Corticosteroids allergy

Allergy. Corticosteroids, particularly hydrocortisone and budesonide, or other ingredients in the for-... 

Antihistamines are drags used to counteract the effects of histamine on body organs and structures. Examples of antihistamines include diphenhydramine (Benadryl), loratadine (Claritin), fexofenadine (Allegra), and cetirizine (Zyrtec). A new antihistamine, deslorata-dine (Clarinex), is die active metabolite of loratadine and is intended to eventually replace loratadine (Claritin). Topical corticosteroid nasal sprays such as fluticasone propionate (Flonase) or triamcinolone ace-tonide (Nasacort AQ) are also used for nasal allergy symptoms. See Chapter 56 for more information on die topical corticosteroids. 

Transgrund AJ, Whitaker AL, Small RE. Intranasal corticosteroids for allergic rhinitis. Pharmacotherapy 2002 22 1458-1467. van Cauwenberge P, Bachert C, Passalacqua G, et al. Consensus statement on the treatment of allergic rhinitis. Allergy 2000 55 116-134. 

If all these avenues are ineffective, short-term topical corticosteroids and immunotherapy are the third-line treatments for ocular allergy.17... 

Evaluate the patient for drug interactions, allergies, and adverse effects with chemotherapy and/or corticosteroid therapy. 

Because of its high cost, it is only indicated as step 5 or 6 care for patients who have allergies and severe persistent asthma that is inadequately controlled with the combination of high-dose inhaled corticosteroids and long-acting /f2-agonists. 

Hawrylowicz C, Richards D, Loke TK, Corrigan C, Lee T A defect in corticosteroid-induced IL-10 production in T lymphocytes from corticosteroid-resistant asthmatic patients. J Allergy Chn Immunol 2002 109 369-370. 

Frick OL, Teuber SS, Buchanan BB, Morigasaki S, Umetsu DT Allergen immunotherapy with heat-killed Listeria monocytogenes alleviates peanut and food-induced anaphylaxis in dogs. Allergy 2005 60 243-250. Stock P, Akbari 0, DeKruyff RH, Umetsu DT Respiratory tolerance is inhibited by the administration of corticosteroids. J Immunol 2005 175 7380-7387. 

Hoogsteden HC Increased numbers of dendritic cells in the bronchial mucosa of atopic asthmatic patients downreg-ulation by inhaled corticosteroids. Clin Exp Allergy 1996 26 517-524. 

C may be treated initially with corticosteroid scalp application D is a lifelong condition E is a form of food allergy... 

Sofradex contains dexamethasone, framycetin and gramicidin and is indicated in otitis externa. Canesten contains clotrimazole and is indicated for fungal infections and may be used in otitis externa where a fungal infection is suspected. Nasonex contains mometasone, a corticosteroid, and is used in nasal allergy. 

Dermatitis is a common inflammatory condition, which may require the use of 0 potent topical corticosteroid. Rosacea is a skin disorder whereby the blood vessels of the face become more prominent giving the face a flushed appearance. Urticaria refers to the appearance of red wheals, which may be due to on allergy. 

Bismuth Subsalicylate (Pepto-Bismol) [Antidiarrheal/ Adsorbent] [OTC] Uses Indigestion, N, D combo for Rx of H. pylori Infxn Action Antisecretory anti-inflammatory E>o e Adults. 2 tabs or 30 mL PO PRN (max 8 doses/24 h) Feds. 3—6 y 1/3 tab or 5 mL PO PRN (max 8 doses/24 h) 5-9 y 2/3 tab or 10 mL PO PRN (max 8 doses/24 h) 9-72 y 1 tab or 15 mL PO PRN (max 8 doses/24 h) Caution [C, D (3rd tri), -] Avoid w/ renal failure Hx severe GI bleed Contra Influenza or chickenpox (T risk of Reye synd), ASA allergy (see Aspirin) Disp Chew tabs, caplets, Liq, susp SE May turn tongue stools black Interactions T Effects OF ASA, MTX, valproic acid effects OF tetracyclines i effects W/ corticosteroids, probenecid EMS Monitor for hypovolemia and electrolyte disturbances d/t D may darken tongue stool OD Similar to ASA OD V, tinnitus, metabolic acidosis activated charcoal may be effective... 

Barnes PJ. Efficacy of inhaled corticosteroids in asthma. J Allergy Clin Immunol 1998 102 531-8. 

Boushey HA. Effects of inhaled corticosteroids on the consequences of asthma. J Allergy Chn Immunol 1998 102 S5-S16. 

Fluorination of corticosteroids at C-9 or/and C-6 increases glucocorticoid activity, while mineralocorticoid activity, responsible for sodium retention (the main adverse effect of corticoids), is decreased (cf. Chapter 4). Fluorocorticoster-oids were the first fluorinated compounds to be used clinically. They are still major drugs against many inflammatory disorders rheumatoid polyarthritis, ORL (asthma, rhinitis), brain edema, dermatological, allergies, anaphylactic shock, Quincke s edema). 

Intranasal corticosteroids are preferred therapy unless allergy symptoms are mild and infrequent... 

Omalizumab is an anti-IgE recombinant humanized monoclonal antibody that is approved for the treatment of allergic asthma in adult and adolescent patients whose symptoms are refractory to inhaled corticosteroids (see Chapter 20). The antibody blocks the binding of IgE to the high-affinity Fes receptor on basophils and mast cells, which suppresses IgE-mediated release of type I allergy mediators such as histamine and leukotrienes. Total serum IgE levels may remain elevated in patients for up to 1 year after administration of this antibody. 

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