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 stomach diseases (help to reduce gastric secretion).
H3 blockers - used in the treatment of neurological diseases.
Among them, cetrin (cetirizine), fencarol (hifenadine), diphenhydramine, clemastine, suprastin stop the emission (for example, cromoglycic acid) or the action (like diphenhydramine) of histamines.
Available in the form of tablets, nasal spray, drops, including eye drops, solution in ampoules for intramuscular administration (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, and the duration of action increases.
First generation
Before buying a medicine - paracetamol, ibuprofen, antiallergic (antihistamines) drugs, remedies for the common cold and cold, you need to know:
Paracetamol
Analgesic, antipyretic, anti-inflammatory agent. The active substance is paraacetaminophenol, on the basis of which many other similar drugs are produced in different countries, such as acetaminophen, panadol, efferalgan, myalgin, paramol, pylaren, etc.
Benefit. In its action, paracetamol is in many ways similar to aspirin, but has less pronounced side effects. It does not reduce blood viscosity, so it is safe to use it in preparation for and after surgery.
It is less likely to cause allergic reactions than aspirin, and less irritating to the stomach. Paracetamol is a part of many combined drugs in combination with aspirin, analgin, caffeine, etc. It is produced in the form of tablets, capsules, mixtures, syrup, “effervescent” powders (Panadol, Panadon).
Potential harm. When combined with alcohol, it can damage and even destroy the liver. Therefore, it, like aspirin, is dangerous to take by people who regularly drink alcohol. Paracetamol negatively affects the liver and in case of violation of the rate of its intake (in case of overdose).
Output. Take no more than 2 g per day (4 tablets of 500 mg) - People who drink alcohol on a daily basis should stop taking paracetamol.
Ibuprofen
It has analgesic and anti-inflammatory effects. Ibuprofen is the active ingredient in drugs such as brufen, arthril, 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.)
Potential harm. If the body is severely dehydrated as a result of hard physical work, heat, or taking diuretics (diuretics), then ibuprofen can adversely affect the kidneys. The risk of kidney damage increases with regular ibuprofen use.
Long-term use of ibuprofen is dangerous for the stomach. In people who regularly drink alcohol, taking ibuprofen can affect the liver.
Output. Try not to dehydrate the body. When taking ibuprofen, you need to monitor your kidney function. In no case should you exceed the permissible daily intake (6 tablets of ibuprofen, 200 mg each, or 2 tablets of naproxen, 220 mg each).
Antiallergic (antihistamines) drugs
Preparations in this group are intended for people suffering from hay fever (hay fever), asthma, hives or other allergic diseases.
Benefit. They relieve a runny nose, sneezing, sore throat, bouts of coughing and choking, unbearable itching and other symptoms of these diseases.
Potential harm. Most of the 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 response in difficult situations.
Output. To avoid the risk, you should take new generation 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.
Cold remedies
The effect of drugs such as sanorin, naphthyzin, galazolin, otrivin, etc. is that they constrict the 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 weakens or stops, breathing through the nose is restored, and the headache passes.
Potential harm. When taking these drugs, blood vessels not only in the nose are narrowed, as a result of which blood pressure can increase in patients with hypertension.
This is especially dangerous for hypertensive patients, as the medications they take to lower their blood pressure will be ineffective. In addition, drugs in this group are dangerous for those taking antidepressants such as pyrazidol, pirlindol, nialamide.
Output. For people with hypertension, common cold remedies can only be taken under blood pressure control. In case of increased pressure, the dosage of antihypertensive drugs should be increased.
Patients with depression taking the listed antidepressants or the like are contraindicated in this group of drugs.
Complex preparations for colds used by antihistamines
Among the complex anti-cold drugs, such as askofen, tsitramon, sedalgin, alkaseltzer plus, bicarminth, etc. are especially known.
Benefit. They help to get rid of different symptoms of the disease at the same time: from cough, runny nose, pain, fever, allergic manifestations.
Potential harm. When taking complex drugs, the so-called "unforeseen overdose" is quite often allowed.
This happens when, with a severe cold or headache, in order to increase the effectiveness of treatment, a complex cold preparation containing aspirin is also added to the intake of aspirin. As a result, peptic ulcer disease may worsen or even stomach 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.
Output. Before taking a complex drug for 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 in use, but the same experience indicates a whole bunch of side effects:
All of these drugs, to a greater or lesser extent, affect the central nervous system, providing sedative and hypnotic effects.
Classic antihistamines dry out the mucous membranes. Dry mouth, viscosity of sputum in the lungs (which is especially dangerous in ARVI, as it seriously increases the risk of developing pneumonia) - does not have the best effect on the child's condition.
The simultaneous use of antiallergic drugs of the first generation with other drugs enhances the effect of the latter. So, antipyretic, analgesic, hypnotic effects are enhanced. The combination of antihistamines with other drugs that actively affect the functioning of the central nervous system is especially dangerous. In this case, the development of side effects up to fainting is possible. 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 do without pluses. 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 has eaten 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 of the first generation allergy remedies are forbidden to be taken 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 characteristic feature, which is important to consider when drawing up a treatment regimen. So, it is not advisable for a child 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 Fenkarol.
For babies up to one year old, the intake of antiallergic drugs of the first generation is undesirable. For the smallest, there are more modern drugs that are practically safe and very effective.
The principles of action of antihistamines, the second generation on the child's body
The undoubted advantage of second and third generation anti-allergic drugs is the absence or minimization of the sedative, hypnotic, and CNS-inhibiting 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 out mucous membranes;
do not affect the mental and physical activity of the child;
have a quick and long-term (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 effects (some drugs); do not reduce their effectiveness with prolonged use.
Perhaps the only drawback of second generation antiallergic drugs is their ability to have a negative effect 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 of the heart and blood vessels.
Among the most prominent representatives of the second generation:
Claritin (loratidine);
Allergy treatment, antihistamines
Diazolin dragee 50mg No. 20
Diazolin tab. 100mg No. 10
Suprastin (chloropyramine) is one of the most widely used sedative antihistamines. It has significant antihistaminic activity, peripheral anticholinergic and moderate antispasmodic effect.
Effective in most cases for the treatment of seasonal and year-round allergic rhinoconjunctivitis, Quincke's edema, 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, therefore it does not cause an overdose with prolonged use. The effect is quickly onset, but short-term; to increase the duration, it is combined with non-sedating H1-blockers.
Suprastin injection solution 2% 1ml amp. No. 5 (Egis, Hungary)
Suprastin tab. 25mg No. 20 (Egis, Hungary)
Chloropyramine g / x tab. 25mg No. 40
Tavegil (Clemastine) is a highly effective antihistamine, similar in effect to diphenhydramine. It has 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 also an allergy to tavegil.
Peritol (cyproheptadine), along with an antihistamine, has a significant antiserotonin effect. It is often used for some forms of migraine and increases 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.
Pipolfen dr. 25mg No. 20 (Egis, Hungary)
Pipolfen solution for injection 50mg 2ml amp.№10 (Egis, Hungary)
Diprazin tab. 25mg No. 20
Fenkarol (quifenadine) - has less antihistaminic activity than diphenhydramine, however, it is also characterized by less penetration through the blood-brain barrier, which determines the lower severity of its sedative properties. In addition, fencarol not only blocks histamine H1 receptors, but also reduces the content of histamine in tissues. It can be used when developing addiction to other sedative antihistamines.
Fenkarol tab. 25mg No. 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, do not adsorb with food in the gastrointestinal tract, have a high affinity for H1 receptors, and have a quick therapeutic effect. ... However, for them, the cardiotoxic effect was noted to varying degrees; when they are taken, constant monitoring of cardiac activity is required (prescribed on an outpatient basis). They should not be taken by patients with disorders of the cardiovascular system, elderly patients.
The effect occurs quickly and for a longer time (delayed elimination).
When drugs are used 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.
Lack of tachyphylaxis (decrease in antihistamine activity) with prolonged use.
The cardiotoxic effect arises from 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 intraconazole), macrolides (erythromycin and clarithromycin), antidepressants (fluoxetine, sertraline), and paroxetine , as well as in patients with severe liver dysfunction.
There are no parenteral forms, only enteral and local dosage forms.
The most common second generation antihistamines are:
Trexil (terfenadine) is the first antihistamine of the second generation, there is no depressing effect on the central nervous system, but with a significant cardiotoxic effect and an increased ability to cause fatal arrhythmias.
Trexil tab. 60mg No. 100 (Ranbaxi, India)
Histalong (astemizole) is one of the longest acting drugs in the group (up to 20 days). It is characterized by irreversible binding to H1 receptors. Virtually no sedative effect, does not interact with alcohol.
It is effective in chronic allergic diseases; in an acute process, its use is impractical. But the risk of developing serious heart rhythm disturbances, sometimes fatal, increases. Due to these dangerous side effects, the sale of astemizole in the United States and some other countries has been suspended.
Astemizole tab. 10mg No. 10
Histalong tab. 10mg No. 20 (India)
Semprex (acrivastin) is a drug with high antihistamine activity with minimal sedative and anticholinergic action. The therapeutic effect is achieved quickly, but for a short time.
Semprex caps. 8mg # 24 (GlaxoWellcome, UK)
Fenistil (dimetendene) is the closest to the first generation antihistamines, but it differs from them in a much lower severity of the sedative effect, higher antiallergic activity and duration of action than the first generation drugs. There is a gel for external use.
Claritin (loratadine) is one of the best-selling second generation drugs. Its antihistaminic 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. Practically does not interact with other drugs and does not have a cardiotoxic effect. It can be taken by drivers, children from 1 year old.
Claritin syrup 5mg / 5ml 120ml (Schering-Plow, USA)
Claritin tab. 10mg No. 10 (Schering-Plow, USA)
Loratadin tab. 10mg No. 10
Agistam tab. 10mg No. 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 peripheral H1 receptor blocker. Cetirizine is almost not metabolized in the body, the rate of its excretion depends on renal function. It penetrates well into the skin and is effective for skin allergies.
The effect appears 2 hours after ingestion and lasts 24 hours. They do not have a sedative and cardiotoxic effect in therapeutic doses. It is prescribed with caution in case of impaired renal 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 No. 10 (Hoechst Marion Roussel)
Telfast tab. 180mg No. 10 (Hoechst Marion Roussel)
Allergy is a pathological process that occurs when the body responds inadequately to various substances (foreign agents). The development of civilization and the abundance of chemicals in food and the world around it provokes a wide spread of the disease. Recently, people are increasingly exposed to or the sun, which is basically unnatural for humans.
Doctors do not yet know exactly what the deep causes of the body's inadequate response to stimuli are, so allergy medications can only relieve symptoms, and not completely cure the patient. You should be especially careful with children who suffer from allergic reactions. After all, this disease disrupts the functioning of the immune system and can lead to a failure in other organs and systems.
Allergy medication can help relieve skin rashes, itching, runny nose and cough relief. There are a number of medications that are used to treat allergic reactions, but you can only start taking them after consulting your 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, will prescribe the correct treatment.
The following factors can cause an allergic reaction:
- Medicines, especially if taken too often and for too long
- Dust, including household dust, in which dust mites live
- Pollen from plants during the flowering period causes hay fever (a separate type of allergy)
- Sudden temperature changes (cold and)
- Hair of animals, especially cats, dogs, rodents and rabbits, as well as feathers of birds
- Bee, wasp and mosquito bites
- Mold fungi
- Household chemicals, perfumes and cosmetics, due to the abundance of chemical components, can cause an allergic reaction not only in a child, but also in an adult
- Food products. Food allergies are most common in children, but they can also occur in adults. The most common reactions are inadequate to cow's milk, citrus fruits, red fruits and vegetables, seafood, grains and nuts.
Allergy medications are part of a comprehensive 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 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.
- For severe and prolonged allergies, drugs with corticosteroids are used. But this is an extreme measure, since such medicines can be taken only in limited quantities and for a short time, and the course of treatment should be stopped gradually. Medication with corticosteroids is used only if there is no other way to eliminate the signs of allergy.
- They strive to cleanse the patient's body of toxins as much as possible. For this, sorbent preparations are prescribed, such as activated carbon, Enterosgel, Polysorb and Polyphepan.
- Less commonly, blood purification is used, such as invasive methods such as plasmapheresis.
The best allergy remedies
Allergy symptoms lead to the production of large amounts of histamine. Therefore, to combat inflammation of the eyes, skin and respiratory organs, antihistamines are prescribed. There are currently three generations of these medicines.
Below we 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 of a purely informative nature, and only a qualified doctor can prescribe a particular remedy.
At the moment, 3rd generation antihistamines (metabolites) are considered the most effective remedy against allergies. They quickly eliminate the 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 of age and to adults who work with mechanisms and need constant concentration of attention.
In rare cases, the use of metabolites may cause drowsiness. But this effect is only observed in people with hypersensitivity or in those who suffer from chronic fatigue. Therefore, this symptom is not a reason to stop taking medication.
Allergy drugs of the new generation include Cetirizine, Loratadin, Ebastin, Acelastin, Astemizole, Akrivastin and others. Cetirizine () and Loratadine are considered the most effective for oral administration. As an external agent, Acelastine 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
- Year-round allergic rhinitis
- and adults
- Hives
- 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 medications do not interfere with mental and physical activity. They can be taken with or without food, 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 medications can cause side effects. For example, Terfenadine and Astemizole should not be taken simultaneously with antibiotics and antimycotic drugs. Also, do not drink them with citrus juices. This can cause cardiotoxicity and impair liver function. Therefore, these funds are not prescribed for elderly people and patients with diseases of the liver and 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 analogous drugs:
Cetirizine
It is considered the most effective allergy medicine. 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 re-manifestation of the disease in the future.
Relief comes within two hours after ingestion, and the effect lasts long enough. 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 mild sedative effect, so it is rarely prescribed for people with kidney problems. The remedy is also suitable for the treatment of children over two years old (in the form of a syrup or suspension).
The table below shows a list of analog drugs with their approximate price and form of release.
Analogue tablets are cheaper. Drops and syrups are allowed for children and are more expensive drugs.
Loratadin
At the moment, it is the most popular 3rd generation drug for the treatment of allergies. It is suitable for all ages 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 over a year old. The table below shows a list of analogs. The most powerful of these is Erius. It should not be used during pregnancy or to treat children under one year old.
| Name | approximate price | Form of preparation |
| Erius | 450-700 rubles | Tablets for adults and syrup for children |
| Loratadin | 20 rubles | Pills |
| Lomilan | 100-130 rubles | Tablets, suspension |
| Clarisens | 30-60 rubles | Tablets and syrup |
| Lorahexal | 50 rubles | Pills |
| Claritin | 220-205 rubles | Tablets and syrup |
| Desloratadine Teva | 360 rubles | Pills |
| Desal | 160 rubles | Pills |
| Lordestine | 210 rubles | Pills |
| 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 the age of six.
Analogous drugs are Telfast (average price 450 rubles), Feksofast (200 rubles) and Feksadin (160 rubles). All of them are available only in tablets.
Dimetindene
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 to relieve inflammation on the skin. Dimetinden's analogs are Fenistil drops, gel and emulsion, the cost of which ranges from 280 to 350 rubles, depending on the form of release.
The drugs Akrivastin, Astemizole, Terfenadine and their analogues (Semprex, Histalong 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.
Choice of drugs depending on the patient
Depending on the age and the presence of other diseases in the patient, a certain type of medication for allergies is prescribed:
- Children from 1 to 4 years old can use Loratadine and Cetrinisin.
- Patients under 12 years of age are prescribed Cetirizine, Loratadin 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 Clemastine.
- In case of liver disorders, patients are recommended to take Loratadine, Fexofenadine and Cetirizine, and people with renal failure, in addition to Loratadine, are also suitable Astemizole and Terfenadine.
Description of 1st generation antihistamines
Such funds are rarely used now because of their shortcomings, which are completely absent in metabolites:
- Reduce muscle tone
- Causes drowsiness and sedation
- The action of the drug comes quickly, but lasts no more than five hours
- Children may experience psychomotor agitation. This effect can appear in adults with prolonged use and non-compliance with dosages.
- You cannot use 1st generation antihistamines for people whose work is associated with concentration of attention: drivers, students and people who work with different mechanisms.
- They enhance the effect of sleeping pills, analgesics and alcohol.
- In most countries, these drugs are not manufactured because of their serious side effects: urinary retention, constipation, dry mouth, tachycardia, and decreased visual acuity.
An approximate list of 1st generation drugs that are better replaced with metabolic agents is given below:
- Tavegil is still being used because of the relatively long-lasting effect of the drug (up to 8 hours). However, recently, cases of allergy to Tavegil itself have begun to be recorded.
- Diphenhydramine is not recommended for use, as it can have unpredictable effects 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 drug to be used for a long time. Most often, the funds are used to treat urticaria, to relieve itching, etc. The only drawbacks are mild sedation and short duration.
- Peritol is used to treat migraine headaches, but may cause an increase in appetite.
- Diazolin is not used due to the fact that the agent irritates the mucous membrane of the digestive system, inhibits mental and physical reactions, causes drowsiness, urinary retention and dizziness.
- Fenkarol is similar in properties to diphenhydramine, but has less sedative effect. This tool is used mainly after getting used to other drugs of the 1st generation.
- Pipolfen and Diprazin are used to relieve the gag reflex, but the funds must be used with caution because of their adverse effects on the nervous system.
Allergy medications for children
Allergy tablets for children are used only in older children, and for small patients, drops, syrups or suspensions are mainly used.
Children with allergies are only prescribed certain types of drugs. Among antihistamines babies over a year old can use Lomilan, Loratadin, Claritin, Clarisens and Clarotadin. After two years, it is allowed to take Tsetrin, Zodak and Parlazin, but only in the form of drops or syrup.
For strengthening the mast cell membrane, Ketotifen syrup, Kromoglin and Kromohexal sprays, as well as Intal are used. These drugs prevent the destruction of mast cell membranes, increasing the defense of the immune system and preventing the increased production of histamine. However, all these drugs can only be used in children over a year old.
Corticosteroids they 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 can appear long after the completion of the course of treatment. Taking prednisolone, 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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