Doxepin may be useful at initial stages especially at night due to its sedative effect. ,but it has interactions with lots of medication in case of polypharmacy in elderly patients. Young adults may also not tolerate sedating medication during the day.
I found combination of non sedating antihistamine during the day and sedating ones at night with low dose of steroid daily useful in some of my patients.
Mr Ibrahim
how long for systemic steroid? systemic steroid has significant side effect>
Javad
I agree that ,long term low dose are not usually recommended duty to side effects, but in rare cases it may be warranted on alternate days. Doses during the flaring of urticarial.
Most chronic urticaria are idiopathic biut about 10% are due to autoimmune so relevant autoantibodies should be part if investigation,
Combinations of antihistamine and sedative ones at night are found to be more effective than one type of antihistamine.
Also Antileukotriene agents such as Montelukast could be used .
Note Cetirizine is the quickest acting antihistamine and desloratidine is the most long acting .
Sorry missed some key points above. I meant that I agreed with you that. Long term use of steroid even at low dose is not usually recommended.
Thank you Salau.
my experience showed often chronic urticaria response to antihistamine , antileukotreine and Doxepine.
chronic resistant urticaria, well it is almost the saame as Chr idiopathic urticaria. cause for most of these cases are unknown. anti histamines are main stay. levocetrizine, hydroxyzine, levocetrizine, or alternate day low dose steroid which again is monitored.
search for a cause has most often not given good results.
doxepine has a mild sedative and anxiolytic effect.
more study required to associate cases with immune function disorders.
Dear
what is your experience about IVIG in treatment of chronic urticaria?
Dear
simple chronic urticaria ( no fever,no artheritis,no organomegally and etc. Do you recommend evaluation of collagen tissue disorders?
Sir with due respects.
connective tissue disorders evaluation is done taking into consideration a proper history and examination to rule out assciations. very often a simple chronic urticaria is seen as a simple ailment.. the final call for the test lies with the examining physician
Idiopathic would be the most common condition and very rarely an association with connective tissue disorders. What i meant was please do not overlook connective tissue disorder.
Dear
what is your commend about alternative and or traditional therapy in simple cu? People have different culture in different countries.
I agree that most urticaria are idiopathic, but it can be a sign of parasite infection our country. Many patients, who are living in the central Vietnam, have been infected a Toxocara spp kind leading to chronic urticaria and these cases should be treated with antiparasite agents.
Here is one article about urticaria and immune dysfunction.
http://www.google.co.in/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=6&cad=rja&ved=0CEYQFjAF&url=http%3A%2F%2Fwww.allergyclinic.co.za%2Fallergies%2Furticaria%2F&ei=1vzhUpHYNYOqkAXF3oGQBw&usg=AFQjCNEAZ2t9TqaXKNj_WdQ8yb7FJzHkEw&sig2=zj7WdBr1zBy5dOpfopUWuw
Kindly go through the article
http://www.google.co.in/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=7&cad=rja&ved=0CEwQFjAG&url=http%3A%2F%2Fwww.aaaai.org%2FAaaai%2Fmedia%2FMediaLibrary%2FPDF%2520Documents%2FPractice%2520and%2520Parameters%2Furticaria_prt2-(1).pdf&ei=1vzhUpHYNYOqkAXF3oGQBw&usg=AFQjCNFn1to9h2_-26hluxABrlQH7Tn0dA&sig2=mIxE6SK_xXc0XV4dZ1x03g
Dear Giogi
could you upload a research paper of your country about parasitic infection and urticaria?
Dear Giogi
could you upload a research paper of your country about parasitic infection and urticaria?
- Badges
- Science topic
- Similar topics
- Medicine