--Chlorpheniramine maleate, Cetirizine Hydrochloride, Loratadine,
Promethazine hydrochloride, Adrenalin, Hydrocortisone, Dexamethasone and
Calamine lotion Chlorpheniramine maleate is used in symptomatic relief of allergy such as hay fever, urticaria; emergency treatment of anaphylactic reactions Cetirizine Hydrochloride, Loratadine are used in symptomatic relief
of allergy such as hay fever and chronic idiopahtic urticaria Adrenalin is used in emergency treatment of acute anaphylaxis, angioedema and cardiopulmonary resuscitation Hydrocortisone is used in adrenocortical insufficiency,
hypersensitivity reactions e.g. anaphylactic shock and angioedema
asthma, severe inflammatory bowel disease, haemorrhoids and rheumatic
disease Dexamethasone is used in suppression of inflammatory and allergic
disorders, diagnosis of Cushing’s disease, congenital adrenal
hyperplasia, cerebral oedema associated with malignancy, nausea and
vomiting with chemotherapy Calamine lotion is indicated for pruritus Most individual drug which can be used as anti-allergies has different properties which make them to be contraindicated to patient with some specific conditions. Chlorpheniramine maleate like many antihistamines it should be avoided in acute porphyria Cetirizine Hydrochloride and Loratadine like many antihistamines they
should be avoided in acute porphyria they should also be avoided in
pregnancy and breast-feeding Promethazine hydrochloride like many antihistamines it should be avoided in acute porphyria Hydrocortisone and dexamethasone are contraindicated to patients with systemic infection (unless specific therapy given): Chlorpheniramine maleate Promethazine hydrochloride By mouth, 10–20 mg 2–3 times daily; CHILDREN under 2 years not recommended, 2–5 years 5–15 mg daily in 1–2 divided doses, 5–10 years 10–25 mg daily in 1–2 divided doses Adrenalin Hydrocortisone Dexamethasone Effects and Adverse Effects of Anti-Allergies Chlorpheniramine maleate and Promethazine Hydrochloride Drowsiness Cetirizine Hydrochloride and Loratadine Psychomotor impairment Adrenalin Nausea, vomiting, tachycardia, arrhythmias, palpitation, cold extremities, hypertension (risk of cerebral haemorrhage); dyspnoea, pulmonary oedema (on excessive dosage or extreme sensitivity); anxiety, tremor, restlessness, headache, weakness, dizziness; hyperglycaemia; urinary retention; sweating Calamine lotion No reported side effect so farAnti-allergies listed in essential medicine list include;
Indications of drugs with anti-alergies properties are;
Promethazine hydrochloride is used in symptomatic relief of allergy such as hay
fever and urticaria; emergency treatment of anaphylactic reactions; sedation nausea and vomitingContraindication of Anti-allergies
Live virus vaccines should also be avoided due to possible suppression of immunity because serum antibody response diminished)Dose, Dosage and Course of Anti-allergies
By mouth, 4 mg every 4–6 hours, max. 24 mg daily Children, 1–2 years 1 mg twice daily; 2–6 years 1 mg every 4–6 hours, maximum 6 mg daily; 6–12 years 2 mg every 4–6 hours, max. 12 mg daily
By intramuscular injection or by intravenous injection over 1 minute, 10 mg, repeated if required up to 4 times in 24 hours; CHILD under 6 months 250 micrograms/kg (max. 2.5 mg), repeated if required up to 4 times in 24 hours; 6 months–6 years 2.5 mg, repeated if required up to 4 times in 24 hours; 6–12 years 5 mg, repeated if required up to 4
Cetirizine Hydrochloride and Loratadine
ADULT and CHILD over 6 years 10 mg once daily; CHILD 2–6 years 5 mg once daily
By deep intramuscular injection, 25–5mg; max.100 mg; CHILD 5–10 years 6.25–12.5 mg
By slow intravenous injection in emergencies, 25–50 mg as a solution containing 2.5 mg/mL in water for injections; max. 100 mg
The drug should be administered twice daily for not more than five days
Acute anaphylaxis, by intramuscular injection of 1 in 1000 (1 mg/mL) solution.
Acute anaphylaxis when there is doubt as to the adequacy of the circulation, by slow intravenous injection of 1 in 10 000 (100 micrograms/mL) solution
By mouth, replacement therapy, 20–30 mg daily in divided doses, CHILDREN 10–30 mg
By intramuscular injection or slow intravenous injection or infusion, 100–500 mg, 3–4 times in 24 hours or as required; CHILDREN by slow intravenous injection up to 1 year 25 mg, 1–5 years 50 mg, 6–12 years 100 mg
By mouth, usual range 0.5–10 mg daily; CHILDREN 10–100 micrograms/kg daily
By intramuscular injection or slow intravenous injection or infusion (as dexamethasone phosphate), initially 0.5–24 mg
CHILDREN 200–400 micrograms/kg daily Cerebral oedema associated with malignancy (as dexamethasone phosphate), by intravenous injection, 10 mg initially, then 4 mg by intramuscular injection every 6 hours as required for 2–4 days then gradually reduced and stopped over 5–7 days
Calamine lotion should be applied occlusive to the affected partSide and adverse effects of ant allergies
Headache
Psychomotor impairment
Antimuscarinic effects such as urinary retention, dry mouth, blurred vision, and gastro-intestinal disturbances
Other rare side-effects of antihistamines include hypotension, palpitation, arrhythmias, extrapyramidal effects, dizziness, confusion, depression, sleep disturbances, tremor, convulsions, hypersensitivity reactions (including bronchospasm, angioedema, and anaphylaxis, rashes, and photosensitivity reactions)
Dermatitis and tinnitus reported
antimuscarinic effects such as urinary retention, dry mouth, blurred vision, and gastro-intestinal disturbances
Other rare side-effects of antihistamines include hypotension, palpitation, arrhythmias, extrapyramidal effects, dizziness, confusion, depression, sleep disturbances, tremor, convulsions, hypersensitivity reactions (including bronchospasm, angioedema, and anaphylaxis, rashes, and photosensitivity reactions)
Tissue necrosis at injection site
Hydrocortisone and Dexamethasone
Mineralocorticoid side-effects include hypertension, sodium and water retention, and potassium and calcium loss
Glucocorticoid side-effects include diabetes and osteoporosis which is a danger, particularly in the elderly, as it can result in osteoporotic fractures for example of the hip or vertebrae
Other side-effects include: gastro-intestinal effects: dyspepsia, abdominal distension, acute pancreatitis, oesophageal ulceration and candidiasis
Musculoskeletal effects: muscle weakness, vertebral and long bone fractures, tendon rupture
Endocrine effects: menstrual irregularities and amenorrhoea, hirsutism, weight gain
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Hello, I am a patient with an acute porphyria diagnosis and wonder if you could please provide me with some links to the research that were used to establish the connection between the acute porphyrias and anti-allergy (anti-histamine) intolerance. I have had great difficulty in convincing my GP that I cannot tolerate Loratadine and Promethazine for management of the nausea and vertgo which have been with me since a major flare a few years ago. Since I'm just a patient maybe showing him some science might prove my point for me. Thanks.