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چرا داروي داكسپين را مي گويند : نيست؟ |
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نوشته شده توسط مدير سايت
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۱۲ شهريور ۱۳۹۰ |
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Antihistamines. Systemic antihistamines act primarily by blocking the H1-receptors in the dermis, thereby reducing histamine-induced pruritus. However, histamine is only one of many mediators that can induce pruritus of the skin and, therefore, patients may derive minimal benefit from a
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ntihistaminic therapy. Because pruritus is usually worse at night, the sedating antihistamines (e.g., hydroxyzine or diphenhydramine) may offer an advantage with their soporific adverse effects when used at bedtime. Doxepin hydrochloride has both tricyclic antidepressant and H1- and H2-receptor blocking effects. If nocturnal pruritus remains severe, short-term use of a sedative to allow adequate rest may be appropriate. Studies of newer nonsedating antihistamines have shown variable results in the effectiveness of controlling pruritus in AD, although they may be useful in the small subset of AD patients with concomitant urticaria.
Systemic Glucocorticoids. The use of systemic glucocorticoids is rarely indicated in the treatment of chronic AD. The dramatic clinical improvement that may occur with systemic glucocorticoids is frequently associated with a severe rebound flare of AD after discontinuation. Short courses of oral glucocorticoids may be appropriate for an acute exacerbation of AD, whereas other treatment measures are being instituted. If a short course of oral glucocorticoids is given, it is important to taper the dosage and begin intensified skin care, particularly with topical glucocorticoids and frequent bathing followed by application of emollients, to prevent rebound flaring of AD.
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