Acceptance of first-generation antihistamines is indicated for seasonal and chronic allergic disorders - seasonal allergic rhinitis, vasomotor rhinitis Vasomotor rhinitis - when the nose is constantly incorporated , Allergic conjunctivitis, urticaria.

Some antihistamines used not only to treat allergic diseases. Thus, for example, diphenhydramine also used as an antitussive and sedative, as well as to alleviate motion sickness and symptoms of Parkinson's disease. The antihistamine hydroxyzine can be used as an additional sedative or analgesic agent for general anesthesia before surgery. Promethazine can be used as an analgesic for postoperative pain.

Indications to receive first-generation antihistamines

• Azatadine (Optimine) - for children over the age of twelve and adults in the treatment of chronic allergic rhinitis, chronic urticaria, seasonal allergic rhinitis.
• Azelastine - for children over three years old and adults in the treatment of chronic allergic rhinitis, seasonal allergic rhinitis, vasomotor rhinitis, allergic conjunctivitis.
• Brompheniramine (Dimetane) - for children over six years old and adults in the treatment of allergic rhinitis, hypersensitivity reactions of the first type.
• Chlorpheniramine (Chlor-Trimeton) - for children over two years old and adults in the treatment of allergic rhinitis.
• Clemastine (Clemastine) - for children over six years old and adults in the treatment of chronic allergic rhinitis, seasonal allergic rhinitis, chronic urticaria.
• Cyproheptadine (Tavist) - for children over two years old and adults in the treatment of chronic allergic rhinitis, seasonal allergic rhinitis, chronic urticaria.
• Dexchlorpheniramine (Polaramine) - for children over two years old and adults in the treatment of chronic allergic rhinitis, seasonal allergic rhinitis, chronic urticaria.
• Hydroxyzine (Atarax, Vistaril) - for children of all ages and adults to relieve the symptoms of allergic diseases: itching, nausea, as well as a sedative, analgesic.
• Promethazine (Phenergan) - for children over two years old and adults for the treatment of hypersensitivity reactions of the first type, to alleviate the symptoms of motion sickness, as a sedative and a painkiller.
• Tripelennamine (PBZ) - for children older than one month, and adults in the treatment of chronic allergic rhinitis, seasonal allergic rhinitis, chronic urticaria.
• Antihistamines are the second and third generations are used for the treatment of certain allergic diseases:
• Cetirizine (Zyrtec) - for children over two years old and adults in the treatment of chronic idiopathic urticaria (urticaria), chronic and seasonal allergic rhinitis.
• Fexofenadine (Allegra) - for children over six years old and adults in the treatment of seasonal allergic rhinitis and chronic idiopathic urticaria (urticaria).
• Loratadine (Claritin) - for children over two years old and adults in the treatment of seasonal allergic rhinitis and chronic idiopathic urticaria (urticaria).
• Desloratadine (Clarinex) - for children over the age of twelve and adults in the treatment of chronic idiopathic urticaria (urticaria), chronic and seasonal allergic rhinitis.

Contraindications and precautions

Contraindications to receiving first-generation antihistamines: Hypersensitivity to the drug, glaucoma uzkouglovaya Glaucoma - a perspective possible blindness , Gastric ulcer or duodenal ulcer, symptomatic prostatic adenoma, obstruction of the bladder Urinary bladder - structure and function , Bladder neck contracture, lower respiratory tract disease (including asthma), antidepressants - monooksidazy inhibitors. Antihistamines are the first generation is not recommended for lactating women, newborns, young children, the elderly and people weakened by illness.

Contraindications to receive antihistamines second and third generation: Hypersensitivity to the drug. Desloratadine is contraindicated in individuals with hypersensitivity to loratadine and cetirizine - people with hypersensitivity to hydroxyzine.

Side effects

Side effects of first generation antihistamines:

• Allergic - photosensitivity, anaphylactic shock, dermatitis, allergic rashes.
• Cardiovascular - hypotension, palpitations, reflex tachycardia Tachycardia - the body to the limit? , Thrombus formation at the injection site (characteristic of promethazine).
• Disorders of the central nervous system - drowsiness, weakness, dizziness, loss of coordination, fainting.
• Disorders of the gastrointestinal tract - stomach discomfort, lack of appetite, bitter taste in the mouth.
• Disorders of the genitourinary system - frequent urination, dysuria (difficulty or pain when urinating).
• Respiratory - the feeling of chest tightness, dryness of the mouth, nose and throat irritation, burning sensation in the nasal cavity, sealing the contents of the bronchi, nasal bleeding.

Side effects of antihistamines second and third generation:

• Allergic - photosensitivity, anaphylactic shock, dermatitis, allergic rashes.
• Respiratory - dryness of the mouth, throat (typical for loratadine, cetirizine).
• Disorders of the central nervous system - drowsiness, weakness, headache, fainting.
• Disorders of the gastrointestinal tract - nausea, vomiting, diarrhea (typical for tsetrizina, fexofenadine).

An allergy to fluconazole is not as common. But the feature of this product is the possibility of severe allergic reactions such as erythema multiforme exudative, Stevens - Johnson syndrome and toxic epidermal necrolysis. Such allergy require immediate medical attention.

Immediate allergic reaction to fluconazole

Repeated use of fluconazole may occur such immediate type allergic reactions like hives, angioedema (angioedema) and anaphylactic shock.

Allergic reactions of immediate type proceed with the formation of antibodies belonging to the class of immunoglobulin E (IgE). Antibodies are attached to certain types of leukocytes in conjunction with such antibodies corresponding allergen (antigen) in these cells is allocated a biologically active substance, 15-20 minutes causing an allergic reaction (mediators, such as histamine).

Hives and angioedema develop 15-20 minutes after taking fluconazole inside. Urticaria - is the most common type of immediate reaction to the defeat of the surface layers of the skin. It is manifested in the form of itchy blisters (papules - elevations on the skin), as in the sting. Papules first are small (up to 5 mm in diameter) .. Gradually increase the number of papules, they grow up, have the middle and bright red edges, merge with each other, covering large areas of skin. Rash hives can pass quickly, but can last several hours, it is rarely lasts more than two days.

Angioedema (angioneurotic edema) can be a complication of urticaria, with allergic reactions are involved in the deeper layers of the skin and subcutaneous tissue, which leads to swelling Prevention and treatment of edema - it is important to understand the root cause . This itching is most often held, but may appear a burning sensation and pain. In the propagation of swelling on the vocal cords can occur threat to life.

The cause of urticaria and angioedema is the release of large amounts of histamine. Therefore, at the first sign of hives should take an antihistamine (fenistil, Claritin Claritin - histamine receptor blocker , Tavegilum and so on). If that does not work and is rapidly spreading rash, you should call an ambulance.

Anaphylaxis can occur with intravenous drip of fluconazole. It is manifested very quickly, sometimes within a few seconds after the start of administration of fluconazole. Appears depression of consciousness, drop in blood pressure Blood pressure - dangerous if his swing? , Cramps, involuntary urination, sometimes - fast growing angioedema or bronchospasm.

When these symptoms should immediately discontinue administration of fluconazole, tourniquet above the site of administration put the patient in a horizontal position (on the side) and pull the tongue out of his mouth to prevent him and sticking of strangulation. The following activities should be medical in nature.

Allergic reactions immediate-delayed type to fluconazole

These allergic reactions may include exudative erythema multiforme and extreme poverty - Stevens - Johnson. The disease begins with the rise of temperature and the appearance of facial skin, mucous membranes, extensor surface of the extremities, back of the hands and feet, hands, torso, symmetrical arrangement of a rash of different nature. Gradually middle elements disease bubbles are formed with a transparent or bloody contents which burst and form erosion. Land erosion merge among themselves, are covered by a yellowish coating, and then peel. Resolution of rash occurs after two to three weeks.

Very often affects the oral mucosa, gastrointestinal tract, airways. The heavy defeat of this kind are called Stevens-Johnson syndrome. This also develop eye lesions of the mucous membranes of the nasal cavity, the genital organs. The patient's condition can be very serious, even his possible death.

Treatment of Stevens-Johnson syndrome in most cases carried out in intensive care.

Immediate allergic reaction to fluconazole

Severe reactions such as delayed at fluconazole can be toxic epidermal necrolysis or Lyell's syndrome. This type of reaction starts after 24-48 hours after repeated oral or intravenous fluconazole. Starts toxic epidermal necrolysis relatively slowly, the temperature rises, growing signs of intoxication, the skin appears at first papular rash or punctulate and then on her background appear larger flat bubbles with clear or bloody contents resembling skin burns. They quickly opened with the advent of extensive erosion of bright red color. At the same time if you rub a healthy patch of skin, it is separated to form erosion. The patient's condition is deteriorating on the rise: join toxic-allergic lesions of the internal organs and in the absence of immediate intensive care patient dies.

An allergy to fluconazole occurs, so the appearance of the skin lesions of any patient should immediately stop treatment with fluconazole Fluconazole - used with caution   and seek medical help.

Galina Romanenko