Antiallergic drugs. Antiallergic drugs, classification of antiallergic drugs

To the teacher

Pharmacology of Guyanese Medi-

ANTI-ALLERGIC DRUGS.

CLASSIFICATION OF ANTI-ALLERGIC DRUGS.

1. Antihistamines: H-1 blockers.

2. Glucocorticoids.

3.Mast cell membrane stabilizers.

4.α-,β-adrenergic agonists of direct action.

5. Calcium preparations.

1.Allergy-an immunopathological process resulting from a sensitized organism to the action of various substances with antigenic properties (allergens). Allergy-- excessive perverted reaction of the immune system to contact with a foreign substance. Allergoses these are allergic diseases of mild and moderate severity: urticaria, hay fever, Quincke's edema, bronchial asthma, serum sickness, allergic dermatitis, exanthema, photodermatosis.

Acute urticaria- The reaction is immediate, it is a humoral reaction. Caused by drugs (penicillin, aspirin, food (fish, nuts, eggs), environmental antigens (animal hair, dust, mushrooms), insect bites. Characterized by skin hyperemia, swelling, itching, blistering. Histamine plays a decisive role in the last link reactions are caused within 15-20 minutes.

Hay fever (hay fever) - caused by pollen from flowering plants. Clinical picture: swelling of the nasal mucosa, “sheet syndrome” (profuse rhinorrhea), lacrimation, headache, sometimes itching of the mucous membrane of the eyes, nose, palate at the beginning of plant flowering. In severe cases, coughing attacks and asthmatic breathing may develop.

Allergic rhinitis a combination of allergic rhinitis with sneezing, itching, rhinorrhea with conjunctivitis, laryngitis. Caused by fungal spores, animal dander, dust, plant pollen, and scattered particles in the air.

Allergic conjunctivitis- swelling and hyperemia of the conjunctiva, sometimes with profuse lacrimation and severe itching. For cosmetics exposed to ultraviolet rays.

Serum sickness- immune complex reaction type 3. When an antigen enters the body, an antigen-antibody immune complex is formed, which settles on the walls of blood vessels and joints; symptoms appear 6-9 days after the body encounters the antigen. Characterized by fever, skin manifestations, swelling in the joints and lymph nodes, and vasculitis. Caused by drugs (penicillin, streptomycin, serums, radiocontrast agents).

Quincke's edema- angioedema, affects deep-lying tissues, including skin and subcutaneous loose connective tissue. Most often the tissues of the back of the hands or feet, eyelids, lips, genitals, mucous membranes. Swelling of the upper airway (around the throat) can cause breathing problems and death.

Anaphylactic shock- immediate allergic reaction of the humoral type. More often it develops after injection of a drug or vaccine, sometimes with an insect bite in a matter of minutes. The patient experiences fear, anxiety, dizziness, accompanied by tinnitus, decreased hearing and vision, headache, feeling of heat, itching, cold sweat, and a feeling of goosebumps. Experiences a feeling of compression, heaviness behind the sternum, and possible pain in the heart or pain in the abdominal cavity. There may be motor agitation or convulsions of the limbs, the pupils dilate. Blood pressure decreases sharply, breathing is impaired as a result of bronchospasm and laryngeal edema; without timely medical care, a person can die in 5-10 minutes (adrenaline, prednisolone are administered). Anaphil. shock can have a variety of clinical symptoms, depending on the localization of the stages of anaphylactic shock in the organs.

Cases of the development of anaphylactic shock have been described 30 minutes to 2 hours after ingesting nuts, honey, strawberries, and raspberries. Allergenic properties are expressed in antibiotics: penicillin, streptomycin, sulfonamides, novocaine, vitamins B1 and B6, salicylates and pyrazolones (analgin, aspirin), more commonly caused allergic reactions.

REMEMBER: allergic reactions of varying severity, including shock, can be caused by medications used to treat allergies! There are known cases with prednisolone, calcium chloride, pipolfen.

REMEMBER: under certain conditions any drug may cause the development of anaphylactic shock even with prolonged use.

REMEMBER: the medicinal product contains various excipients that do not have pharmacological activity, or combination preparations of medicinal substances --- they can also cause an allergic reaction.

Bronchial asthma- chronic inflammatory disease of the respiratory tract, causing a concomitant increase in hyperactivity

respiratory tract, leading to episodic attacks of bronchospasm, expiratory shortness of breath (difficulty exhaling), the development of status asthmaticus, threatening the patient’s life. Inducers in a sensitized body are household allergens (household dust, animal hair and dander, fungal allergen, bed mites), external allergens (plant pollen), medications (aspirin), chemical compounds (chloramine, rosin, washing powder, formaldehyde and etc.).

“Triggers” (provoking factors) can be inducers, respiratory infections, weather conditions, physical activity, drugs from the group of β-blockers. Mast cells, eosinophils, and T-lymphocytes play a decisive role in the development of bronchial asthma. Let us consider the mechanism of development of the pathogenesis of bronchial asthma. There are 3 stages:

Stage 1: Immunopathological.

An allergen (antigen) enters the body and has a protein structure that is foreign to the body. B and T lymphocytes (these are types of immunocompetent cells in the submucosal and mucous layer of the bronchi) study the antigen, take an “imprint” of the structure from it and turn into plasma cells (plasmocytes), “antibody factories” that synthesize antibodies to it, that can neutralize an antigen by combining with it. Until the antigen (allergen) re-enters the body, no clinical signs of allergosis appear. See Figure 1.

Antagonism" href="/text/category/antagonizm/" rel="bookmark">antagonists of allergy mediators.

Histamine antagonists or antihistamines, or histamine H-1 blockers. Drugs: diphenhydramine, suprastin, diprazine, fenkarol, astemizole, loratadine, allergodil and others;

Leukotriene antagonists: montelukast, zafirlukast;

Bradykinin antagonists: parmidine.

3.Agents that prevent the release of allergy and inflammatory mediators from mast cells.

Mast cell membrane stabilizers: cromoglycic acid, etc. Preparations: intal (cromolyn sodium), cromohexal, nalcrom, highcrom, nedo-cromil (Tyled) and others;

Mast cell membrane stabilizers with a different chemical structure: ketotifen. With a less pronounced effect of aminophylline, β-2-adrenergic agonists. For bronchial asthma, they are used more often by inhalation (Intal, ketotifen, β-2-adrenergic agonists.)

4. Functional antagonists of allergy mediators or symptomatic therapy.

4.1.anticongestants (decongestants) or vasoconstrictors:

--α-2- adrenergic agonists: naphthyzin, xylometazoline, Nazivin, ephedrine, sunoref ointment. Drops in the nose and eyes for allergic rhinitis, hay fever, allergic conjunctivitis. "Sunoref" is an ointment for the nose.

Vasoconstrictor α-1-adrenergic agonists: mezaton, fethanol for injection in anaphylactic shock to increase blood pressure.

Vasoconstrictor α- and β-adrenergic agonists (norepinephrine and adrenaline hydrochloride) or sympathomimetics (ephedrine) to increase blood pressure and relieve bronchospasm;

Bronchodilators-mimetics: adrenaline, ephedrine, β-2-salbutamol, fenoterol.

Long-acting β-2-adrenergic agonists: formaterol, salmeterol.

Glucocorticoids (prednisolone, fluocinolone acetonide, hydrocortisone,

dexamethasone, beclomethasone) have a powerful immunosuppressive effect on allergic processes, membrane-stabilizing effect, bronchodilator, anti-edematous effect;

5.Auxiliary means.

Calcium preparations: calcium chloride, calcium gluconate and calcium lactate for various allergies. The antiallergic effect is associated with sealing the vascular wall and reducing tissue edema, stabilizing the mast cell membrane. When administered intravenously, they cause a feeling of heat due to the release of histamine from mast cells --- the "locking effect" leads to depletion of mast cells.

6.Drugs used to suppress slow-type immune reactions with cytotoxic reactions.

Immunosuppressants, cytostatics: chloroquine, hydroxychloroquine, azathioprine, crizanol.

ANTIHISTAMINES.

Block histamine H receptors. They are divided into H-1 and H-2 receptors, respectively, antihistamines are called H-1 blockers and H-2 blockers. Let's consider the localization of histamine receptors and their effects upon stimulation according to Table No. 1.

H-1 RECEPTORS and histamine effects	H-2 RECEPTORS and histamine effects.
Intestinal smooth muscle; Smooth muscle. bronchi; Smooth muscle. urinary bubble; Capillaries, vessels; Nasal mucous membranes.	Stomach glands; Salivary glands; Musculature of the uterus.
Muscle contraction intestines; Contraction of the bronchi; Bladder contraction; Dilatation of blood vessels, capillaries, decrease in blood pressure; increased penetration vascular tightness, swelling, hyperemia, feeling of heat, itching; Rhinorrhea (increased secretion mucus from the nose), swelling of the nose, sneezing.	Increased secretion gastric juice; Increased salivation; Decreased uterine tone.

Table No. 1.

Antagonists or blockers of histamine receptors cause opposite effects. H-2 blockers (ranitidine, famotidine) are used to treat hyperacid gastritis, gastric ulcer, reflux esophagitis, accompanied by severe heartburn. They inhibit the secretion of acid and pepsin and are considered antisecretory agents.

N-1-BLOCKERS.

Medicines with antiallergic effects eliminate the effects of histamine. They are divided into 1st and 2nd generation. See table. No. 2.

1st GENERATION	2nd GENERATION.
Diphenhydramine; Suprastin; Pipolfen; Diazolin; Tavegil; Fenkarol; Hydroxyzine (atarax).	Loratadine (Claritin); Desloratadine (Erius); Cetirizine; Fexofenadine (Telfast).
They pass the blood-brain barrier and have a sedative or hypnotic or other effect on the central nervous system. Possess antispasmodic, hypotensive or other effects. Short duration. Many are suitable for small children.	They do not pass or pass the BBB poorly, and do not have a sedative or psychotropic effect. Long-acting drugs. Not for pregnant women and small children under 2 years of age.

H-1 blockers enhance the effect of CNS depressants ( anesthesia, narcotic analgesics, tranquilizers, sleeping pills, neuroleptics, ethyl alcohol, sedatives), except for diazolin.

1st generation of H-1-histamine blockers.

Diphenhydramine.Dimedrolum. valid the substance is diphenhydramine.

Release form: 1).tablets, powders, 0.02-0.03-0.05g. 3-4 times a day;

2).rectal suppositories with diphenhydramine, 0.01-0.02-0.015-0.005g;

3).solution 1% - 1 ml for injection subcutaneously, intramuscularly, intravenously.

Children's dosages from 0.005 to 0.05 grams.

Effects: local anesthetic (numbness in the mouth), antiallergic (antipruritic, decongestant, etc.), sedative, hypnotic in large doses, antiemetic, slight antispasmodic and even hypotensive due to the ganglion-blocking effect. The effects of diphenhydramine are not only due to the blockade of H-1 receptors, but also due to the blockade of H-(nicotinic) and M-cholinergic receptors.

P: Allergoses of mild to moderate severity (serum sickness, urticaria, hay fever), insect bites, allergic reactions to medications, pruritic dermatoses, o. and chronic eczema.

PE: Drowsiness, lethargy, dizziness, dry mouth, dyspeps. disorders (constipation or diarrhea), daytime weakness, difficulty urinating, allergic reactions. Rarely: inhibition of hematopoiesis.

ETC: Increased sensitivity, acute asthmatic attack, pregnancy, newborns up to 2 months, caution in case of prostate adenoma, glaucoma. Not for drivers while working or people with a profession that requires increased attention and reaction (mental and motor). Cannot be used with alcohol.

1% diphenhydramine solution is administered with 50% analgin solution and 2% novocaine solution together for intramuscular pain. often in a hospital (analgesic mixture"), while both analgin and novocaine more often cause allergic reactions.

Suprastin.Suprastinum. valid substance-chloropyramine.

Release form: 1).Tablets, 0.025g. for adults orally during meals 3-4 times a day. 2) 2.5% solution, 2 ml intramuscularly. or intravenously with saline solution for severe anaphylactic and allergic reactions.

Children from 1 to 12 months	1/4 tablet.	Accept during 2-3 times a day.
Children from 1 year to 6 years	1/3 table.

Effects Suprastin has a pronounced antipruritic, antihistamine, antispasmodic and sedative effect due to the M-anticholinergic effect.

Suprastin increases the binding of histamine to plasma proteins and reduces its release from mast cells. It is advisable to prescribe it

when using histamine liberating drugs that increase

release of histamine from mast cells.

P: Various moderate, severe and mild allergies, skin diseases (neurodermatitis, contact dermatitis), etc.

PE: Possible drowsiness, dizziness, nausea, loss of coordination, dry mouth.

ETC: Similar to diphenhydramine, additionally: children under 1 month should not take simultaneous use of MAO inhibitors with peptic ulcer disease in the acute phase.

Tavegil.Tavegilum. Synonym for "clemastine".

Release form: 1). Pills 0.001g each

retard tablets contain 0.0025gr. №20.

Adults and children over 12 years old.	1 table each	Accept 2 times a day morning and evening before meals, washed down with water.
Children from 6 to 12 years old.	1/2 - 1 table.
Children aged 1 to 6 years.	Individually the doctor selects.

Effects tavegil: sedative, slight antispasmodic, pronounced antiallergic and antipruritic effect, characterized by a rapid onset and a significant duration of up to 12 hours. It is advisable to use in the treatment of short-term allergic reactions, for example food or drug allergies.

P: Various allergies.

PE: Similar to suprastin and diphenhydramine, rarely palpitations, arrhythmia and decreased blood pressure were observed in elderly people.

ETC: Children under 1 year of age should not take MAO inhibitors, lactation, during pregnancy strictly according to doctor’s indications. Not allowed with alcohol; People with a profession that requires increased attention and reaction are not allowed during work.

Fenkarol. Phencarolum. The active substance is hifenadine hydrochloride.

Release form: 1).Tablets of 0.025-0.05 grams.

For adults	2 tablets 3-4 times a day.	After
Children over 12 years old to 18 years old	1 tablet 2-3 times a day.
Children from 7 to 12 years old	0.01-0.015g each. 2-3 times a day.
From 3 to 7 years	0.01g each. 2 times a day.
From 2 to 3 years	0.05g each. 2-3 times a day.

Effects and Benefits fenkarol: antiallergic and antipruritic, mild sedative effect due to poor penetration through the blood-brain barrier, due to some M-anticholinergic effect, slight antispasmodic effect on the smooth muscles of the bronchi and intestines, blocks H-1 and H-2 receptors of the gastric glands , thereby providing local protection of the gastric mucosa in case of food allergies. Reduces vascular permeability and reduces the hypotensive effect caused by histamine, a slight antiserotonin effect and antiarrhythmic effect on the myocardium - the sum of the protective effects on the cardiovascular system! Therefore, it is advisable to use it to prevent possible anaphylactic reactions to the administration of a vaccine or drug to children and allergy sufferers. The positive quality of fenkarol has been established: it does not enhance the inhibitory effect of alcohol and hypnotics on the central nervous system.

P: Various allergies: hay fever, allergic rhinitis, urticaria, food allergies, children 3 days before vaccination, drug allergies, bronchial asthma, angioedema.

PE: Dry mouth, slight sedation, dyspeptic symptoms.

ETC: Increased sensitivity, drivers or people with a profession that requires attention, mental and motor reactions; period of breastfeeding, severe diseases of the cardiovascular system, liver and kidneys, peptic ulcer of the stomach and duodenum. During pregnancy (especially in the 1st trimester), use carefully and strictly as prescribed by your doctor.

Diprazine.Diprazinum. The active ingredient is promethazine.

Synonym for "pipolfen".

Release form: 1). Dragee 0.025-0.05 grams at night or 2 times a day before meals.

2).0.025% solution for injection, 2 ml for intramuscular/muscular. injections.

The drug passes the BBB, depresses the central nervous system, blocks H-1 receptors, α-adrenergic receptors, serotonin, cholinergic receptors.

Effects of diprazine: antiallergic, antipruritic, antiemetic, hypnotic and sedative effects. Also hypotensive, hypothermic in doses above average. Diprazine reduces the excitability of the vestibular system, inhibits the functions of the labyrinth and trigger zones of the medulla oblongata, therefore, it is prescribed for dizziness and nausea during travel, Meniere's disease.

Adults with allergies, vestibular disorders	1 tablet (25 mg) 1 time per night or 2 times a day. IRR = 150 mg (for adults).	Before meals!
Adults for prevention nausea and vomiting.	25 mg every 4-6 hours
Children over 10 years old, teenagers	5-20mg 1-3 times per day
Children 5-10 years old	5-15 mg 1-3 times per day
Children 2-5 years old	5-10 mg 1-3 times a day
Children from 2 months to 14 years solution is injected intravenously/muscularly	0.5mg-1mg per kg of weight child 3-5 times a day.

Diazolin is used in lytic mixtures to potentiate anesthesia; the doses of analgesics and anxiolytics are reduced. It is advisable to use diprazine in situations where a combination of antiallergic and sedative effects is necessary: ​​pre- or postoperative period, burn disease.

P: Various allergies, painful itching, angioedema, prevention and relief of vomiting, nausea during and after anesthesia,

with analgesics in the mixture, Meniere's disease, dizziness, dizziness when traveling by transport.

PE: Drowsiness, anxiety, dry mouth, in young children increased frequency of sleep apnea, dyspeptic disorders, suppression of hematopoiesis (rare cases), decreased blood pressure, tachycardia or bradycardia, allergic reactions, difficulty urinating, when taking high doses, extrapyramidal disorders.

ETC: Children under 2 months and infants under 2 years of age should not take oral tablets during lactation or pregnancy. Hypersensitivity, alcohol poisoning, intoxication with drugs that depress the central nervous system. Do not use with MAO inhibitors, alcohol, or for vomiting in children of unspecified origin. Not for drivers or people with a profession that requires attention and reaction.

Very careful for young children and the elderly due to the risk of side effects and apnea in children. Caution for patients with prostate adenoma, glaucoma, epilepsy, Raynaud's disease, ARVI, blood diseases.

Diazolin.Diazolinum. The active ingredient is mebhydrolin.

Release form: 1).dragée 0.01g. orally after meals 1-2 times a day. Children take ½ or 1/4 tablet per dose.

It penetrates the BBB poorly and does not cause a pronounced sedative and hypnotic effect. It weakly blocks M-cholinergic receptors, which means it does not have an antispasmodic effect. The duration of the effect can reach 48 hours.

Effects: Antiallergic and antipruritic effect, antiexudative.

P: Allergic reactions with painful itching, runny nose: hay fever and allergic rhinitis, seasonal and chronic, urticaria, eczema, insect bites. In combination therapy of bronchial asthma, itchy dermatoses.

PE: In high doses, dry mouth, drowsiness, dyspeptic symptoms: heartburn, nausea, epigastric pain, difficulty urinating. Rarely, suppression of hematopoiesis. Children have paradoxical reactions in the form of irritability, insomnia, and tremor.

ETC: Hypersensitivity, peptic ulcer of the stomach and duodenum in the acute phase, inflammatory diseases of the gastrointestinal tract, prostate adenoma, epilepsy, angle-closure glaucoma, arrhythmias, pyloric stenosis, drivers and people with a profession requiring attention and reaction,

Caution during pregnancy and kidney and liver diseases with impaired function.

Hydroxyzine.Hydroxyzinum. Synonym "Atarax".

Release form: 1).Tablets, 0.025g. 2). Syrup contains 1 ml = 0.05 g.

3). Solution for injection intramuscularly. in 1 ml = 50 mg.

It passes through the BBB, blocks central H-1-histamine receptors, M-cholinergic receptors, and inhibits the subcortical structures of the central nervous system.

Effects: pronounced sedative and moderate tranquilizing effect, improves memory and attention. The antiallergic effect occurs 1 hour after ingestion and lasts for 20 hours or more, depending on age and liver disease. Therefore, the drug is used once a day or once every two days. Adults are prescribed up to 300 mg per day in psychiatry, and 25-100 mg per day in general practice. Children are prescribed taking into account body weight and age. From 1 year to 6 years, 1-2.5 mg per day per kg of weight in several doses.

P: Relief of anxiety, psychomotor agitation, alcohol withdrawal syndrome, premedication, postoperative period, itching.

PE: Drowsiness, weakness, neurological disorders (headache, dizziness), urinary retention, dyspeptic disorders, tachycardia, dry mouth.

ETC: Pregnancy, lactation, hypersensitivity, porphyria.

REMEMBER! Many drugs have an antihistamine effect: ketotifen with a membrane-stabilizing effect, donormil from the group of hypnotics.

2nd generation of H-1-histamine blockers.

Loratadine.Loratadinum. Synonyms: “Claritin”, “Erolin”, “Klargotip”.

Release form:.

1).Syrup 5 (10) mg in 1 teaspoon.

2).Tablets, plain and effervescent, 0.01g each

Take orally before meals 1 time per day, after dissolving the effervescent tablets in a glass of water; simple tablets are washed down well with water before meals.

For adults and children over 12 years old (with body weight more than 30 kg)	10 mg (1 tablet) or 2 teaspoons of syrup 5 mg each.	Orally 1 time per day before meals
Children aged from 2 to 12 years	5 mg (1/2 tablet) or 1 teaspoon of syrup.	Orally 1 time per day before meals.
Adults with liver or kidney failure (Cl creatinine< 30мл/мин).	The initial dose is 10 mg every other day or 5 mg daily.	Orally every other day, or in a minimal dose daily.

Effects: antiallergic, antiexudative and antipruritic.

It develops in 1-3 hours and lasts up to 24 hours. The BBB does not pass.

P: Allergic rhinitis, hay fever, urticaria, angioedema,

bronchial asthma, insect bites causing allergic reactions, pseudo-allergic reactions to histamine liberators.

PE: Neurological reactions: headache, dizziness, drowsiness, insomnia, impaired concentration, agitation (in children), tremor, paresthesia, dry mouth, dyspeptic disorders, jaundice, anorexia, nasal congestion, sneezing, bronchospasm, arthralgia, myalgia, palpitations, tachycardia, hypotension, hypertension, dysmenorrhea, allergic reactions, etc.

ETC: Increased sensitivity, children under 2 years of age, breastfeeding period in women (lactation), drivers and people with a profession requiring attention and reaction.

REMEMBER: Histamine blockers have more undesirable side effects on almost all body systems with a highly effective antiallergic effect compared to 1st generation drugs.

Desloratadine.Desloratadinum. Synonym "Erius".

Release form: 1).Tablets, 0.005g. Adults can take it orally at the same time, 1 time per day, without chewing, with water, during meals.

2).Syrup containing 1 ml = 0.0005 g. For children and teenagers.

The effect occurs within 30 minutes and lasts 24 hours. The effects are similar, as it is an active metabolite of loratadine. Difference: rapid onset of antiallergic action and can be used with meals.

Cetirizine.Cetirizinum. Synonymous with “Zirtek”, “Allertek”, “Tsetrin”, “Zintset”.

Release form: 1).Tablets, 0.01g. cetirizine. 2). Drops for oral administration. 3). Syrup, contains 5 ml = 5 mg or 10 mg of cetirizine.

For adults and children over 6 years old	10 mg 1 time per day or 5 mg 2 times a day	Inside regardless of food intake
Children from 2 to 6 years old	2.5 mg 1 time per day (5 drops), sometimes 2 times a day.
Children over 6 years old with dysfunction liver and kidneys.	Up to 5 mg per day per dose.

Effects: Antiallergic, antipruritic and antiexudative effect due to blockade of peripheral H-1 receptors, reduces skin and vascular reactions to histamine: swelling, hyperemia, blistering, relieves symptoms of allergoses caused by histamine. Inhibits the release of allergy mediators, suppresses the migration of eosinophils, neutrophils and basophils in response to the introduction of an allergen, inhibits the activity of histamine inducers, and much more.

The effect of cetirizine occurs 1-2 hours after oral administration. The duration of the antiallergic effect in adults is 24 hours, in children and newborns up to 12 hours.

P: Various chronic and seasonal allergies, itchy skin, eczema.

PE: Neurological disorders (similar to loratadine), drowsiness (14%), fatigue (6%), ototoxicity, tinnitus, deafness, hemorrhage in the eye, dyspeptic disorders: taste perversion, anorexia, inflammatory diseases of the gastrointestinal tract, diarrhea, hemorrhoids, bleeding from the rectum, palpitations, hypertension, allergic reactions, bronchitis, respiratory tract infection, skin manifestations, liver dysfunction, etc.

ETC: Hypersensitivity, including to hydroxyzine, pregnancy, lactation, children under 2 years of age (up to 6 years with impaired renal and liver function), caution in old age, strictly as prescribed by a doctor.

Fexofenadine.Fexofenadinum. Synonym for "Telfast".

Release form: 1). Suspension for oral administration.

2).Tablets of 0.12 grams or 0.18 grams in a coat. Orally for adults and children over 12 years of age, 60 mg 2 times a day, for seasonal allergic rhinitis 120 mg 1 time a day, chronic idiopathic urticaria 180 mg 1 time a day.

Effects: Antiallergic and membrane stabilizing of mast cells. Fexofenadine selectively blocks peripheral histamine H1 receptors. The drug suppresses the release of interleukin-6 from fibroblasts, reduces the basal expression of adhesion molecules, and the development of tolerance was not observed when used for 28 days. The effect occurs an hour after administration, reaches a maximum after 2-3 hours and lasts for 12 hours or more. Side effects are mild and rare.

P: Allergic rhinitis, vasomotor and seasonal, hay fever, angioedema, urticaria.

PE: Neurological disorders: headache, rarely dizziness, drowsiness, insomnia, dyspepsia, rhinorrhea, tendency to ARVI, suppression of hematopoiesis.

ETC: Increased sensitivity, children under 12 years of age. During pregnancy and breastfeeding, use strictly as prescribed by a doctor.

Glucocorticoids.

Hormonal drugs identical in action to gluco-corticoid hormones of the adrenal cortex. GLA (natural hormone hydrocortisone) affects carbohydrate, protein, fat and, to a lesser extent, mineral metabolism. Possess pronounced immunosuppressive effect : suppress both immediate-type immune reactions (anaphylactic shock, angioedema, skin manifestations, etc.) and delayed-type immune manifestations associated with the precipitation of antigen-antibody complexes in tissues, the formation of killer lymphocytes, response to transplanted tissue antigens, etc. Therefore, they are classified as immunosuppressants. Glucocorticoids prevent and suppress inflammatory reactions regardless of the cause that caused them (mechanical, chemical, radiation, infectious, immunological tissue damage): pronounced anti-inflammatory effect. GLA inhibits not only the early manifestations of the inflammatory process: edema, dilation of capillaries, fibrin deposition, migration of leukocytes to the inflammatory zone, phagocytic activity; with continued therapy, they also suppress the late proliferative phase of inflammation: capillary ingrowth, proliferation of fibroblasts, synthesis of collagen and mucopolysaccharides of the interstitial substance, and in the final phase of inflammation - scarring. GLA suppresses the formation of mediators of allergic reactions in leukocytes, lymphocytes, macrophages - monocytes, inhibiting their activation by antigens, the release of interleukins 1 and 2, prostaglandins, leukotrienes --- antiallergic effect, coincides with the anti-inflammatory effect in the early stages of allergic and inflammatory processes. Suppressing the activity and division of immunocompetent cells (mast cells, macrophages, lymphocytes, eosinophils, etc.), secreting mediators of allergy and inflammation, inhibit the development and growth of connective tissue cells, membrane-stabilizing effect on mast cells, reduces the secretion of bronchial glands due to inhibition of the production of prostaglandins, used to prevent allergies. They increase the sensitivity of β-2-adrenergic receptors in the bronchi to bronchodilator agonists (β-2-adrenergic agonists). The sum of the effects of GLA leads to a decrease in bronchial hyperreactivity, so they are necessarily used for the treatment of bronchial asthma, preferring aerosol dosage forms that are practically non-resorbable through the lungs (not absorbed into the blood). GLA is the most effective drugs for the relief and treatment of acute allergic reactions, shock states, since their main effects are: immunosuppressive, anti-allergic, anti-inflammatory, bronchodilator, decongestant, membrane-stabilizing, antipruritic and anti-shock. GLA is indispensable for the treatment of autoimmune diseases, liver cirrhosis, and infectious and allergic diseases.

Preparations: prednisolone, betamethasone, dexamethasone, budesonide, fluticasone.

Prednisolone (tablets). Synonym for "Prednisol".

Prednisolone hemisuccinate.Prednisoloni hemisuccinatis.

Release form: 1) Tablets 1-5-20 mg. Take in the first half of the day, taking most of the dose early in the morning, and the rest of the dose at lunchtime. 2).Powder for injection in ampoules of 25 mg. Intravenously or intramuscularly, pre-dissolved with water for injection, for severe and acute allergies.

Average doses for adults are 5-60 mg per day, for children 0.4-2 mg per day in 3-4 doses.

P: Acute allergic reactions, bronchospasm, anaphylactic shock, cardiogenic, infectious-toxic shock, burn cheek, thyrotoxic crisis, o. adrenal insufficiency, infectious-allergic myocarditis, rheumatism and arthrosis deformans, systemic and lupus erythematosus, o. hepatitis, liver cirrhosis, bronchial asthma.

PE: Edema, increased blood pressure, increased blood clotting or a tendency to thrombosis, increased blood sugar (steroid diabetes), leaching of calcium from bones (osteporosis), insomnia, excitability, virilization and amenorrhea in women, obesity, susceptibility to infections, “syndrome” withdrawal”, gastritis, peptic ulcer of the stomach and duodenum.

ETC: Gastrointestinal ulcer, hypersensitivity, hypertension, steroid diabetes, thrombosis, Itsenko-Cushing's disease, renal failure, viral, fungal infections, tuberculosis, epilepsy, pregnancy, lactation, steroid osteoporosis, thromboembolism, psychosis. Children under 6 years of age strictly as prescribed by a doctor for relief, children over 6 years of age strictly as prescribed by a doctor.

Betamethasone. Synonym for “Celeston”, “Betazon”, “Celestoderm”, “Diprospan”.

Betamethsonum.

Contains a fluorine atom, is a highly active hormonal drug, has the same effects as prednisolone.

Release form: 1). The ointment or cream is applied topically, applied in a thin layer 2-6 times a day until clinical improvement, then 2 times a day.

2).Eye and ear drops. Subconjunctivally at an average dose of 2 mg.

3).Diprospan suspension for injection: for adults and adolescents, IV/venous stream and slow drip, 4-8 mg per day, then maintenance doses of 2-4 mg; or intramuscularly 4-6 mg (up to 9 mg) per day. Injected intraarticularly, into the ganglia and soft tissues, the lesion, mixing, if necessary, with anesthetic solutions.

P: Various acute and chronic allergies, autoimmune diseases, shock conditions of various origins, systemic connective tissue diseases (arthritis, bursitis, tendonitis, ankylosing spondylitis, myositis, lupus, etc.), cirrhosis of the liver, itching, prurigo, eczema, diaper rash, keratitis, iridocyclitis, iritis, dermatosis of the external auditory canal, breast and prostate cancer.

PE: The same.

ETC: Same as prednisolone.

To prevent bronchospasm and reduce bronchial hyperreactivity, 1st and 2nd generation GLA aerosols are used.

Ointments and creams should not be applied to ulcerative and wound surfaces, or to the edges of wounds, as they interfere with healing and scarring.

Dexamethasone.Dexamethasonum. Synonym for "Dexon".

Release form: 1).Eye drops with suspension. In the first days of acute inflammatory diseases of the eyes, instill 1-2 drops 4-5 times a day for 2 days, then 3-4 times a day for 4-6 days.

For chronic conditions, instill 1-2 drops 2 times a day.

Included in the combined drops for the treatment of the outer and middle ear "Polydex".

P: O. and hr. allergic, inflammatory processes of the eyeball of the anterior and posterior part of the eye: conjunctivitis, scleritis, deep keratitis without damage to the epithelium, choroiditis, retinitis, optic neuritis, uveitis, conditions after injuries and surgical operations (not earlier than 7 days after injury or surgery), chemical and thermal burns in the later period.

PE: Burning sensation, conjunctival hyperemia, lacrimation, increased intraocular pressure.

ETC: Hypersensitivity, viral, bacterial and fungal eye infections, glaucoma, violation of the integrity of the cornea. Should not be used by drivers and people whose profession involves increased concentration of attention.

PRECAUTIONS: Remove soft contact lenses before use; install no earlier than 15 minutes. Intraocular pressure should be measured and the condition of the cornea monitored.

Budesonide. Synonym for "budesonide", "benacort", "budenofalk".Budesonidum.

It is 1000 times stronger than cortisol (a natural hormone) when applied locally to inflammation or allergic manifestations, when administered subcutaneously it is 40 times more active, when taken orally it is 25 times more active than cortisol.

Release form: 1).Powder for inhalation, the dose is selected for an adult individually, taking into account the severity of the disease. Adults: 200-800 mcg per day, sometimes up to 1600 mcg per day. Children, depending on age.2).Nasal drops: intranasal 2-3 drops in each nasal passage for adults for 10-14 days. 3).Capsules whole orally: 30 minutes before meals, 3 mg 3 times a day, washed down well with water.

P: Bronchial asthma, allergic rhinitis, Crohn's disease.

PE: Candidiasis of the oral mucosa, dry mouth, paradoxical bronchospasm, vasculitis, gastrointestinal ulcer, Cushing's disease, hypokalemia.

ETC: Lactation period, active form of tuberculosis, candidiasis, viral and bacterial infections, childhood, diabetes mellitus, glaucoma,

pregnancy (strictly under the supervision of a doctor if there is a threat to the life of a pregnant woman).
Beclomethasone dipropionate in aerosols of 200 doses, contains 50 mcg, or 100 mcg or 250 mcg in 1 dose. It is used by inhalation for bronchial asthma, the dose is selected individually for the patient depending on the severity and course of the disease, age. Basic therapy: 100-400 mcg 2 times a day for moderate severity of bronchial asthma, for severe form from 800-1600 mcg per day in several doses, etc.

More active aerosols of the 2nd generation of GLA, 2-3 times stronger than beclomethasone and its analogues (beclocort, becotide), containing a fluorine atom in their molecule:

fluticasone, flunisolide . The phrase “flu” means fluorine.

Fluticasone. Synonym for “flixotide”, “cutivate”, “flixonase”.

Fluticasonum.

Release form: 1) Nasal spray: in the morning, 100 mcg (children under 12 years old, 50 mcg) in each nasal passage.

2).aerosol for inhalation 2 times a day, 100-250 µg for mild BA, 250-500 µg for moderate BA, and 500 µg for severe BA, respectively.

3) Cream or ointment is applied in a thin layer to the affected area of ​​the skin 2 times a day.

P: Allergic rhinitis, prevention of exacerbations of asthma, eczema, nodular prurigo, psoriasis, lupus erythematosus, insect bites, prickly heat, seborrheic dermatitis.

PE: Nasopharyngeal irritation, nasal septum perforation (nasal spray), paradoxical bronchospasm, allergic contact dermatitis.

ETC: Hypersensitivity, pregnancy, breastfeeding, acne, itching in the genital area, skin lesions of infectious origin, infancy up to 1 year, spray and aerosol for children under 4 years of age.

REMEMBER: ointments and creams are prescribed according to a doctor’s indication for allergic and inflammatory lesions in the initial stage, and are prescribed for itching, provided that the skin is intact. Do not apply to open wounds, ulcerative lesions, the edges of wounds and burns. Do not use for bacterial, fungal, or viral skin lesions. As prescribed by a doctor, if necessary, ointments with GLA and antiseptics are used for treatment: “Lorinden-S” or “Lorinden-A”.

REMEMBER: for aerosols with GLA, a “spacer” nozzle is used to minimize the dispersion of aerosol droplets in the oral cavity, which leads to a decrease in the immunity of the mucous membrane to fungal infection. If there is no spacer or the aerosol disperses in the mouth, the patient should rinse his mouth and spit it out.

REMEMBER: drops with GLA are widely used in the early stages of acute inflammatory or allergic processes in the eye and ear diseases. In the first days, to reduce inflammation, swelling, itching, instillation should be done more often, up to 4-5 times a day; in subsequent days, as inflammation subsides and swelling decreases, it should be used less frequently 2-3 times a day. External dosage forms with GLA should not be used for a long time due to their pronounced immunosuppressive effect and effect on connective tissue.

Mast cell membrane stabilizers.
These include derivatives of cromoglycic acid (cromoglycates ): intal, nalcrom, cromohexal, cromoglin, highcrom, nedocromil, lecrolin, cromogen, bicromat, ifaral. They are easily destroyed in the gastrointestinal tract, about 1% is absorbed into the blood, therefore they are more often used topically (eye drops, nasal sprays) and inhalation; capsules are used for food allergies and some intestinal lesions. They give a rapid antiallergic effect, however, when treating bronchial asthma (BA), a course of treatment should be followed.

Mechanism of action: they have the ability to block the entry of calcium ions into mast cells (according to some data they stimulate the release of calcium), leads to a blocking effect of the membrane, degranulation of mast cells is suppressed, allergy mediators are located in the granules of mast cells and cannot exit through the membrane. Membrane stabilizers block the activity of the phosphodiesterase enzyme, which causes the breakdown of c-AMP, as a result of the accumulation of c-AMP substrate in the bronchi

gradually relax. The drug also has a membrane-stabilizing effect ketotifen, some β-2-adrenergic agonists, aminophylline. Cromoglycates are well tolerated and are prescribed for the prevention of asthma bronchospasm.

Intal.Intal. Synonyms “cromohexal”, “cromoglin”, “highkrom”.

Contains cromoglycic acid.

Release form: 1). Capsules for inhalation of 0.02 grams, inhaler included. Dissolve 1 capsule in a solution for injection and inhale 3-4 times a day. 2) Eye drops 3). Nasal spray..

Effects: membrane stabilizing and antiallergic.

P: Prevention of bronchospasm (inhalation), acute and chronic allergic conjunctivitis, allergic rhinitis and hay fever (to pollen).

PE: When used in inhalation, irritation of the pharynx, larynx, rarely allergic reactions, dermatitis, malaise, insomnia, tinnitus, dyspeptic disorders, myositis, chest pain, vasculitis.

ETC: Hypersensitivity, pregnancy (especially 1st trimester), children under 2 years of age, lactation period.

Ketotifen. Synonym for "Zaditen". Ketotifen.

Release form: 1).Capsules or tablets of 1 mg or syrup for children. Take orally during meals for adults and children over 3 years of age for the first 3-4 days, 1 mg in the evening, then 2 mg per day (1 mg in the morning and evening).

If necessary, the dose is increased to 4 mg per day. It should be used for more than 1-1.5 months to achieve a pronounced membrane-stabilizing effect. Effects of ketotifen: membrane-stabilizing, anti-allergic, antihistamine (H-1-blocking), anti-asthmatic.

P: Prevention of bronchospasm of any form of asthma, allergic bronchitis, urticaria, conjunctivitis, atopic dermatitis.

PE: Sedation (lethargy, drowsiness, lethargy), dry mouth, nausea, vomiting, constipation, allergic skin reactions, thrombocytopenia and cystitis rarely.

ETC: Hypersensitivity, pregnancy, lactation, children under 3 years of age (tablets) and syrup for children under 6 months.

PRECAUTIONARY MEASURES: Not for people with a profession that requires attention and mental and motor reactions. Cannot be used in conjunction with oral antidiabetic drugs. Enhances the effect of drugs and ethanol that depress the central nervous system .

Calcium preparations.

In medicine, calcium chloride and calcium gluconate are used. Calcium replenishes calcium deficiency in the body, which is necessary for blood clotting, for contraction of muscles and myocardium, blood vessels, and for the formation of dental and bone tissue. Calcium reduces the permeability of cell membranes and vascular walls, prevents the development of inflammatory reactions, increases the body's resistance to infections and can significantly enhance phagocytosis. When administered intravenously, it stimulates the sympathetic division of the autonomic nervous system. Enhances the release of adrenaline by the adrenal glands, providing a moderate diuretic effect.

Calcium chloride.Calcium chloridum. Common list.

Release form:% solution of 10 ml for IV. injections in saline slowly. 2).5-10% solution for oral administration after meals, 10-15 ml 2-3 times a day, for children 5-10 ml per dose.

P: Increased need for calcium (pregnancy, lactation), bleeding of various locations (uterine, intestinal, pulmonary, nasal), allergies and allergic manifestations, bronchial asthma, tetany, spasmophilia, osteoporosis, hypocalcemia, hypoparathyroidism, hepatitis, nephritis, eclampsia, magnesium salt poisoning , oxalic and fluoric acid, psoriasis, weakness of labor, inflammatory and exudative processes (pneumonia, pleurisy, adnexitis, endometritis).

PE: When taken orally, heartburn, pain in the epigastric region. With intravenous administration, a feeling of heat, facial hyperemia, bradycardia; with rapid administration, fibrillation of the ventricles of the heart.

ETC: Hypercalcemia, atherosclerosis, tendency to thrombosis.

REMEMBER! It cannot be administered subcutaneously or intramuscularly - tissue necrosis is possible; high concentrations of the solution, starting from 5%, cause severe irritation of subcutaneous tissues.

Calcium gluconate Available in tablets of 0.5 grams for adults, 0.25 grams for children with cocoa, 5% solution with fruit syrup and 10% solution for intravenous/mouse. and intravenous injections of 5 and 10 ml.

Prescribed to adults: 1-3 grams or more 2-3 times a day; children under 1 year - 0.5 grams; from 2 to 4 years --- 1g; from 5 to 6 years --- 1-1.5 grams; from 10 to 14 years old - 2-3g. 2-3 times a day.

Calcium lactate in tablets of 0.5 grams orally, 1-2 tablets 2-3 times a day, previously dissolved in warm water.

Indications are the same as for calcium chloride.

Symptomatic remedies for allergic diseases. Read the definitions of allergies at the beginning and fix the main symptoms in your memory.

Local decongestants agents or decongestants	α-2-adrenergic agonists: naphthyzin, galazolin, nazivin.	Nasal drops, sometimes in the eyes.	Allergic rhinitis, hay fever, conjunctivitis.
Hypertensive facilities	-α-1-adrenergic agonist: 1% mesatone solution; -α-and-β-adrenergic agonists: 0.1% adrenaline solution; Sympathomimetics: 5% ephedrine solution.	Solutions for injections intravenously and subcutaneously.	Anaphylactic shock (low blood pressure).
Bronchodilators	-β-2-adrenergic agonists: Salbutamol, fenoterol, formoterol, salmeterol.	Aerosols, capsules for inhalation. powders for injections.	Bronchial asthma.
Adsorbents	Activated carbon, polyphepane, smecta.	Tablets, granules, powders internally.	Food and drug allergies (if the allergen is ingested).
Antipruritic, anti-inflammatory means	Hormonal preparations of glucocorticoids: hydrocortisone, betamezone, proctosedyl, dexamethasone, etc.	Ointments, creams, drops in the eyes and ears. Rectal capsules.	Hives, eczema, Allergic dermatitis, skin itching, inflammation and swelling with itching after an insect bite.

An allergy is the body’s reaction to external irritating factors, such as household chemicals, pollen, medications, household dust and many others. Itching, runny nose, sneezing, tearfulness, various skin rashes - all these are signs of allergies.

In the modern world, allergy pills are most popular among people who suffer from this problem. They are unable to independently remove the manifestations of allergic reactions, but can prevent their development.

In order not to harm yourself, you should remember that if the pathogen is still entering the body, then even the largest doses of medicine will not help stop this process and everything will be ineffective.

Allergy tablets: list and prices

When choosing medications, we ask ourselves the question: “Which tablets for skin allergies are better?” To answer this question, you need to make sure that the main allergen has been eliminated before taking any allergy medication. If this does not happen, any drugs will not give the desired result, even if the dose is increased.

List of the most effective anti-allergy tablets:

• Lordestin;
• Erius;
• Loratadine;
• Fenkarol;
• Telfast;
• Diazolin;
• Zodak;
• Kestin.

Thanks to the wide range of anti-allergy tablets, you can choose any drug that is right for you. The average price of such drugs is from 200 to 600 rubles. The variety of drugs allows you to purchase both a cheap analogue and the best of the latest generation.

1st generation antihistamines

Today, drugs of this group are practically not prescribed by doctors, but we still suggest studying the list:

1. Suprastin, Chloropyramine– the safest of group 1. Price 128.00 rub.
2. Tavegil - allergic reactions to its ingredients occur. Price 159.00 rub.
3. Diphenhydramine - affects the central nervous system. Price 75.00 rub.
4. Diazolin – irritates the lining of the gastrointestinal tract. Price 69.00 rub.
5. Peritol – increases appetite.
6. Pipolfen - reduces intestinal motility.
7. Diprazil - affects the activity of the nervous system.
8. Fenkarol – low medicinal effectiveness. Price 376.00 rub.

These drugs are used much less frequently today than 2nd and 3rd generation drugs, as they have a number of side effects:

• dry mouth.
• excitation.
• constipation
• decreased visual acuity.
• depression of the central nervous system: drowsiness, inhibition of reaction, decreased concentration.

Suprastin and chloropamine are the only 1st generation drugs that continue to be popular because they do not cause strong cardiotoxic effects. However, we do not recommend their use, as there are more effective medications.

Antihistamines 2nd generation

The second generation of drugs with antihistamine effect was developed relatively recently. A significant advantage of these medications is the absence of a negative effect on the central nervous system, that is, they do not cause drowsiness and lethargy.

The most popular second generation medications are

1. - a popular drug that is suitable even for older people and for children from one year old. It acts quickly and for a long time, does not affect the functioning of the heart and has no sedative effect. Price 174.00 rub.
2. Semprex is a medicine that combines high antihistamine and minimal sedative effects.
3. Trexil is the first second-generation anti-allergy drug. It works effectively, but inhibits the functioning of the cardiovascular system. Price 97.45 rub.
4. Fenistil is an anti-allergy tablet that does not cause drowsiness or sedation. Price 319.00 rub.
5. Gistalong is an effective drug in the fight against chronic allergies, as it has an antihistamine effect for up to three weeks.

When used in the treatment of children, Claritin is often prescribed; this medicine is approved for use in the treatment of diseases in infants and has the smallest group of possible side effects.

Antihistamines 3rd generation

To effectively combat allergies, the best third-generation drugs have been developed. They are the most progressive and perfect and help a lot. Such drugs do not have an effect on the functioning of the heart, nor do they have a negative effect on the human central nervous system. They are essentially active metabolites of second generation drugs.

List and prices:

1. Telfast is a metabolite of terfenadine; it also does not interact with other drugs, is not metabolized in the body, does not cause drowsiness and does not impair psychomotor functions. It is considered a safe and effective antihistamine. These anti-allergy tablets should not be taken by children under 6 years of age. Price 570.00 rub.
2. Fexofenadine is an analogue of the previous drug. It also has no effect on the brain and nervous system, does not interact with drugs and alcohol, and is an effective and safe remedy. Price 281.79 rub.
3. Cetirizine is effective for skin irritations. It is not metabolized in the body and quickly penetrates the skin, so it eliminates dermatitis well. Can be used in children over 2 years of age. Price 105.00 rub.
4. Zyrtec - has virtually no side effects, acts throughout the day (the effect occurs after about 1-2 hours). Since the substances of the drug are excreted by the kidneys, in case of renal failure and other problems, the drug should be used carefully and under the supervision of a specialist. Price 199.00 rub.
5. – its use is possible in the treatment of both adults and small allergist patients, starting from the age of two. It is considered the safest and most effective remedy for relieving allergy symptoms. The drug does not inhibit the functioning of the central nervous system and practically does not cause a sedative effect. Price 164.00 rub.

Only a specialist can select and prescribe tablets against skin allergies. It must take into account existing diseases, as well as the manifestations and severity of allergies.

Latest generation allergy tablets: list

There are not many such drugs, however, the result of their use speaks for itself:

1. Erius helps block peripheral histamine receptors, resulting in inhibition of a whole cascade of negative reactions in the body.
2. Zyrtec prevents the development and significantly alleviates the course of an allergic reaction. In addition, the drug perfectly fights itching.
3. Telfast can be used for a long time without any harm to health. The effect of the medicine begins an hour after administration and reaches a maximum after about six hours.

Despite these positive qualities, the latest generation of antiallergic tablets should be prescribed by a specialist. This will allow you to carry out treatment more effectively and not spend extra money on purchasing unnecessary expensive drugs.

Glucocorticoids

They can be prescribed locally and systemically for very severe forms of allergies. Locally - in the form of ointments and gels, systemically - in the form of injections and tablets.

In most cases, taking glucocorticoids saves you from allergies, because in essence they are steroid hormones produced by the adrenal cortex and have a powerful anti-inflammatory and anti-allergic effect.

Hormonal drugs include:

1. Dexamethasone;
2. Beclamethasone.

Regardless of the drug that the patient uses, this should be done with extreme caution and in no case should you self-prescribe this or that medicine. In the case of antihistamines, you can still guess, but taking hormones on your own in most cases ends up being detrimental to your health.

Allergy treatment program

When treating any allergic reaction to the skin, you need to adhere to a certain program of therapeutic measures:

1. Partial or absolute elimination of the causative agent of an allergic reaction in any possible way.
2. Limiting the influence of irritating factors (overheating, hypothermia, overdrying and waterlogging of the skin).
3. Refusal of those foods that may increase the risk of developing allergies. These include sweet foods, citrus fruits, dairy products, chocolate and coffee;
4. Elimination of excessive physical and mental stress.

It is advisable to use anti-allergy pills only when the impact of these factors is minimized - if this rule is not followed, you have to constantly increase the dose of medications, but you will not be able to get the expected effect.

Despite the fact that allergy pills currently remain the most popular medications used to eliminate and prevent all classes of allergic reactions that can occur in the human body, their independent use cannot prevent the development of symptoms of this pathological process. If the allergen continues to enter the body (the route of its entry does not matter significantly), then even the highest doses of medications used to break the chain of an allergic reaction will not be effective.

Allergy treatment program

That is why doctors say that when treating any allergic reaction on the skin or face, you need to adhere to a certain program of therapeutic measures. These include:

• limiting or completely stopping the entry of the allergen into the body in any way– wet cleaning of the home is necessary, limiting contact with potential allergens (pets, plants, household items on which allergens can accumulate);
• recommended limiting the intake of foods that increase the risk of allergic reactions(products with a high sugar content, citrus fruits, milk, coffee, chocolate);
• avoiding excessive physical and mental stress;
• limiting the influence of irritating factors(overheating, hypothermia, overdrying and waterlogging of the skin).

Which allergy pills are good and effective? What is better to use in treatment?

It is advisable to use anti-allergy pills only when the impact of these factors is minimized - if this rule is not followed, you have to constantly increase the dose of medications, but you will not be able to get the expected effect.

Medicines for the treatment of allergies in tablets

The drugs that modern allergology recommends for the treatment of allergies belong to the following groups of medicinal substances:

• antihistamines– medications that prevent the release of the allergy mediator histamine;
• stabilizers of the membranes of “mast” cells of the body– medications that reduce the excitability of cells responsible for the development of allergic reactions;
• systemic glucocorticoid hormones.

Antihistamine tablets for the treatment of allergies are used to quickly eliminate the manifestations of an allergic reaction - they suppress the production of histamine in cells and reduce the sensitivity of peripheral tissue receptors to mediators of allergic reactions. Actually, first-generation antihistamines actually suppress the production of histamine, so these drugs (dibazole, diphenhydramine, tavegil, suprastin, citrine, Erius, loratadine, claritin) must be administered several times a day at approximately equal intervals. Most of these drugs are contraindicated during pregnancy. For children they are available in the form of syrup or drops.

The effect of second and third generation antihistamines is due to the influence of the drugs on histamine receptors - they temporarily lose sensitivity to the allergy mediator, and even with a high level of histamine in the blood serum, an allergic reaction cannot develop.

The main positive effects of second and third generation drugs can be considered the fact that such allergy pills need to be used only once a day, and they do not have a sedative (hypnotic) effect.

List of antihistamine tablets from cheap and inexpensive to the strongest and best:

Mast cell stabilizers are also used as allergy pills - their action is due to the “strengthening” of the membrane of basophils (“mast cells”), and it is not destroyed when the allergen enters the body, leading to the development of a classic type of allergic reaction. Most often, these drugs are prescribed for the treatment of chronic allergic diseases (atopic dermatitis, eczema, bronchial asthma and severe asthmatic bronchitis)

Systemic glucocorticoid hormones as tablets for the treatment of allergies are prescribed when it is impossible to prevent the development of allergies by other means. By their nature, all these substances are analogues of hormones of the adrenal cortex - these substances have a pronounced anti-allergic and anti-inflammatory effect. When prescribing this class of allergy pills, it is important to remember that once you start taking it, you cannot stop using the medicine at once - the dose should be reduced gradually, by no more than 1/3 of the daily dose of any similar drug. These medications must be prescribed by a qualified physician.

If you bloom in the spring along with flowers, you urgently need to deal with this...

Currently, allergic diseases are the scourge of the 21st century. The number of people suffering from this disease is growing every year. The most unpleasant thing about this situation is that young children are most susceptible to negative reactions to certain substances. Based on this, nursing mothers should not consume many foods until the child’s body reaches a certain degree of maturity.

Among the adult population there are also enough people suffering from allergies.

How to deal with intolerance to pollen, cat hair or citrus fruits? The ideal option is to eliminate the allergen. That is, avoid contact with anything that causes an allergic reaction.

What if this is impossible?

It was this question that served as a prerequisite for active research and creation of the most effective and safe antiallergic drugs. What medications are the most effective in the difficult task of fighting an allergic reaction?

To choose the right medicine, you should know the nature of the allergic reaction. Itching, sneezing, redness of the skin, suffocation - these are all symptoms caused by the substance histamine. To eliminate an allergic reaction, it is necessary to deprive it of its ability to act in the body, in other words, to block it.

Antihistamines can do this.

We present to your attention a list of the most effective and popular medicines, from which you can choose what is most suitable for you.

Attention! Our rating is for you if you have been bitten by a harmful insect, or you ate an exotic fruit for breakfast, or you sneeze from poplar fluff... That is, if your allergy is an unpleasant episode, and not a chronic disease. Otherwise, only a doctor should prescribe treatment. And further. All the drugs listed here have contraindications; before purchasing, be sure to read the instructions and contraindications for use in detail - what if the chosen drug is absolutely not suitable for you?

Rating of the best allergy remedies

Exclusive of its kind - Cetrin
the best allergy drug at the moment

Photo: www.utkonos.ru

In first place in terms of effectiveness is the third generation antihistamine, Cetrin.

The average estimated cost of the drug is from 160 to 200 rubles.

The main advantages of Cetrin are its high degree of effectiveness, as well as its rapid action after taking the drug. It is also preferable because it does not cause drowsiness and “abstains” from negative effects on the liver.

Cetrin should be taken to eliminate symptoms of seasonal allergies, hay fever or atopic dermatitis.

This drug is the best choice for both adults and children. It has a pleasant taste and has virtually no contraindications or restrictions on use. Unlike other drugs, it is enough to use it once a day, which greatly simplifies the application process.

In the ranking of the most effective antiallergic drugs, Cetrin takes first place. On a ten-point scale, he can safely be given 9.5 points. 0.5 points are deducted for the only drawback - the price. Allergy medications can be purchased at a more reasonable price, but this is precisely the case when it is appropriate to remember the words of the wise Jew: “I am not rich enough to buy cheap things.”

Claritin is a true, reliable, safe medicine for allergies

Photo: lechimsya.org

Next on the list of the most effective drugs for treating allergies is Claritin (Loratadine).

The average cost of this drug is from 160 to 220 rubles.

Before the advent of third generation antihistamines, Claritin was the most common. It is one of the first antiallergic drugs that did not affect the patient's state of attention, which made it possible for use by doctors and drivers.

It is used for various manifestations of the allergic process, ranging from skin forms (itching and redness) to laryngospasm (suffocation).

Claritin is good for its speed of action, the possibility of use in children after one year, as well as in people who need concentrated attention while working.

The rating of this drug is 9.2 out of 10, since the drug has some disadvantages, such as limited use in people with impaired renal function, in women who are breastfeeding, and in children under one year of age. To some extent, the price also stops it - for the same money you can buy the safest and most effective Cetrin.

Fenistil - old, but still effective...

Photo: apkiwi.ru

The average price for it currently ranges from 220 to 280 rubles.

Fenistil is a second generation antiallergic drug. It has less effect compared to Claritin, however, it is much more effective than first-generation drugs.

The drug is used for the development of an allergic reaction from foods, medications, skin rashes and nasal discharge during the flowering period.

Fenistil has a good, pronounced anti-allergic effect, preventing the development of an allergic reaction even with a high concentration of allergen and histamine.

In terms of frequency of use, it is in third place among all drugs in the rating. Its rating is 8.2 out of 10. The drug has such disadvantages as a sedative, calming effect, increased effect of alcohol when used together, distortion of the effect of some other drugs. Contraindicated in breastfeeding, pregnancy, and in children under 2 years of age.

Dangerous, but extremely effective - Gistalong

Photo: www.gippokrat.kz

Gistalong (Astemizole) is an antihistamine drug with the longest clinical effect.

The price of this drug ranges from 300 to 460 rubles, which makes it one of the most expensive drugs.

Gistalong belongs to the second generation drugs. Has the longest therapeutic effect (in some people it can reach up to 20 days)

This drug is used in the treatment of chronic allergic processes.

The duration of action of Gistalong allows it to be used with a frequency of about once a month. Its use allows you to avoid taking other antiallergic drugs.

Despite its duration of action and antiallergic activity, the drug ranks only fourth in the ranking. Its rating on a ten-point scale is 8 out of 10. This result is due to the side effects of this drug - when taken, it may disrupt the normal heart rhythm, which can lead to death in people with heart disease. Contraindicated for use in the acute phase of allergy development, as well as in pregnant women and children.

Time-tested drug - Tavegil
good reliable first generation allergy remedy

Photo: sanatate.md

Tavegil (Clemastine) is one of the most common and used first-generation drugs.

You can buy Tavegil for, on average, 100 rubles.

The drug is used in both tablet and injection forms. It has a fairly strong antiallergic effect. It is often used as an additional drug for anaphylactic shock and pseudoallergic reactions.

The low incidence of side effects and high efficiency allowed Tavegil to be included in the ranking of the most used drugs. In addition, the drug begins to act quite quickly, and the effect of its use lasts quite a long time, which makes it the drug of choice in the treatment of allergic processes.

The average rating of this drug on a ten-point scale is 8. 3 out of 10. Tavegil receives a similar rating for such shortcomings as the possible development of an allergic reaction to tavegil itself, a slight sedative effect, which makes it impossible for drivers and doctors to use it. Also, the drug is contraindicated for use in pregnant women, nursing mothers and children under 1 year of age.

Will help quickly and in any situation - Suprastin

Photo: alfavitnik.ru

Suprastin (Chloropyramine) is a drug often used in most branches of medicine. You can buy it for 120-140 rubles.

One of the most effective first generation histamine blocking drugs

It is used for almost all types and manifestations of allergic reactions; used to provide emergency care for allergies (one of the mandatory medications).

Suprastin does not accumulate in the blood serum, which prevents the possibility of an overdose of the drug. The effect develops quite quickly, but to prolong it it is necessary to combine Suprastin with other drugs. The low cost of the drug is also its undoubted advantage, since it is extremely difficult to choose a high-quality and inexpensive drug on the modern drug market.

In the ranking of the best antiallergic drugs, Suprastin receives 9 points out of 10. Its use is prohibited during pregnancy, lactation, in children under 1 month, in persons with individual intolerance to chloropyramine, as well as during an acute attack of bronchial asthma.

Standing guard from time immemorial... - Diphenhydramine

Photo: www.syl.ru

Diphenhydramine (Diphenhydramine) is a drug of the first generation of antihistamines, the founder of this group of drugs.

Prescription drug.

It is one of the cheapest antiallergic drugs. Its cost ranges from 15 to 70 rubles.

One of the antiallergic drugs that were invented first. It has a fairly strong antihistamine effect.

Diphenhydramine is used to eliminate the manifestations of most allergic processes. It is produced primarily in the form of products applied topically (in the form of an ointment), but can also be used for systemic treatment. It is part of the so-called triad due to its anti-inflammatory effect.

Diphenhydramine has a pronounced antiallergic effect: the effect develops quickly, but ends just as quickly. Thanks to its low cost, anyone can buy it.

In the drug rating, Diphenhydramine receives a rating of 8 out of 10. Despite its effectiveness in treating allergies, Diphenhydramine has a number of side effects, among which the most pronounced are drowsiness after using the drug, mild confusion with a sedative effect, anemia, and heart rhythm disturbances.

Results... Which allergy medicine is best?

Having understood in detail the principles of action, effectiveness and degree of safety of each of the above drugs, we should once again mention the crowned Cetrin. Due to its safety and effectiveness, it takes first place in our rating, and can be recommended for a home medicine cabinet.

This drug deserves a huge plus for its lack of effect on a person’s attention and concentration. You can take it without worrying about side effects and your psycho-emotional state.

Of course, before taking it, it is best to consult with an allergist and study the instructions.

Be healthy and don't sneeze...

Attention! There are contraindications, consultation with a specialist is required

There are several groups of medications used for allergic diseases. This:

• antihistamines;
• membrane-stabilizing drugs - cromoglycic acid preparations () and ketotifen;
• topical and systemic glucocorticosteroids;
• intranasal decongestants.

In this article we will talk only about the first group - antihistamines. These are drugs that block H1-histamine receptors and, as a result, reduce the severity of allergic reactions. Today there are more than 60 antihistamines for systemic use. Depending on the chemical structure and the effects they have on the human body, these drugs are combined into groups, which we will discuss below.

What are histamine and histamine receptors, the principle of action of antihistamines

There are several types of histamine receptors in the human body.

Histamine is a biogenic compound formed as a result of a number of biochemical processes, and is one of the mediators that takes part in the regulation of vital functions of the body and plays a leading role in the development of many diseases.

Under normal conditions, this substance is in the body in an inactive, bound state, however, during various pathological processes (hay fever, hay fever, and so on), the amount of free histamine increases many times, which is manifested by a number of specific and nonspecific symptoms.

Free histamine has the following effects on the human body:

• causes spasm of smooth muscles (including bronchial muscles);
• dilates capillaries and reduces blood pressure;
• causes stagnation of blood in the capillaries and increased permeability of their walls, which entails thickening of the blood and swelling of the tissues surrounding the affected vessel;
• reflexively excites the cells of the adrenal medulla - as a result, adrenaline is released, which contributes to the narrowing of arterioles and an increase in heart rate;
• increases the secretion of gastric juice;
• plays the role of a neurotransmitter in the central nervous system.

Externally, these effects manifest themselves as follows:

• bronchospasm occurs;
• the nasal mucosa swells - nasal congestion and mucus discharge appear;
• itching, redness of the skin appears, all kinds of rash elements form on it - from spots to blisters;
• the digestive tract responds to an increase in the level of histamine in the blood with a spasm of the smooth muscles of the organs - there are pronounced cramping pains throughout the abdomen, as well as an increase in the secretion of digestive enzymes;
• on the part of the cardiovascular system, and may be observed.

There are special receptors in the body for which histamine has an affinity - H1, H2 and H3 histamine receptors. In the development of allergic reactions, the role played mainly by H1-histamine receptors located in the smooth muscles of internal organs, in particular the bronchi, in the inner lining - the endothelium - of blood vessels, in the skin, as well as in the central nervous system.

Antihistamines act specifically on this group of receptors, blocking the action of histamine through competitive inhibition. That is, the drug does not displace histamine already bound to the receptor, but occupies a free receptor, preventing histamine from attaching to it.

If all receptors are occupied, the body recognizes this and gives a signal to reduce histamine production. Thus, antihistamines prevent the release of new portions of histamine, and are also a means of preventing the occurrence of allergic reactions.

Classification of antihistamines

Several classifications of drugs in this group have been developed, but none of them is generally accepted.

Depending on the characteristics of the chemical structure, antihistamines are divided into the following groups:

• ethylenediamines;
• ethanolamines;
• alkylamines;
• quinuclidine derivatives;
• alphacarboline derivatives;
• phenothiazine derivatives;
• piperidine derivatives;
• piperazine derivatives.

In clinical practice, the classification of antihistamines by generation has become more widely used, of which today there are 3:

1. 1st generation antihistamines:

• diphenhydramine (diphenhydramine);
• doxylamine (donormil);
• clemastine (tavegil);
• chloropyramine (suprastin);
• mebhydrolin (diazolin);
• promethazine (pipolfen);
• quifenadine (fencarol);
• cyproheptadine (peritol) and others.

1. 2nd generation antihistamines:

• acrivastine (Semprex);
• dimethindene (fenistil);
• terfenadine (histadine);
• azelastine (allergodil);
• loratadine (lorano);
• cetirizine (cetrin);
• bamipin (Soventol).

1. 3rd generation antihistamines:

• fexofenadine (Telfast);
• desloratodine (erius);
• Levocetirizine.

1st generation antihistamines

First generation antihistamines have a pronounced sedative effect.

Based on the predominant side effect, drugs in this group are also called sedatives. They interact not only with histamine receptors, but also with a number of other receptors, which determines their individual effects. They act for a short time, which is why they require multiple doses throughout the day. The effect comes quickly. Available in different dosage forms - for oral administration (in the form of tablets, drops) and parenteral administration (in the form of an injection solution). Affordable.

With prolonged use of these drugs, their antihistamine effectiveness is significantly reduced, which necessitates the need for periodic - once every 2-3 weeks - drug changes.

Some 1st generation antihistamines are included in combination medications for the treatment of colds, as well as sleeping pills and sedatives.

The main effects of 1st generation antihistamines are:

• local anesthetic – associated with a decrease in membrane permeability to sodium; the most powerful local anesthetics from this group of drugs are promethazine and diphenhydramine;
• sedative – due to the high degree of penetration of drugs of this group through the blood-brain barrier (that is, into the brain); the degree of severity of this effect varies between drugs; it is most pronounced in doxylamine (it is often used as a hypnotic); the sedative effect increases with the simultaneous consumption of alcoholic beverages or taking psychotropic drugs; when taking extremely high doses of the drug, instead of the effect of sedation, pronounced agitation is observed;
• anti-anxiety, calming effect is also associated with the penetration of the active substance into the central nervous system; most expressed in hydroxyzine;
• anti-sickness and anti-emetic - some representatives of the drugs in this group inhibit the function of the labyrinth of the inner ear and reduce the stimulation of receptors of the vestibular apparatus - they are sometimes used for Meniere's disease and motion sickness in transport; This effect is most pronounced in drugs such as diphenhydramine and promethazine;
• atropine-like effect - causes dryness of the mucous membranes of the oral and nasal cavities, increased heart rate, visual impairment, urinary retention, constipation; may increase bronchial obstruction, lead to exacerbation of glaucoma and obstruction in cases of – not used for these diseases; These effects are most pronounced in ethylenediamines and ethanolamines;
• antitussive - drugs of this group, in particular diphenhydramine, act directly on the cough center located in the medulla oblongata;
• the antiparkinsonian effect occurs by inhibiting the effects of acetylcholine by the antihistamine;
• antiserotonin effect - the drug binds to serotonin receptors, alleviating the condition of patients suffering from migraine; especially pronounced in cyproheptadine;
• dilatation of peripheral vessels - leads to a decrease in blood pressure; is maximally expressed in phenothiazine preparations.

Since drugs in this group have a number of undesirable effects, they are not the drugs of choice for the treatment of allergies, but are still often used for it.

Below are some of the most commonly used representatives of the drugs in this group.

Diphenhydramine (diphenhydramine)

One of the first antihistamines. It has pronounced antihistamine activity, in addition, it has a local anesthetic effect, and also relaxes the smooth muscles of internal organs and is a weak antiemetic. Its sedative effect is similar in strength to the effects of neuroleptics. In high doses it also has a hypnotic effect.

It is quickly absorbed when taken orally and penetrates the blood-brain barrier. Its half-life is about 7 hours. It undergoes biotransformation in the liver and is excreted by the kidneys.

It is used for all kinds of allergic diseases, as a sedative and hypnotic, as well as in complex therapy for radiation sickness. Less commonly used for pregnancy vomiting and seasickness.

Orally prescribed in the form of tablets of 0.03-0.05 g 1-3 times a day for 10-14 days, or one tablet before bed (as a sleeping pill).

1-5 ml of 1% solution are administered intramuscularly, 0.02-0.05 g of the drug in 100 ml of 0.9% sodium chloride solution is administered intravenously.

Can be used in the form of eye drops, rectal suppositories, or creams and ointments.

Side effects of this drug are: short-term numbness of the mucous membranes, headache, dizziness, nausea, dry mouth, weakness, drowsiness. Side effects go away on their own, after reducing the dose or completely stopping the drug.

Contraindications are pregnancy, lactation, prostate hypertrophy, and angle-closure glaucoma.

Chloropyramine (suprastin)

It has antihistamine, anticholinergic, myotropic antispasmodic activity. It also has antipruritic and sedative effects.

It is quickly and completely absorbed when taken orally, the maximum concentration in the blood is observed 2 hours after administration. Penetrates the blood-brain barrier. Biotransformed in the liver, excreted by the kidneys and feces.

Prescribed for all kinds of allergic reactions.

It is used orally, intravenously and intramuscularly.

Orally, take 1 tablet (0.025 g) 2-3 times a day, with meals. The daily dose can be increased to a maximum of 6 tablets.

In severe cases, the drug is administered parenterally - intramuscularly or intravenously, 1-2 ml of a 2% solution.

When taking the drug, side effects such as general weakness, drowsiness, decreased reaction speed, impaired coordination of movements, nausea, and dry mouth are possible.

Strengthens the effect of sleeping pills and sedatives, as well as narcotic analgesics and alcohol.

Contraindications are similar to those of diphenhydramine.

Clemastine (tavegil)

In structure and pharmacological properties it is very close to diphenhydramine, but it acts longer (within 8-12 hours after administration) and is more active.

The sedative effect is moderate.

Take 1 tablet (0.001 g) orally before meals, with plenty of water, 2 times a day. In severe cases, the daily dose can be increased by 2, maximum 3 times. The course of treatment is 10-14 days.

Can be used intramuscularly or intravenously (within 2-3 minutes) - 2 ml of 0.1% solution per dose, 2 times a day.

Side effects are rare when taking this drug. Possible headache, drowsiness, nausea and vomiting, constipation.

Prescribed with caution to persons whose profession requires intense mental and physical activity.

Contraindications are standard.

Mebhydrolin (diazolin)

In addition to the antihistamine, it has anticholinergic and. Sedative and hypnotic effects are extremely weak.

When taken orally, it is slowly absorbed. The half-life is only 4 hours. Biotransformed in the liver and excreted in the urine.

Used orally, after meals, in a single dose of 0.05-0.2 g, 1-2 times a day for 10-14 days. The maximum single dose for an adult is 0.3 g, the daily dose is 0.6 g.

Generally well tolerated. Sometimes it can cause dizziness, irritation of the gastric mucosa, blurred vision, and urinary retention. In especially rare cases - when taking a large dose of the drug - a slowdown in the reaction rate and drowsiness.

Contraindications are inflammatory diseases of the gastrointestinal tract, angle-closure glaucoma and prostatic hypertrophy.

2nd generation antihistamines

Second generation antihistamines are characterized by high efficiency, rapid onset of action and a minimum of side effects, however, some of their representatives can cause life-threatening arrhythmias.

The goal of developing drugs in this group was to minimize sedation and other side effects while maintaining or even stronger antiallergic activity. And it was a success! Antihistamines of the 2nd generation have a high affinity specifically for H1-histamine receptors, with virtually no effect on choline and serotonin receptors. The advantages of these drugs are:

• rapid onset of action;
• long duration of action (the active substance binds to protein, which ensures longer circulation in the body; in addition, it accumulates in organs and tissues, and is also slowly excreted);
• additional mechanisms of antiallergic effects (suppress the accumulation of eosinophils in the respiratory tract associated with the entry of the allergen into the body, and also stabilize the membranes of mast cells), causing a wider range of indications for their use (,);
• with long-term use, the effectiveness of these drugs does not decrease, that is, there is no tachyphylaxis effect - there is no need to periodically change the drug;
• since these drugs do not penetrate or penetrate in extremely small quantities through the blood-brain barrier, their sedative effect is minimal and is observed only in patients who are particularly sensitive in this regard;
• do not interact with psychotropic drugs and ethyl alcohol.

One of the most adverse effects of 2nd generation antihistamines is their ability to cause fatal arrhythmias. The mechanism of their occurrence is associated with the blocking of potassium channels of the heart muscle by an antiallergic drug, which leads to a prolongation of the QT interval and the occurrence of arrhythmia (usually ventricular fibrillation or flutter). This effect is most pronounced in drugs such as terfenadine, astemizole and ebastine. The risk of its development increases significantly with an overdose of these drugs, as well as in the case of combining their use with antidepressants (paroxetine, fluoxetine), antifungals (intraconazole and ketoconazole) and some antibacterial agents (antibiotics from the macrolide group - clarithromycin, oleandomycin, erythromycin), some antiarrhythmics (disopyramide, quinidine), when the patient consumes grapefruit juice and severe.

The main form of release of 2nd generation antihistamines is tablets, but parenteral ones are not available. Some drugs (such as levocabastine, azelastine) are available in the form of creams and ointments and are intended for topical administration.

Let's take a closer look at the main drugs in this group.

Acrivastine (Semprex)

It is well absorbed when taken orally and begins to act within 20-30 minutes after administration. The half-life is 2-5.5 hours, it penetrates the blood-brain barrier in small quantities and is excreted unchanged in the urine.

It blocks H1-histamine receptors and has a slight sedative and anticholinergic effect.

It is used for all kinds of allergic diseases.

In some cases, while taking it, drowsiness and a decrease in reaction speed are possible.

The drug is contraindicated during pregnancy, lactation, severe, severe coronary heart disease, and children under 12 years of age.

Dimetindene (fenistil)

In addition to antihistamine, it has weak anticholinergic, antibradykinin and sedative effects.

It is quickly and completely absorbed when taken orally, the bioavailability (degree of digestibility) is about 70% (in comparison, when using cutaneous forms of the drug this figure is much lower - 10%). The maximum concentration of the substance in the blood is observed 2 hours after administration, the half-life is 6 hours for the regular form and 11 hours for the retard form. It penetrates the blood-brain barrier and is excreted in bile and urine in the form of metabolic products.

The drug is used orally and topically.

Adults take 1 capsule of retard orally at night or 20-40 drops 3 times a day. The course of treatment is 10-15 days.

The gel is applied to the affected areas of the skin 3-4 times a day.

Side effects are rare.

Contraindication is only the 1st trimester of pregnancy.

Strengthens the effects of alcohol, sleeping pills and tranquilizers on the central nervous system.

Terfenadine (histadine)

In addition to antiallergic, it has a weak anticholinergic effect. It does not have a pronounced sedative effect.

Well absorbed when taken orally (bioavailability is 70%). The maximum concentration of the active substance in the blood is observed after 60 minutes. Does not penetrate the blood-brain barrier. Biotransformed in the liver to form fexofenadine, excreted in feces and urine.

The antihistamine effect develops after 1-2 hours, reaches its maximum after 4-5 hours, and lasts for 12 hours.

The indications are the same as for other drugs in this group.

Prescribe 60 mg 2 times a day or 120 mg 1 time a day in the morning. The maximum daily dose is 480 mg.

In some cases, when taking this drug, the patient develops side effects such as erythema, fatigue, headache, drowsiness, dizziness, dry mucous membranes, galactorrhea (leakage of milk from the mammary glands), increased appetite, nausea, vomiting, in case of overdose - ventricular arrhythmias.

Contraindications include pregnancy and breastfeeding.

Azelastine (allergodil)

Blocks H1-histamine receptors and also prevents the release of histamine and other allergy mediators from mast cells.

It is quickly absorbed in the digestive tract and from the mucous membranes, the half-life is as much as 20 hours. Excreted in the form of metabolites in the urine.

Used, as a rule, for allergic rhinitis and.

When taking the drug, side effects are possible such as dryness and irritation of the nasal mucosa, bleeding from it and taste disorders when administered intranasally; irritation of the conjunctiva and a feeling of bitterness in the mouth - when using eye drops.

Contraindications: pregnancy, lactation, children under 6 years of age.

Loratadine (lorano, claritin, lorizal)

Long-acting H1-histamine receptor blocker. The effect after a single dose of the drug continues throughout the day.

There is no pronounced sedative effect.

When taken orally, it is absorbed quickly and completely, reaches maximum concentration in the blood after 1.3-2.5 hours, and is half eliminated from the body after 8 hours. Biotransformed in the liver.

Indications include any allergic diseases.

It is generally well tolerated. In some cases, dry mouth, increased appetite, nausea, vomiting, sweating, pain in joints and muscles, and hyperkinesis may occur.

Contraindications include hypersensitivity to loratadine and lactation.

Prescribed with caution to pregnant women.

Bamipin (Soventol)

H1-histamine receptor blocker for topical use. Prescribed for allergic skin lesions (urticaria), contact allergies, as well as frostbite and burns.

The gel is applied in a thin layer to the affected areas of the skin. After half an hour, the drug can be reapplied.

Cetirizine (Cetrin)

Metabolite of hydroxyzine.

It has the ability to easily penetrate the skin and quickly accumulate in it - this determines the rapid onset of action and high antihistamine activity of this drug. There is no arrhythmogenic effect.

It is rapidly absorbed when taken orally, its maximum concentration in the blood is observed 1 hour after administration. The half-life is 7-10 hours, but if renal function is impaired, it extends to 20 hours.

The range of indications for use is the same as for other antihistamines. However, due to the characteristics of cetirizine, it is the drug of choice in the treatment of diseases manifested by skin rashes - urticaria and allergic dermatitis.

Take 0.01 g in the evening or 0.005 g twice a day.

Side effects are rare. These are drowsiness, dizziness and headache, dry mouth, nausea.

3rd generation antihistamines

Third generation antihistamines have high antiallergic activity and are devoid of arrhythmogenic effect.

These drugs are active metabolites (metabolic products) of previous generation drugs. They are devoid of cardiotoxic (arrhythmogenic) effect, but retain the advantages of their predecessors. In addition, 3rd generation antihistamines have a number of effects that enhance their antiallergic activity, which is why their effectiveness in treating allergies is often higher than that of the substances from which they are produced.

Fexofenadine (Telfast, Allegra)

It is a metabolite of terfenadine.

Blocks H1-histamine receptors, prevents the release of allergy mediators from mast cells, does not interact with cholinergic receptors, and does not depress the central nervous system. It is excreted unchanged in feces.

The antihistamine effect develops within 60 minutes after a single dose of the drug, reaches its maximum after 2-3 hours, and lasts for 12 hours.

Side effects such as dizziness, headache, weakness are rare.

Desloratadine (erius, eden)

It is an active metabolite of loratadine.

Has anti-allergic, anti-edematous and antipruritic effects. When taken in therapeutic doses, it has virtually no sedative effect.

The maximum concentration of the drug in the blood is achieved 2-6 hours after oral administration. The half-life is 20-30 hours. Does not penetrate the blood-brain barrier. Metabolized in the liver, excreted in urine and feces.

In 2% of cases, while taking the drug, headaches, increased fatigue and dry mouth may occur.

In case of renal failure, prescribe with caution.

Contraindications include hypersensitivity to desloratadine. As well as periods of pregnancy and lactation.

Levocetirizine (aleron, L-cet)

Cetirizine derivative.

The affinity for H1-histamine receptors of this drug is 2 times higher than that of its predecessor.

Facilitates the course of allergic reactions, has a decongestant, anti-inflammatory, antipruritic effect. Practically does not interact with serotonin and cholinergic receptors, does not have a sedative effect.

When taken orally, it is quickly absorbed, its bioavailability tends to 100%. The effect of the drug develops 12 minutes after a single dose. The maximum concentration in blood plasma is observed after 50 minutes. It is excreted primarily by the kidneys. Excreted in breast milk.

Contraindicated in cases of hypersensitivity to levocetirizine, severe renal failure, severe galactose intolerance, deficiency of the lactase enzyme or impaired absorption of glucose and galactose, as well as during pregnancy and lactation.

Side effects are rare: headache, drowsiness, weakness, fatigue, nausea, dry mouth, muscle pain, palpitations.

Antihistamines and pregnancy, lactation

Therapy for allergic diseases in pregnant women is limited, since many drugs are dangerous to the fetus, especially in the first 12-16 weeks of pregnancy.

When prescribing antihistamines to pregnant women, the degree of their teratogenicity should be taken into account. All medicinal substances, in particular antiallergic ones, are divided into 5 groups depending on how dangerous they are to the fetus:

A – special studies have shown that there is no harmful effect of the drug on the fetus;

B – experiments on animals did not reveal any negative effects on the fetus; no special studies were conducted on humans;

C – experiments on animals have revealed a negative effect of the drug on the fetus, but this has not been proven in humans; drugs of this group are prescribed to a pregnant woman only when the expected effect outweighs the risk of its harmful effects;

D – the negative effect of this drug on the human fetus has been proven, but its use is justified in certain situations that threaten the life of the mother, when safer drugs were ineffective;

X – the drug is certainly dangerous for the fetus, and its harm exceeds any theoretically possible benefit for the mother’s body. These drugs are absolutely contraindicated in pregnant women.

Systemic antihistamines during pregnancy are used only when the expected benefit outweighs the possible risk to the fetus.

None of the drugs in this group are included in category A. Category B includes 1st generation drugs - tavegil, diphenhydramine, peritol; 2nd generation – loratadine, cetirizine. Category C includes Allergodil, Pipolfen.

The drug of choice for the treatment of allergic diseases during pregnancy is cetirizine. Loratadine and fexofenadine are also recommended.

The use of astemizole and terfenadine is unacceptable due to their pronounced arrhythmogenic and embryotoxic effects.

Desloratadine, suprastin, levocetirizine cross the placenta and are therefore strictly contraindicated for use by pregnant women.

Regarding the lactation period, we can say the following... Again, uncontrolled use of these drugs by a nursing mother is unacceptable, since no human studies have been conducted on the extent of their penetration into breast milk. If these medications are needed, the young mother is allowed to take the one that is approved for her child to take (depending on age).

In conclusion, I would like to note that even though this article describes in detail the drugs most commonly used in therapeutic practice and their dosages are indicated, the patient should start taking them only after consulting a doctor!

Which doctor should I contact?

If acute allergy symptoms appear, you can contact a therapist or pediatrician, and then an allergist. If necessary, a consultation with an ophthalmologist, dermatologist, ENT doctor, or pulmonologist is scheduled.