Dangers of Allergy Meds for Your Heart

Allergy medications might seem harmless enough — they’re sold over the counter (OTC), so that makes them safe, right?

Not necessarily.

Though allergy drugs can stop the misery of seasonal bouts with pollen, hay fever, and grasses, some can aggravate a heart condition, or be downright dangerous when mixed with blood pressure drugs and certain heart medicines.

“If a patient has allergies or a cold and is considering OTC medications, it is always recommended to talk with the pharmacist on site, or to ask your physician for recommendations in the context of the other medications that are prescribed,” says L. Kristin Newby, MD, MHS, a cardiology professor at Duke Medicine in Durham, North Carolina.  

“Some OTC medications — for example, those containing pseudoephedrine or similar components — may cause increases in heart rate or blood pressure that could exacerbate some cardiac conditions,” explains Dr. Newby.

Which Allergy Meds Are Safe for Your Heart?

There are three major classes of allergy medications:

“In general, antihistamines are safe in patients with high blood pressure and other forms of heart disease,” explains Richard Krasuski, MD, director of adult congenital heart disease services at the Cleveland Clinic in Ohio, but an antihistamine may elevate blood pressure or increase heart rate, according to the U.S. Food and Drug Administration (FDA).

Antihistamines for allergies include common OTC allergy drugs such as loratadine (Claritin), fexofenadine (Allegra), and cetirizine (Zyrtec). However, if the drug also has a “D” after the name, be aware that it contains an added decongestant that can cause problems.

The combination of decongestants and blood pressure problems can be big trouble, according to the American Heart Association. Dr. Krasuski says it’s important that people with high blood pressure and other heart problems avoid decongestants, especially pseudoephedrine (Sudafed and other brands). “They can raise the blood pressure and increase the pulse, neither of which is ideal in either problem,” he says. “They can also increase the risk for heart rhythm disturbances such as atrial fibrillation.”

The way decongestants ease allergy congestion is by constricting the blood vessels, which helps to shrink swollen mucus membranes in the nose. “Unfortunately, this vasoconstriction can also occur throughout the body and can lead to an increase in blood pressure and/or heart rate,” says Kristen Bova Campbell, PharmD, a cardiology clinical pharmacist and program director of the cardiology pharmacy residency at Duke University Hospital.

“This can reduce the antihypertensive effects of blood pressure medications and lead to loss of blood pressure control,” adds Dr. Campbell.

Anti-inflammatory allergy medications, such as intranasal steroids, are typically considered safe, as long as you take the exact prescribed dosage. Take too many, and you can wind up with salt and water retention. And they can raise blood pressure, counteracting the effects of your blood pressure medications, Krasuski says.

Heart-Healthy Tips for Allergy Drug Safety

Problems with over-the-counter allergy medications are not uncommon. That makes it all the more important to rely on the knowledge and guidance of your healthcare team, from your doctor to your pharmacist.

Your individual risk can depend on a number of factors, but there’s a basic rule of thumb: More drugs means more risk. “The more medications that the patient is on, the greater the risk for interactions,” Krasuski says. “Most medications are either removed from the body by the liver or the kidney. Patients with liver or kidney problems as well as older patients are also at great risk for medication problems.”

To be safe, always check labels before taking an allergy medication to make sure you know what’s in it. “It is important to recognize that antihistamines are often paired with the decongestants,” says Krasuski. “In such cases, the medication name will have a “D” at the end, which stands for pseudoephedrine.”

As noted above, anyone with high blood pressure, heart rhythm problems, or other heart problems should avoid allergy medications with a “D” added after the name.

But you can still find relief from allergy symptoms, and safely, even if you have heart problems. “There are prescription medications that are generally well tolerated when used in conjunction with heart medications,” Newby says. Talk over your options at your next a visit with your cardiologist or other health care provider.

“It is always important to discuss your medications with both your doctor and your pharmacist,” stresses Krasuski. “Bring your medicines to your appointment or to the pharmacy. Sharing your list of OTC medications is critical as this is often missed during routine office visits.”

Also, try to have all of your prescriptions filled at the same pharmacy. This way, the staff has all of your medications on file. And don’t be shy about asking your pharmacist some safety questions. Be your own health advocate.

Alternative Methods for Controlling Allergies

RELATED: 10 Allergy-Fighting Tricks You May Not Have Tried

If you continue to suffer from allergy symptoms but can’t take allergy medications because of high blood pressure or other heart problems, there are other ways you can help mitigate the sneezing, sniffling, coughing, and watery eyes that allergies can trigger.

Consider these allergy-control methods:

• Run a dehumidifier, because mold loves moisture.
• Use allergen-reducing bedding such as mattress and pillow protectors.
• Try a saline nasal spray or wash to reduce nasal congestion.

What allergy medicines can I safely take if I have heart disease or high blood pressure?

Oklahoma Heart Institute Director of Interventional Laboratories, Dr. Wayne Leimbach, shares insights on allergies, heart disease and high blood pressure on our blog today.

Springtime brings not only beautiful weather and beautiful flowers, but it also brings high pollen counts and suffering to people with allergies.  Many people often ask what allergy medicines can I safely take if I have heart disease or high blood pressure.  Many allergy medications include decongestants that can raise blood pressure, create palpitations and interfere with some other heart medications.

Medications that often can be safely used by people with significant allergies include nasal corticosteroids.  In addition, antihistamines are very effective.  The antihistamines include fexofenadine (Allegra), cetirizine (Zyrtec), loratadine (Claritin) and diphenhydramine (Benadryl).

Often manufactures will include a decongestant with the antihistamines in order to provide additional control of the runny nose often seen with allergies.  Manufacturers will often indicate which of the antihistamines also contain a decongestant by adding the letter D to the name of the medicine.  These decongestants can be phenylephrine or pseudoephedrine or oxymetazoline.

For patients who have high blood pressure, rhythm problems (palpitations), or who have severe blockages in their blood vessels to their heart, these decongestants have the potential to cause problems.  Decongestants can raise blood pressure or stimulate fast heart rhythms.  Anyone with heart conditions or high blood pressure, before taking medications that include phenylephrine or pseudoephedrine, should consult their doctor to see if they can safely take such medicines. 

Therefore, advertised medicines such as Allegra, Zyrtec, or Claritin should be safe for most patients with heart disease and allergies; however, Allegra-D, Zyrtec-D, Claritin-D could cause problems for patients with allergies and heart disease. 

Why High Blood Pressure and Cold Meds Don’t Mix

Cold medicines are not off-limits if you have heart disease, but patients with high blood pressure, or hypertension, should check the label carefully when choosing a cold or allergy medicine.

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That’s because decongestants such as pseudoephedrine, ephedrine, phenylephrine, naphazoline and oxymetazoline can increase your blood pressure and heart rate. Make sure the cold or allergy medication you plan to take is free of those ingredients.

Decongestants can also prevent your blood pressure medication from working properly. And always check the active and inactive ingredient lists, because many medications are high in sodium, which also raises blood pressure.

For allergy sufferers with heart disease, medicines such as Allegra, Zyrtec or Claritin should be safe. However, medicines containing decongestants — including Allegra-D, Zyrtec-D and Claritin-D — could increase your blood pressure and heart rate or interfere with your heart medication.

Managing a cold with hypertension

If you can’t take a decongestant because of high blood pressure, there are other ways to reduce your cold or allergy symptoms:

• Take Coricidin HBP, which is free of decongestants

• Drink plenty of fluids — including water, juice, tea and soup — to prevent dehydration and clear mucus from your lungs 

• Take a pain reliever such as Tylenol or Motrin for fever, sore throat, body aches and headache

• Flush your sinuses with a saline spray to relieve nasal congestion

• Soothe a sore or scratchy throat with lozenges

• Use a vaporizer or humidifier if necessary to boost humidity

• Get plenty of rest

• Return to your doctor after five to seven days to make sure you’re on the road to recovery

Before taking any new medication

Always check with your pharmacist before you take a new medication, whether it’s for a cold, allergies or something else, to find out if it is compatible with certain medical conditions and your current drug therapy.

SEE ALSO: Millions More People Now Have High Blood Pressure. Why That’s a Good Thing

If you have a heart condition, be sure to discuss all medication choices with your cardiologist before taking anything.

Everything You Need to Know

Allergy season seems to be year-round these days. This means, for some, battling symptoms like sneezing, congestion, runny nose, itching, and watery eyes. If you are among these allergy sufferers, you may head to a pharmacy near you for relief. 

It may be a bit tricky if you have hypertension (high blood pressure). We have a few tips to help you out when choosing the best and safest medicine for allergy relief. Read on to learn how some allergy medicines may affect your blood pressure and your blood pressure medication.

Allergy Medication and Hypertension

Some allergy medicines can affect your blood pressure or interact with your blood pressure medication. Don’t fret! There are safe options out there for treating your allergy symptoms relative to your high blood pressure and we will review them here.

While most antihistamines are generally safe to take with your blood pressure medication, we want you to keep in mind the following drug interactions if you are taking medicines for your blood pressure:

• Fexofenadine (Allegra) and Carvedilol (Coreg): This may increase the side effects of fexofenadine. You may want to use fexofenadine cautiously if you are taking carvedilol.
• Cetirizine (Zyrtec) and levocetirizine (Xyzal): If either of these drugs is combined with methyldopa (Aldomet), you may experience increased drowsiness.
• Diphenhydramine (Benadryl): Make sure to talk with your doctor before taking any diphenhydramine products because any product containing itmay counteract the effects of some blood pressure medications.

Second-generation antihistamines that are not combined with decongestants are generally [2] safe to use if you arenot taking the blood pressure medicines listed in the section above. The same goes for intranasal corticosteroids. Second-generation antihistamines and intranasal corticosteroids include the following:

• Zyrtec (cetirizine)
• Clarinex (desloratadine)
• Claritin (loratadine)
• Xyzal (levocetirizine)
• Allegra (fexofenadine)
• Flonase
• Nasacort
• Nasonex
• Rhinocort

Antihistamine eye drops, such as Pataday (olopatadine) and Zaditor (ketotifen), are also safe options for itchy and watery eyes.

Allergies can also have a recurring effect that can cause highblood pressure. For example, if you have seasonal allergies, you may have aconstant stuffy nose. While it can be annoying, and you may not even see it asa cause for concern, this can lead to sleep apnea which is a much more severe health concern. Sleep apnea occurs when your breathing is interrupted duringsleep. Over time, nasal congestion can contribute to sleep apnea, which can lead to high blood pressure and even other more serious health conditions.

Can Allergy Medications Increase Blood Pressure?

Although allergies don’t usually directly increase blood pressure, they can indirectly contribute to high blood pressure. When you choose to use decongestants, such as pseudoephedrine (Sudafed, Actifed, others)and phenylephrine (Sudafed PE), you can worsen the existing high blood pressure.  

Decongestants constrict blood vessels to open nasal passages and facilitate breathing. This can worsen hypertension because they are not selective to just blood vessels in the nose and thus, can constrict blood vessels in other parts of the body and increase blood pressure.

Although these medicines can ease nasal congestion and improve breathing, they can constrict blood vessels throughout the body, making the heart work harder to pump blood. This is what increases blood pressure. 

When choosing an over-the-counter allergy medication, beware of combination products that contain decongestants. These products typically have the words sinus, cold, congestion, or decongestant on the label. They also might be labeled with the letters D, PD, or PE after the name.

If you choose to take an over-the-counter allergy product, look for one that doesn’t contain pseudoephedrine or phenylephrine. Some Antihistamines can help with the congestion that accompanies allergies and is safer for the heart, such as cetirizine (Zyrtec), fexofenadine (Allegra) diphenhydramine (Benadryl), and loratadine (Claritin).

Are nasal sprays harmful for people with hypertension? 

Nasal sprays are actually an option that is less impactful to use on the rest of your body. Nasal sprays act directly on the nose’s blood vessels and have less impact anywhere else in the body. 

If your allergy symptoms include nasal congestion, here are some options that are generally safe to use as decongestants:

• steroid nasal sprays (i.e. Flonase (fluticasone), Nasacort(triamcinolone), and Rhinocort (budesonide))
• antihistamine nasal sprays (i.e. Astelin (azelastine) and Patanase (olopatadine))
• saline nasal sprays or rinses, such as Ayr, Ocean, SimplySaline, or Neti Pot

Does Dayquil help with allergies?

Dayquil can be used to relieve symptoms temporarily caused by allergies. It will help relieve watery and itchy eyes, throat, runny nose, and sneezing. As usual, we do recommend that you consult a professional before using it as a treatment for your allergies.

Over the counter and even some prescription medicines are solutions that we get used to but are not long-term solutions. We want you to live your life to the fullest, without allergies or sinus issues. So, if you are ready to get rid of your allergy symptoms, schedule your appointment with one of our allergy specialists today!

Can antihistamines cause high blood pressure? – Mvorganizing.org

Can antihistamines cause high blood pressure?

Can antihistamines cause high blood pressure? If you’re already taking medication for high blood pressure, combining that with an antihistamine can increase your heart rate and raise your blood pressure.

What is the best allergy medicine for someone with high blood pressure?

What Allergy Medicines Can I Take if I Have High Blood Pressure?

• Allegra (fexofenadine)
• Clarinex (desloratadine)
• Claritin (loratadine)
• Xyzal (levocetirizine)
• Zyrtec (cetirizine)

Can allergy medicine affect blood pressure?

Many allergy medications include decongestants that can raise blood pressure, create palpitations and interfere with some other heart medications. Medications that often can be safely used by people with significant allergies include nasal corticosteroids. In addition, antihistamines are very effective.

What is the best decongestant for high blood pressure?

Coricidin ® HBP is the #1 selling† brand of powerful cold medicine specially formulated for those with high blood pressure. According to the American Heart Association (AHA), nasal decongestants in common cold medications may raise one’s blood pressure.

Does allergies affect blood pressure?

Although allergies don’t usually directly increase blood pressure, they can indirectly contribute to high blood pressure.

What can I take for sinusitis with high blood pressure?

Phenylephrine. For those with high blood pressure, phenylephrine is an alternative to pseudoephedrine. They are in the same drug class known as nasal decongestants, which help relieve sinus congestion and pressure. You can buy products containing phenylephrine right off the shelf at the pharmacy.

Can sinus congestion cause high blood pressure?

Decongestants relieve nasal stuffiness by narrowing blood vessels and reducing swelling in the nose. This narrowing can affect other blood vessels as well, which can increase blood pressure.

Is mucinex OK with high blood pressure?

Yes, it’s fine for you to take Mucinex DM if you have high blood pressure. It contains two active ingredients: dextromethorphan and guaifenesin. Dextromethorphan is a cough suppressant.

Can Flonase cause high blood pressure?

Can FLONASE products increase blood pressure? When used as directed, FLONASE products do not increase blood pressure.

When is the best time to take zinc?

Zinc supplements are most effective if they are taken at least 1 hour before or 2 hours after meals. However, if zinc supplements cause stomach upset, they may be taken with a meal.

How long does zinc stay in your system?

Zinc may stay in the bone for many days after exposure. Normally, zinc leaves the body in urine and feces. More information on how zinc enters and leaves your body can be found in Chapter 3.

Benadryl: 7 things you should know

Medically reviewed by Carmen Fookes, BPharm. Last updated on March 15, 2021.

1. How it works

• Benadryl is a brand (trade) name for diphenhydramine which is an antihistamine that may be used for the treatment of allergies, motion sickness, to help induce sleep, and to relieve symptoms of Parkinson’s Disease.
• Diphenhydramine treats allergic-type reactions by blocking histamine-1 (h2) receptors. This prevents histamine from having an effect on the airways, blood vessels, and the gastrointestinal tract, reversing symptoms such as bronchoconstriction (narrowing of the airways), rash and itch, and stomach cramps. Diphenhydramine also blocks acetylcholine receptors, sodium channels, and inhibits the reuptake of serotonin, among other effects. These latter effects are responsible for its sedative effects and side effects such as a dry mouth.
• Benadryl belongs to the class of medicines known as first-generation antihistamines. Benadryl is an antihistamine of the ethanolamine class.

2. Upsides

• Used to treat the symptoms of allergic-type reactions such as sneezing, itching, watery eyes, and runny nose.
• May be used for the treatment of allergies, insect bites, hay fever, allergic conjunctivitis, urticaria (hives), and in addition to epinephrine for anaphylactic reactions.
• May be used to relieve the symptoms of nausea and vomiting associated with motion sickness.
• Can be used to help people relax or fall asleep.
• May also be used for elderly people with Parkinson’s disease who are unable to tolerate more potent agents.
• Available as an injection that may be useful when the oral form is impractical.
• Benadryl is available as a generic under the name diphenhydramine.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

• Drowsiness and sedation may impair judgment and affect a person’s ability to drive or operate machinery. Alcohol should be avoided because it can make this side effect worse.
• Dizziness, low blood pressure, a headache, rapid heartbeat, disturbed coordination, abdominal discomfort and thickening of mucus in the airways may also occur. Elderly people may be more sensitive to effects such as dizziness, sedation, and low blood pressure.
• Has an atropine-like effect and may cause a dry mouth, which may increase the risk of dental caries and worsen the symptoms of gastroesophageal reflux disease (GERD) if taken regularly.
• Not suitable for use in women who are breastfeeding or young children. Elderly people may be more susceptible to the side effects of sedation, dizziness, and low blood pressure (all of which may increase their risk of falls).
• Overdosage of Benadryl has been associated with hallucinations, convulsions, and death.
• May interact with several other drugs including benzodiazepines, antidepressants, antipsychotics, and alcohol.
• May not be suitable for some people including those with respiratory diseases such as asthma, narrow-angle glaucoma, peptic ulcer disease, intestinal obstruction, high blood pressure or heart disease, high thyroid levels, an enlarged prostate, or a narrowing of the neck of the bladder. Do not use in people who are hypersensitive to diphenhydramine.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

Benadryl is an antihistamine that can be used to treat allergic reactions, relieve motion sickness, as a sleep aid, and to relieve some symptoms of Parkinson’s disease. Sedation is a common side effect.

5. Tips

• Benadryl may be taken with or without food.
• Take exactly as directed. Do not take more than is recommended.
• Do not drive or operate machinery if Benadryl makes you drowsy or affects your judgment. Avoid alcohol.
• When using for motion sickness, take Benadryl 30 minutes before any exposure to motion. Take subsequent doses before meals or at bedtime for the duration of the exposure.
• Benadryl should not be used as a nighttime sleep aid in children aged less than twelve. It should not be used at all in newborn babies, especially those that have been born prematurely. In children, Benadryl can cause excitation, sedation, and overdosage may cause hallucinations, convulsions, or death.
• Ensure you maintain good oral hygiene if you are taking Benadryl long-term.
• Stand up slowly when going from a sitting or lying down position. Benadryl may cause a drop in blood pressure which may cause symptoms such as dizziness and increase your risk of falls. Remove any fall hazards in your home (such as rugs) and talk to your doctor if you are experiencing severe dizziness every time you stand up.
• Seek urgent medical advice if you experience any symptoms such as agitation, hallucinations, a fast heart rate, dizziness, flushing, muscle tremor or rigidity, nausea, vomiting, or diarrhea.
• Talk to your doctor or pharmacist before taking any other medications while you are taking Benadryl.
• Talk to your doctor before using Benadryl during pregnancy because there have been no adequate well-controlled studies in pregnant women. Do not use while breastfeeding.

6. Response and effectiveness

• Benadryl is quickly absorbed after oral administration and peak effects are reached within one hour. The effects of diphenhydramine last from four to six hours. Benadryl in the injectable form has a rapid onset of action.
• When used as a night-time sleeping aid, the usual dosage of Benadryl is 50mg at bedtime. A lower dosage may be needed in the elderly.

7. Interactions

Medicines that interact with Benadryl may either decrease its effect, affect how long it works for, increase side effects, or have less of an effect when taken with Benadryl. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with Benadryl include:

• benzodiazepines, such as diazepam, oxazepam, and temazepam
• monoamine oxidase inhibitors, such as isocarboxazid, selegiline, or tranylcypromine
• opioids, such as oxycodone, morphine, or codeine
• sedatives, or any medication that causes sedation, such as sleeping pills, muscle relaxants, or antidepressants
• other medications that contain diphenhydramine, such as creams and gels
• other medications used to treat allergies.

Alcohol may enhance the sedative effects of Benadryl.

Note that this list is not all-inclusive and includes only common medications that may interact with Benadryl. You should refer to the prescribing information for Benadryl for a complete list of interactions.

References

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Benadryl only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2021 Drugs.com. Revision date: March 15, 2021.

Medical Disclaimer

Can Allergies Cause High Blood Pressure?

Allergies do not directly cause high blood pressure, but can be an indirect factor due to inflammation. 

High blood pressure can lead to a number of serious health concerns, like heart disease, which is why it is important to understand how allergies can lead to high blood pressure.

Allergies, Inflammation and Blood Pressure

When your body is exposed to an allergen, like pollen or dust, your immune system tries to protect the body by producing antibodies to fight the allergen. This process, called inflammation, is what causes the allergic reaction(s) you experience.  

An inflammatory response to allergens increases blood flow to the affected area. Inflammation can also constrict blood vessels and arteries that lead to major organs like the heart and kidneys. This stiffening of the arteries can lead to elevated blood pressure, and is harmful if left untreated. 

How Can Allergies Lead to High Blood Pressure?

Allergies can have a cyclical effect that causes high blood pressure. For example, if you have seasonal allergies, you may have a constantly stuffy nose.

While a stuffy nose can be annoying, you may not see it as cause for concern. However, nasal congestion caused by allergies can lead to sleep apnea, a much more serious health concern.

Sleep apnea occurs when your breathing is interrupted during sleep. Sleep apnea is often caused when airways become constricted, as they do when you experience nasal congestion due to allergies.

This inflammation of airways during sleep can lead to high blood pressure, which can in turn worsen your sleep apnea and your nasal congestion.

Over time, high blood pressure due to untreated sleep apnea can lead to heart disease or even stroke. Learn when your allergies become a medical concern.  

Allergy Treatment Options

Managing allergies can decrease your risk of high blood pressure. Based on your medical history, your PartnerMD physician will recommend preventive treatment options before prescribing medication.

These steps may include local treatments like saline washes to clear nasal passages. If your allergies persist despite preventive measures, your doctor may then recommend prescription nasal sprays to combat allergy symptoms.

If you have coexisting health issues, your doctor may recommend against certain medications, such as pseudoephedrine, which can actually increase blood pressure.

Concierge medicine ensures that your doctor takes the time to really understand the cause of your allergy symptoms. While allergies are not a direct cause of high blood pressure, untreated allergy symptoms can lead to health issues that cause high blood pressure.

Keep your blood pressure in check, and contact PartnerMD today to learn more about an allergy management plan that works for you.

90,000 Arterial hypertension and COVID-19

Doctor of Medical Sciences, Professor, Honored Scientist of the Russian Federation Lyudmila Ivanovna Gapon spoke about the features of the treatment of patients with high blood pressure with viral infections, especially coronavirus.

Why does blood pressure rise with viral infections and flu?

Viral diseases are characterized by various symptoms, including a decrease or increase in blood pressure. These fluctuations may be due to an increase in body temperature due to which changes occur in the circulatory system.In some cases, there may be vasospasm, which, in case of hypertension, is dangerous with a relapse of a hypertensive crisis. Pathogenic microorganisms force the body to function in an emergency mode. The work of the central nervous system is disrupted: there is a feeling of apathy, weakness, fatigue. The pressure can rise even if treatment is not started in a timely manner.

During the treatment of viral diseases in the presence of arterial hypertension, you must not:
• take products with caffeine (Panadol Extra, Coldrex and Rinikold)
• use drugs for the common cold with a vasodilating effect based on phenylephrine
• take medicines of antihistamine group
• be treated with alcohol
• take a hot bath, inhalation, rubbing and wrapping
• smoking and drinking caffeinated beverages.

❗ High blood pressure causes extreme distress in coronavirus patients, increasing the likelihood of death. But controlling blood pressure with prescription drugs reduces this danger. There is NO PROOF at this time that taking drugs that protect against serious cardiovascular complications increases the risk of COVID-19! People with high blood pressure are at risk of developing severe forms of COVID-19, therefore, all cardiological professional communities around the world strongly recommend continuing to take life-saving drugs.

For detailed recommendations read here

90,000 Pills for hypertension suggest prescribing bolder

December 24, 2015

Photo author, Thinkstock

Photo caption,

Researchers emphasize that a healthy lifestyle also lowers blood pressure

Blood pressure lowering drugs are useful for people at increased risk hypertension, even if their blood pressure is normal, according to British scientists.

In a report published in the Lancet, it is proposed to move away from the current practice of prescribing such drugs only for people with high blood pressure.

Researchers also emphasize that a healthy lifestyle also lowers blood pressure.

Hypertension increases the risk of heart attack and stroke.

Current guidelines from the UK’s National Institute for Health and Care Excellence (NICE) indicate that blood pressure lowering medications are prescribed only for people whose blood pressure exceeds 140/90 mmHg.

Even high-risk groups, such as those who have had a heart attack or stroke in the past, are now required to be monitored regularly, but not medications.

However, an international group of researchers is now urging doctors to focus their attention not on “arbitrary” levels of pressure, but on people at higher risk.

Healthy lifestyle

Experts analyzed the results of more than 100 large-scale clinical studies conducted between 1966 and 2015 and covering about 600 thousand people.

They found that people at highest risk – including smokers with high cholesterol levels and diabetics over 65 years of age – find it most beneficial to take blood pressure medications as it reduces the risk of heart attack by 20% and also lowers risk of stroke.

In addition, the results of the study indicate that lowering blood pressure is beneficial for almost everyone, regardless of the pressure level before starting medication or changing lifestyle.

The results also indicate that the lower the initial blood pressure level, the less the results from further lowering.

The authors of the report do not suggest that everyone should take medications to lower their blood pressure, and warn that side effects should be taken into account.

Dr. Tim Chico, a cardiologist at the University of Sheffield, also says that medication is not the only way to prevent hypertension.

He points out that eating well, getting enough physical activity, reducing alcohol consumption and maintaining a healthy weight also contributes to this goal.

Allergy

Allergy is an unusual sensitivity to various substances that do not cause painful reactions in most people. The essence of why some people have allergies, while others do not, lies in the peculiarities of the functioning of the immune system of each person.

Immunity is a term that characterizes the body’s ability to recognize and destroy everything that is perceived by the human immune system as “alien”, and therefore harmful to health.Such enemies can be viruses that cause flu and childhood infections, such as chickenpox and other diseases, as well as bacteria – the cause of sore throats, pneumonia, etc., poisons, fungi. For some people, house dust, pollen, mold, certain types of food, etc. become enemies. Then these agents become allergens and the person becomes allergic. In response to such interference, our body produces protective antibody proteins that attack and neutralize these hostile elements.

If you once inhaled, swallowed or touched such allergens, the defense system takes action: it remembers them and produces specific IgE antibodies. This step is called sensitization . On repeated contact with these same allergens, antibodies attach to a special type of cell called mast cells, which are found in the airways, gastrointestinal tract, and skin. The adhered antibodies cause mast cells in the places of contact with the allergen to secrete various substances, the main of which is histamine.Some of these substances neutralize enemies, while excess histamine leads to tissue changes that cause allergy symptoms. For example, dilation of blood vessels leads to inflammation and swelling, which is manifested by a runny nose, sneezing, itching in the nose and eyes, watery eyes, etc. This type of allergy is called atopy , and all diseases that arise in response to exposure to these allergens are atopic . The predisposition to atopy is almost always inherited.Although in the same family, both “atopics” and healthy children can be born. It is interesting that in the future, these healthy children already have their children suffering from atopy.

Unfortunately, in people with allergies, antibodies are produced and interact with substances that are not dangerous for healthy people, such as pollen, house dust, mold. This is why the house dust your son breathes in triggers the production of antibodies in his immune system. These antibodies “sit” on the cells of the respiratory tract and, as a result of the release of histamine and other substances, cause allergy symptoms that interfere with sleep, study, reading, play, and sports.

What can cause allergies?

In most cases, allergies arise from contact with pollen from trees, grasses, fungi, microorganisms, mold, certain food products, animal dandruff, house dust mites, and insect bites. Other factors such as strong odors, colds, exercise, cold air, or even emotions can trigger a reaction similar to an allergic one, but caused by increased sensitivity (hyperreactivity).In other words, if you have asthma caused by, for example, a house dust mite, then while exercising in the open air, where there are no mites, you may develop an asthma attack triggered by intense exercise.

It is important to understand the difference between an irritant and an allergen. Such irritants that can cause a nonspecific reaction, similar to an allergic one, can be paint fumes, aerosol deodorants, tobacco smoke and many other agents. Therefore, when creating hypoallergenic conditions, it is important to pay attention to them and avoid them if possible.

What is hay fever or hay fever?

This term was coined in 1819 by the English physician John Vostok, who every year at the same time in the summer, when he was making hay, had the same symptoms: sneezing, runny nose, watery eyes. Hay fever is not an entirely correct term, since, firstly, with this disease there is almost never a fever (fever), and secondly, hay is not the only cause of such symptoms.In fact, hay fever is a common term used in everyday life for seasonal allergic rhinitis or hay fever (from the Greek pollen – pollen). It manifests itself as sneezing, watery nasal discharge (“run out of the nose”), often by attacks of suffocation, lacrimation, itching, and sometimes swelling of the eyes, unpleasant painful sensations in the mouth and throat. Allergic rhinitis is caused by wind-blown pollen from trees, various ear-bearing grasses and weeds, as well as mold spores that are present in the atmosphere at certain times of the year.

What is asthma?

This question is not easy to answer. Asthma can be considered as a group of symptoms that include difficulty breathing or an attack of suffocation, wheezing when breathing, and coughing. The reason for these symptoms lies in the spasm of the smooth muscles of the bronchi, in the increased production of mucus – sputum, in the swelling of the bronchial mucosa and, as a result, in the narrowing of the airways, as a result of which the movement of air into and out of the lungs becomes difficult. The main symptom of bronchial asthma – difficulty breathing – is a direct consequence of the compression of the smooth muscles of the bronchi, which entails other structural changes.However, this condition is reversible with proper treatment.

Asthma can be allergic . In this case, asthma attacks occur in response to exposure to certain allergens – house dust mites, pollen, certain foods, and mold. Many people have asthma combined with allergic rhinitis. With the development of asthma, the respiratory tract becomes very sensitive to the effects of not only allergens, but also other nonspecific irritants, such as cold air, strong odors, tobacco smoke, physical activity, etc.

With non-allergic asthma , there is no connection with exposure to allergens. In these patients, the disease is usually more severe and requires constant medication.

In all cases, preventive measures will not only not harm patients with asthma, but will also help to improve the condition, which is confirmed by numerous studies.

Why is atopic dermatitis dangerous? What is the “atopic march”?

“ Atopic March ” is a consistent expansion of the range of allergic diseases in a child with age.That is, atopic dermatitis can serve as the initial stage for the development of a systemic allergic disease: first, the upper respiratory tract (allergic rhinitis, laryngitis, adenoiditis), and then the lower respiratory tract (allergic bronchitis, bronchial asthma). So, 50% of children with atopic dermatitis subsequently develop bronchial asthma. By controlling the course of atopic dermatitis, doctors try to prevent the “atopic march” and the development of bronchial asthma.

The task of the parents is not to miss the moment and “capture” the disease at the very beginning of its appearance.

What is urticaria?

Urticaria (from Lat. Urtica – nettle) – the appearance on the skin of blisters of various sizes, similar to rashes after a nettle burn, which are accompanied by itching. In children, urticaria is often a symptom of food allergy and is acute, i.e. occurs within a few minutes after eating an allergenic product and lasts no more than 6 weeks. Also, allergic urticaria can occur with drug allergies, with allergies to the venom of stinging insects (bees, wasps, hornets), etc.Chronic urticaria is usually non-allergic, i.e. occurs regardless of exposure to allergens. The causes of chronic urticaria can be concomitant diseases of the gastrointestinal tract, endocrine system, chronic infections. In such cases, we strongly recommend that you undergo a comprehensive examination by specialist doctors in order to identify and treat the underlying disease.

There are also other types of urticaria: cold, mechanical, contact, cholinergic, etc.

In many patients, urticaria is accompanied by Quincke’s edema , which can be localized in the face and affect the lips, eyelids, and in some – the larynx. Then there is difficulty in swallowing, hoarseness of the voice and asphyxia (suffocation) may develop due to the complete closure of the airways.

What is childhood eczema or atopic dermatitis?

Many children in the 1st year of life develop infantile eczema , or atopic dermatitis .The skin becomes dry, redness, rashes, peeling, cracks, weeping appear, an infection may join. Because of the intolerable itching, children lose peace, sleep poorly, and often cry. At this age, lesions are localized on the skin of the cheeks, forehead, in the area of ​​the extensor and flexion surfaces of the joints, neck and scalp. Previously, this disease was called exudative diathesis. The most common cause of childhood eczema is food allergy to cow’s milk and chicken egg white, which develops after the introduction of complementary foods or after transfer to artificial feeding.Nursing mothers should remember that when such symptoms appear in newborn babies, they themselves need to follow a strict diet and exclude various allergenic foods from their diet.

Children’s eczema can develop against the background of lactase deficiency (deficiency of the enzyme lactase, which breaks down the sugar in cow’s milk). If you do not see a doctor for help in time, a child’s eczema can spread to the skin of the whole body and become chronic.

In children with a hereditary predisposition to allergies, the disease often becomes their unhappy companion for the rest of their lives and can subsequently be combined with rhinitis and asthma.

What is food allergy?

Food Allergy is often associated with skin rashes and itching, which may or may not be associated with food and therefore food allergies. True food allergies are not so common: in 2% of adults and in 2-5% of children. Most often – (in 7-8% of cases) food allergy develops at a very early age – in the 1st year of life, and then there are a lot of problems associated with feeding babies, especially for those mothers who have little breast milk.What is food allergy? This is a state of increased sensitivity of the body to food, which occurs due to failures in the human immune system. In this case, there may be signs of acute urticaria, atonic dermatitis, various disorders of the digestive system: acute abdominal pain, vomiting, lack of appetite, stool disorders in the form of constipation or diarrhea, flatulence, etc. But the most formidable manifestation of food allergy is anaphylactic shock … It develops within seconds or minutes after eating an intolerable food such as shrimp or peanuts.In a patient, due to the massive release of histamine from mast cells in response to the allergen, blood pressure drops sharply, suffocation occurs, loss of consciousness occurs, there may be convulsions, redness and swelling of the face, and even involuntary urination and defecation, which, if untimely assistance is provided, can lead to death. In some people, more often in adults, food allergy can manifest itself in the form of allergic rhinitis, an attack of suffocation, persistent headaches – migraines. In children, the most common allergies are caused by cow’s milk, chicken eggs, soybeans, millet, peanuts, etc.For adults, different types of nuts can be allergenic more often – peanuts, fish and seafood.

In contrast to true food allergy, in food intolerance, the immune system is not involved in the development of clinical symptoms, and the reasons for the development of such reactions are often associated with concomitant diseases that a person suffers from, for example, peptic ulcer disease, intestinal dysbiosis, with the presence of parasites, with inflamed gallstones. bladder and even with caries.

How is Allergy diagnosed?

Obviously, there are certain symptoms that we associate with allergies, such as sneezing, runny nose, watery eyes.For the doctor, they are the first clue to the diagnosis. However, there are many other diseases that have similar manifestations. That is why, in the event of such symptoms, it is imperative to consult a doctor.

Before making a diagnosis, the doctor should analyze your life, habits, dietary habits, work. After you tell the doctor about your complaints, he will ask you many questions to find out what, where, when and how happened to you. For example, if you start to sneeze and breathe whistling while cleaning the apartment or when you knock carpets outside, then there is a high probability that you are allergic to house dust.If you sneeze and your eyes are watery after your daughter has a kitten, it seems that you are developing an allergy to cats, or rather to their dandruff.

In addition to questioning, the doctor has several more accurate and objective methods to confirm the diagnosis.

Skin test is one of the most informative diagnostic tests for allergies. The essence of the method is that droplets containing allergens are applied to the skin of the forearm or back: house dust, pollen, mold, etc.e. Then, at the locations of the droplets, the skin is pierced in such a way that the solution with the allergen penetrates the skin. This is a prick test. A similar test, called a scarification test, differs from the prick test in that, instead of piercing, notches are applied to the skin. If the patient is allergic to any substance, then in either case, redness and swelling form in the place where the allergen is present. The reaction develops within 15 minutes. The intensity of the reaction at the site of the allergen application shows how sensitive you are to this substance.However, these results are only used by the physician to confirm a preliminary diagnosis. It is possible that there is a skin reaction to the allergen, but there are no clinical manifestations. This means that no symptoms of the disease develop upon contact with this allergen.

Along with skin tests, there is another way to diagnose allergies, based on the study of a blood sample. Since these samples are analyzed in a laboratory, they are called “in vitro” (in vitro) methods.

Laboratory test can determine the amount of specific (i.e. corresponding to a specific allergen-key) antibodies-locks present in the blood, on the basis of which the doctor can draw a conclusion about how strongly your body reacts to each specific allergen, from mold in the bathroom to dust in the vacuum cleaner.

Currently, a blood test is usually used for the following category of patients:

• if the patient is afraid of having a skin test;
• if there is a risk of a severe skin reaction to a skin test;
• if the patient is taking antihistamines and certain other medications that may affect the accuracy of the test;
• if the patient has severe skin problems;
• if the patient is a small child under 3 years of age.

The doctor must explain the possibilities, advantages and cost of the diagnostic method chosen by him in relation to you and your case.

You must understand that an accurate diagnosis of your allergic condition is very important for choosing the most effective treatment regimen. Remember that you cannot fix problems without knowing the cause. Medication can reduce symptoms, and creating a hypoallergenic condition can provide some relief as well.

How to treat allergies?

Each person is individual, it is characterized by a certain intensity of symptoms and the severity of the disease, which is extremely important for the choice of treatment tactics.When prescribing a set of therapeutic measures, your doctor should warn you about the possible side effects of drugs or injected allergens, minimize the inconvenience associated with treatment, and also tell you in detail about the causes of the disease and the dangers and benefits of treatment.

Today in the world there are three main methods of treating allergic diseases :

1. Termination or reduction of contact with an allergen or irritant – the so-called elimination measures.

2. Use of medicinal products. Pharmaceutical companies manufacture a large number of anti-allergic drugs. First of all, these are antihistamines that can quickly and effectively suppress the clinical manifestations of any form of allergy or prevent their development. They are called antihistamines because they block histamine receptors. As a result, the action of histamine, the substance responsible for all clinical symptoms of allergy, stops.Therefore, antihistamines are used for seasonal allergies, for year-round rhinitis, for urticaria, for atopic dermatitis, and in general for any allergic diseases. They are available in the form of tablets, drops, syrups for oral administration, as well as ampouled solutions for injections. About 50 antihistamines of different groups are registered in Russia. Among them there are drugs of the first generation, which, in addition to their main antiallergic action, also have a hypnotic effect.Therefore, they are effectively used in atopic dermatitis, the leading symptom of which is itching, which interferes with sleep. The drugs of the new generation do not cause drowsiness, do not reduce attention and performance, they need to be taken only once a day, so they can be used for any form of allergy and for a long time.
Corticosteroid hormones are more powerful anti-allergic agents. They are used in the form of nasal sprays in severe forms of allergic rhinitis, in aerosol form in the form of inhalers – in bronchial asthma, as well as in the form of tablets and solutions for injections in critically ill patients.For patients with bronchial asthma, modern inhaled bronchodilator drugs have been developed to relieve asthma attacks and for constant intake. They can be used with the help of special inhalers – nebulizers, which is especially convenient for children.
For patients with atonic dermatitis, an important link in the complex treatment is external therapy and skin care. Therefore, special ointments and creams containing corticosteroid hormones have been created for them.

3. Allergen-specific immunotherapy (ASIT), or injections with allergens.This is a fairly simple procedure. You receive a series of injections with allergens hostile to you (house dust, house dust mite, pollen, etc.) in a gradually increasing concentration, as a result of which your resistance to these allergens increases, just as as a result of vaccination against polio or smallpox you become immune to these infections.
If you are currently taking medications or undergoing ASIT, there is no doubt that an attempt to remove allergens from your “habitat” will only increase the effectiveness of your treatment and even help reduce the doses of medications you take.

Creation of hypoallergenic conditions?
Do you keep your bedroom tidy?

This is the most important point in creating a hypoallergenic environment. You spend most of your life in the bedroom, and if you can clean it up, the result will not be long in coming. If allergy sufferers spend 8 hours a day in an allergen-free atmosphere, all body systems – lungs, respiratory tract, immune system – get a chance to rest and develop resistance in order to go to the outside world with renewed vigor the next day.Activities to be done at home:

1. Place all mattresses in special anti-mite covers, preferably with a zipper. These covers can be purchased at specialty stores for allergy sufferers.
2. Treat your bed, carpets, upholstered furniture with special compounds to kill mites – the so-called acaricides. For example, one such agent is milbiol. It can be purchased at pharmacies and specialty stores.
3. Vacuum all mattresses, carpets and upholstery regularly.
4. Check the humidity and use a humidifier or dehumidifier to keep it below 40%.
5. Try to install cooling at home, especially in the bedroom – an air conditioner can be especially useful in summer.
6. Shower and wash your hair before bed to remove dandruff and flaky skin.

If you are tested to be hypersensitive to house dust mites, be sure to follow all precautions, especially related to handling your bed and keeping your bedroom clean.

Do you have any animals?

Animals that live even in the next apartment, not to mention their own, can cause an allergic reaction, so before you follow the lead of your young children and go to the bird market for a puppy, “measure seven times and cut once.” … By the way, the presence of aquarium fish, if only you use dry food for their pro-nutrition – daphnia, which is the strongest allergen, can also be destructive.

Houseplants

They can be a source of mold or insects. Check them out.

Do you have upholstered furniture?

Again, upholstered furniture can act as a dust collector, as well as a hideout for the dreaded house dust mites.

There are special preventive measures to minimize contact with an allergen or irritant. These measures must be followed regardless of your condition and the severity of the disease.

• Remove all dust collecting items
• These items can be listed indefinitely. But it is important to remember that all objects with a flat surface have the property of attracting dust, regardless of whether it is a shelf cluttered with decorations or a book lying on a nightstand. The main principle is to avoid clutter! Therefore, all books should be stored in glazed bookcases; it is better not to store toys in the children’s room and not to cover the floors with carpets.
• Clothes
  Store clothes in special zippered covers.Place items such as shoes, sportswear in boxes or drawers to reduce the exposed area.
• Scattered things
  Place all scattered things in their places: books, boxes, magazines, paper, toys – absolutely everything that lies around.
• Carpets
  Old carpets create a lot of dust by breaking down the fibers. The ideal solution is to remove all carpets and replace carpets with wood or tile floors. If this is not possible, they should be regularly cleaned and vacuumed.
• Curtains
  Sorry, no curtains and only light washable curtains made of smooth materials such as cotton or synthetics. Conventional blinds are not recommended due to their dust-accumulating properties. In this case, roller blinds are ideal. It also makes sense to go shopping. Many shops targeting this consumer group, for example shops for allergy sufferers, may provide you with additional information.
• Household chemicals
  Avoid contact with substances with strong odors such as deodorants, perfumes, naphthalene, insect repellants, etc.d.

90,000 NSAIDs: side effects and solutions

NSAIDs: side effects and solutions All drugs cause side effects

NSAIDs: side effects and solutions

All drugs cause side effects, especially when taken for a long time. NSAIDs are no exception.

Fortunately, many adverse reactions can be avoided by taking the drugs correctly or by combining them with other drugs.

The most common side effects of NSAIDs are: gastropathy, increased blood pressure, thrombosis, allergic reactions, nephropathy, bleeding.
travel without pain

Gastropathy

NSAIDs can cause nausea, flatulence, diarrhea, or constipation. More serious complications are not uncommon: ulcers and bleeding.

Always inform your doctor about stomach problems if you are planning to take NSAIDs.

If abdominal pain, black stools occur while taking NSAIDs, consult a doctor immediately.

First, selective COX2 inhibitors (celecoxib) have the lowest risk of developing gastropathy.

Secondly, protection of the stomach (gastroprotection) can be ensured by taking the drug after meals or in conjunction with an antacid (Almagel). Taking proton pump inhibitors (omeprazole, pantaprazole) reduces gastric acidity and reduces the risk of ulcers and intestinal bleeding.

Third, do not drink alcohol during treatment with NSAIDs.It enhances the adverse effect of drugs on the gastric mucosa.

dark chocolate reduces the risk of cardiovascular diseases

Effects on the cardiovascular system

All NSAIDs, except aspirin, increase the risk of arterial hypertension, heart attack or stroke. Such serious adverse reactions can occur as early as the first weeks of taking the medication.

People who already have heart disease, especially those who have had a heart attack or heart bypass surgery, are at greatest risk of heart attack or stroke associated with NSAIDs.

The best thing to do to prevent NSAID-related heart problems is to reduce other risk factors. Smoking, high blood pressure, high cholesterol and diabetes mellitus are significant risk factors for cardiovascular accidents.

Measure blood pressure regularly while taking NSAIDs.

Some NSAIDs can compete with aspirin for receptors. This reduces its effectiveness in thinning blood and preventing recurrent myocardial infarction.Therefore, be sure to discuss the choice of NSAIDs with your doctor. Take the lowest effective dose as soon as possible.

anti-inflammatory effects of dark chocolate

Allergic reactions

An allergic reaction is a non-specific complication of any drug therapy. It can be mild in the form of a rash, or very severe in the form of anaphylactic shock. Quincke’s edema is a rapid and significant edema of the laryngeal mucosa. It makes breathing impossible and life-threatening.

If you do not have such a reaction to one of the NPS drugs, do not exclude its appearance on the other.

Antihistamines are effective for urticaria, swelling of the face.

In case of angioedema, anaphylactic shock, call an ambulance.

dark chocolate and diabetes mellitus

Nephropathy

Chronic interstitial nephritis is a complication of the kidneys. It is manifested by morning edema, clouding of urine, rare urination.

Nephritis disappears after discontinuation of NSAIDs.

Tell your doctor about kidney problems if NSAIDs are planned.

travel with arthrosis

Bleeding

NSAIDs reduce blood clotting. Therefore, bruising is easier and the risk of bleeding is higher.

Bleeding problems can be serious if NSAIDs are taken with an anticoagulant (warfarin).

This article is for informational purposes, not advisory.

Use of a fixed combination of montelukast / levocetirizine in the treatment of allergic rhinitis

Antihistamines and leukotriene receptor antagonists are widely used in allergic rhinitis.The article presents a clinical case of the effective use of a fixed combination of montelukast / levocetirizine in a patient with allergic rhinitis.

Introduction

Allergic rhinitis (AR) is one of the most common diseases of the respiratory system. It affects a significant part of the population (up to 500 million) of the globe [1].

Allergic rhinitis is a disease based on immunoglobulin E-mediated allergic inflammation associated with exposure to allergens in genetically susceptible individuals.Leukotrienes and histamine are considered to be among the main and studied mediators of allergic inflammation.

Antihistamines and leukotriene receptor antagonists have long been successfully used for allergic diseases, including AR. The fixed combination of montelukast and levocetirizine can also be successfully used in the treatment of patients with allergic diseases.

Importance of histamine and leukotrienes in allergic inflammation

Discovered in the late 1970s.leukotrienes (LT), in particular cysteine ​​(cysteine ​​is present in their structure), LTC4, LTD4, LTE4, are lipid inflammatory mediators synthesized from arachidonic acid via the 5-lipoxygenase pathway. The main sources of leukotrienes are eosinophils, mast cells, basophils, and macrophages [2–5]. There are three types of cysteine ​​leukotriene receptors (CysLT1-3). The main pro-inflammatory effects of cysteine ​​leukotrienes are mediated through CysLT1, which is expressed on airway smooth muscle cells, eosinophils, B cells, Th ₂ lymphocytes, stimulating the production of interleukin (IL) 4 and IL-13 and increasing inflammation, mast and monocytes macrophages [4, 5].Leukotrienes cause mucus hypersecretion, increased vascular permeability and tissue edema, smooth muscle spasm, eosinophil recruitment, IL-33 expression, activation of congenital type 2 lymphoid cells (ILC2) [2, 4–8]. Cysteine ​​leukotrienes play a key role in the pathogenesis of both bronchial asthma (bronchoconstriction, airway inflammation, hyperreactivity and remodeling of the airways) and allergic rhinitis, causing mucus secretion, mucosal edema, and are involved in the early and late phases of allergic reactions [4, 9] …The proinflammatory effects of leukotrienes are insufficiently controlled by glucocorticosteroids (GCS) and require a specific targeting, in particular, on CysLT1, for better control of allergic diseases [10].

Histamine is an important mediator that plays a central role in allergic inflammation. It can be found in almost all tissues, especially in the respiratory tract, skin, connective tissue and gastrointestinal tract [11]. The release of histamine occurs mainly through the degranulation of mast cells and basophils.The biological effect of histamine is mediated through the histamine receptors H ₁ –H ₄ . All immediate hypersensitivity reactions are associated with the activation of the H ₁ receptor, which is expressed in many tissues and cells, including nerves, respiratory epithelium, endothelial cells, hepatic cells, vascular smooth muscle cells, platelets, monocytes / macrophages, dendritic cells, neutrophils, T – and B-lymphocytes [12]. Histamine causes an increase in vascular permeability and tissue edema, contraction of smooth muscles, hypersecretion of mucous glands, irritation of peripheral nerve endings, increased secretion of pro-inflammatory cytokines such as IL-1-alpha, IL-1-beta, IL-6, tumor necrosis factor alpha, prostaglandins, leukotrienes, chemokines.In addition, histamine regulates the maturation and activation of leukocytes, modulates the functions of monocytes, T cells, macrophages, neutrophils, eosinophils, B cells and dendritic cells, increases the secretion of T ₂ -cytokines (IL-5, IL-4, IL- 13) and inhibits the production of T ₁ -cytokines (interferon gamma) [12, 13]. Histamine affects both the early and late phase of allergic inflammation.

Role of antihistamines and leukotriene receptor antagonists in AR therapy

Antihistamines and leukotriene receptor antagonists are often used in AR [14].H ₁ – antihistamines are inverse agonists of the histamine H ₁ – receptor. They interfere with the effects of histamine, have an anti-inflammatory effect, although it develops slowly and is less effective than nasal GCS, affect rhinorrhea, itching, sneezing (symptoms of the early phase of allergic inflammation), nasal congestion, nasal hyperreactivity (symptoms of the late phase of inflammation).

Leukotriene receptor antagonists are highly selective antagonists of CysLT1.They can be prescribed for any severity of AR [14], have an anti-inflammatory effect and affect the symptoms of the early and late phases of allergy. The clinical efficacy of antihistamines and leukotriene receptor antagonists in seasonal and perennial AR has been confirmed by numerous studies.

Montelukast and levocetirizine are widely used therapeutic agents. A fixed combination of montelukast and levocetirizine has appeared on the pharmaceutical market.Research data have shown that the safety of a fixed combination of montelukast and levocetirizine in chronic AR is comparable to that of montelukast and levocetirizine alone [15]. When using the combination, there was also a more pronounced improvement in AR symptoms and the quality of life of patients compared to monotherapy with montelukast and levocetirizine [15-18].

Clinical case

Patient K., 44 years old, September 21, 2020applied to the clinic of the St.Petersburg Research Institute of Ear, Throat, Nose and Speech with complaints of almost constant difficulty in nasal breathing, itching in the eyes, mucous discharge from the nose, increased by contact with cats (there are no animals at home, but relatives have cats , which he visits two to three times a month) nasal congestion and nasal discharge, as well as the appearance of a cough after the end of direct contact with animals.

From the anamnesis it is known that heredity for allergic diseases is not burdened.Since childhood, suffers from bronchial asthma and AR. The examination revealed an increased sensitivity to tree pollen, cat epithelium, house dust mites. More than seven years of symptoms of bronchial asthma and the need for short-acting bronchodilators have not been noted. In 2013, he was operated on for the correction of the nasal septum. The worsening of the AR course was observed for three years. The symptoms of rhinitis are constantly disturbing. Not every night, but several times a week, the patient wakes up to take Naphthyzine.For almost six months, he uses Naphtizin daily up to three to four times a day.

As prescribed by the ENT doctor of the polyclinic at the place of residence, he receives Nasonex 200 mcg / day (two months), Erius 5 mg / day (over a month) and additionally independently uses one Erius tablet before visiting relatives with a cat.

He has a history of smoking for over 15 years, has not smoked for the last five years.

Denies professional harm, works as an office manager.

From concomitant pathology – autoimmune thyroiditis (receives L-thyroxine 75 mg / day), drug-induced euthyroidism.

On an objective examination, the condition is satisfactory. The skin and visible mucous membranes are clean. Pulse 76 beats per minute, rhythmic. Blood pressure 110/70 mm Hg. Art. Breathing hard, no wheezing. To determine the severity of violations of nasal patency, nasal peak flowmetry was performed. The indicator was 70 ml / min. The study was carried out using a portable nasal peak flow meter In-check (norm from 100 to 300).Control of bronchial asthma was assessed using the ACQ-5 questionnaire – 0.6 (0–0.75 – controlled bronchial asthma, 0.75–1.5 – partially controlled, more than 1.5 – uncontrolled). The control of AR symptoms was determined by a visual analogue scale (VAS) – 8 (less than 2 – controlled course, from 2 to 5 – partially controlled, more than 5 – uncontrolled course). Spirometry indicators: forced vital capacity (FVC) – 4.64 (99.3%), forced expiratory volume in the first second (FEV ₁ ) – 3.60 (93.7%), FEV ₁ / FVC – 77.66 (94.4%).After inhalation of salbutamol 400 μg – FVC – 4.65 (99.5%), FEV ₁ – 3.72 (96.6%), FEV ₁ / FVC – 79.91 (97.1%). The spirogram is within normal limits, the test with a bronchodilator is negative. In the clinical analysis of blood, the level of eosinophils was 260 cells / μl. Conclusion of the ENT doctor: chronic persistent allergic rhinitis.

Diagnosis: allergic bronchial asthma, mild, controlled course. Chronic persistent allergic rhinitis of moderate, uncontrolled course, pollen, epidermal, household sensitization.

Recommended hypoallergenic life, avoidance of contact with cats, Nasonex 200 mcg / day, refusal of decongestants, Montlesir 10/5 mcg once a day for three months.

During a follow-up visit on October 27, 2020, positive dynamics were noted: nasal breathing improved, the need for Naphthyzine decreased to one or two times a week, there were no night awakenings and itchy eyes. The patient continues to visit relatives who have cats, but Erius does not accept before the visit.The symptoms of rhinitis do not get worse, and the cough does not bother either. The index of nasal peak flowmetry is 120 ml / min (normal), VAS – 4 – partially controlled AR, ACQ-5 – 0 – control of bronchial asthma.

It was recommended to continue therapy.

Thus, in a patient with moderate AR and mild comorbid bronchial asthma, the addition of a fixed combination of montelukast and levocetirizine (Montlesir) to therapy improved the clinical course and control of AR.The therapy decreased the severity of symptoms, objectively improved nasal patency (normal nasal peak flowmetry), VAS decreased from 8 to 4, decreased airway hyperresponsiveness (no cough after contact with a cat), significantly reduced the need for decongestants from daily intake to one – twice a week, while the course of bronchial asthma has not worsened.

Conclusion

The fixed combination of montelukast and levocetirizine (Montlesir) appears to be promising in AR therapy, since it improves AR control and can positively influence the control of comorbid bronchial asthma.In addition, the fixed combination is intended to increase patient adherence to therapy.

90,000 Side Effects of Antihistamines: When to Stop Taking Allergy Medicines

In recent years, the number of diagnosed cases of allergies has increased significantly, and drugs are used against it more often than ever before. However, the side effects of antihistamines limit their use in certain conditions.

There are various types of allergy medications. Some are used to combat acute attacks, while others help prevent or relieve allergic reactions.

Some of these drugs, especially sedative antihistamines and corticosteroids, are known to cause adverse reactions.

Histamine affects smooth muscle and blood vessels, causing muscle spasm and vasodilation.

Antihistamines inhibit the action of histamine by binding its receptors in the body. They are used to stop itching, swelling, skin redness, nasal congestion, watery eyes, and coughing. Their ability to block most of these effects makes them the most common allergy medications in the world.

These medicines are useful for various allergic conditions, as well as for anxiety and sleep disorders. Thus, in addition to treating allergies, they are used to treat symptoms of colds, motion sickness, nausea, skin allergies, and to induce drowsiness in stressed or anxious patients.

Antihistamines can be classified as:

• sedatives – first generation antihistamines;
• Non-sedating – second generation antihistamines.

Both species act on the histamine H1 receptors in the cells of the body, the difference lies in their ability to pass the blood-brain barrier. First generation drugs are less selective and act on other receptors as well.

Sedative antihistamines

These drugs share a chemical structure with muscarinic receptor antagonists, drugs that are used to treat an overactive bladder and reduce urinary frequency.

The structure of antihistamines is also similar to that of cholinergic receptor antagonists, which cause dry mucous membranes and constipation; and on the structure of some antihypertensive drugs and some tranquilizers.

As a result, these drugs are not selective for histamine receptors. They have anti-muscarinic effects, anti-alpha adrenergic effects, and anti-serotonin effects, which we will discuss below.

Sedative antihistamines easily pass the blood-brain barrier, acting on the central and peripheral histamine receptors.

The human brain contains about 64,000 neurons that secrete histamine. They regulate many processes, namely:

• awake,
• learning and memory,
• appetite,
• body temperature,
• heart rate and blood pressure,
• are involved in the release of stress hormones and endorphins.

Central side effects

Since these processes are disturbed by sedative antihistamines, these drugs cause:

• sedation;
• drowsiness
• fatigue;
• lack of concentration;
• learning and memorization difficulties;
• poor grades,
• cognitive and coordination impairments, and because of them – difficulties with work, driving a car.

Even in the morning, after a nightly dose of antihistamines, patients continue to experience fatigue, remain inattentive, forgetful, with poor motor and sensory performance. These side effects of antihistamines occur mainly because histamine shortens the duration of REM sleep.

Anticholinergic and alpha-adrenergic side effects

Sedative antihistamines also have side effects due to blockade of cholinergic and alpha-adrenergic receptors, these are:

• urinary retention,
• constipation,
• sinus tachycardia,
• suppression of intestinal motility,
• Narrow-angle glaucoma worsening.

They also cause or worsen dry mouth, increase appetite and induce tolerance when used for more than 5 days.

Blurred vision, dilated pupils, dry mouth, dry and reddened skin, confusion and fever are all symptoms of the well-known and life-threatening anticholinergic syndrome caused by high doses of these drugs.

Many over-the-counter antihistamines contain decongestants.Therefore, if the patient has a rapid heartbeat, these medications should be discontinued.

Cardiac side effects

Astemizole and terfenadine are two h2-antihistamines that alter the heart rhythm (prolong the QT interval on the electrocardiogram). They can cause dangerous heart rhythm disturbances such as flutter or flutter of the ventricles. These drugs are not approved for use in most countries.

This problem also occurs with high doses or overdose of certain sedative antihistamines such as brompheniramine, promethazine, or diphenhydramine.

Side effects when using drugs in gerontology

These drugs should be used with caution in elderly patients. They, as a rule, have fewer cholinergic neurons and cholinergic receptors in the brain, have impaired renal and liver function, and their blood-brain barrier becomes less stable with increasing age.

Even at small doses, the drugs can cause dizziness in elderly patients, a decrease in blood pressure and the development of sedation the next day.

About 25% of people over 65 have a decrease in their innate ability to control their body. And even if such a decrease is imperceptible, they have it. These people may not respond well to antihistamines with strong anticholinergic effects – even before signs of dementia appear.

Delirium or cognitive impairment is another concomitant side effect of sedative antihistamines in the elderly. Its occurrence can lead to irrational treatment of patients with antipsychotics.Their visits to doctors with hallucinations and other signs of impairment or aggression can also be caused by anticholinergic drugs.

Physicians and other healthcare professionals, as well as elderly patients, should avoid prescribing and using sedative antihistamines, as non-sedating antihistamines are available on the market.

Contraindications for sedative antihistamines

These drugs should be avoided by children who are too young, adults – in the presence of such pathologies:

• urinary retention due to benign prostatic hyperplasia,
• glaucoma,
• heart disease.

Sedative antihistamines should be used with caution and only if necessary in patients with:

• pregnancy;
• constipation;
• dry mouth;
• hyperthyroidism;
• asthma;
• chronic obstructive pulmonary disease;
• renal pathologies;
• liver diseases;
• Benign prostatic hyperplasia associated with chronic urinary retention.

Patients who drink alcohol, are taking antidepressants or anticonvulsants should also consult a physician before taking antihistamines.

In any case, people who are going to take exams, study complex information or perform serious tasks, are going to drive a car or perform other activities that require concentration and concentration, should avoid the use of outdated sedative antihistamines.

In the presence of second-generation antihistamines that do not induce sedation, first-generation antihistamines should be avoided.

Non-sedating antihistamines

These medicines are also called second generation h2 antihistamines. These include:

• loratadine,
• fexofenadine,
• mizolastine,
• ebastine,
• azelastine,
• cetirizine,
• desloratadine,
• levocetirizine.

They currently have no known cardiac side effects.

Calming effect

Fexofenadine and desloratadine, which, along with levocetirizine, are the most commonly used non-sedating antihistamines, have a very mild sedative effect.

Their failure to induce central sedation is explained by interaction with a protein channel, P-glycoprotein, which inhibits their movement across the blood-brain barrier. These drugs generally do not cross the blood-brain barrier, so they have little effect on histamine receptors in the brain.

Levocetirizine very rarely causes sedation in patients, and for this it must be taken in doses exceeding the recommended ones.

Due to the absence of off-target effects, non-sedating antihistamines are much better suited to patients requiring long-term therapy. They are not only safe, but also have a strong anti-allergic effect.

Liver damage

Non-sedating antihistamines can sometimes cause acute liver injury.Although liver damage is usually minor, medication should be discontinued if it occurs.

Liver function is usually only slightly impaired and returns to normal after replacing the antihistamine with another or with the cessation of therapy.

Fortunately, discontinuation of these drugs leads to the rapid elimination of most of the unwanted effects. Typically, the side effects of second-generation antihistamines are mild.

Output

Newer antihistamines are generally safe. But their use, if not necessary, should be avoided in children and pregnant women.

Drugs that should not be consumed at the same time – Kuban Today

Modern drugs can not only cure you of an illness, but also cause great damage if taken at the same time. Be careful about taking medications.

Antibiotics and oral contraceptives

Antibiotics are substances that are produced by some living organisms to destroy others.The first antibiotic was isolated by Alexander Fleming in 1928, for which he received the Nobel Prize.
Since then, antibiotics have changed the life of mankind. Diseases that used to be a death sentence have learned to cure: pneumonia , tuberculosis , meningitis and other infections. It was thanks to antibiotics that the population explosion of the 20th century took place, when the population began to increase exponentially. Antibiotics are a real miracle of medicine.

Oral contraceptives . Regardless of the form of release, the principle of action of hormonal contraceptives is the same: change the hormonal background so that ovulation (the release of an egg from the ovary), and hence pregnancy becomes impossible. There is another important effect: they change the consistency of the cervical mucus, and it becomes impervious to sperm. In addition to preventing unwanted pregnancies, hormonal contraceptives have a positive effect on a woman’s health in general: they reduce the risk of breast and ovarian cancers, prevent the appearance of acne, ease the course of menstruation, and so on.

Why is it dangerous to combine these drugs?

Combining these drugs can reduce the effectiveness of the birth control pill, and you risk getting pregnant. There are two reasons:
1. Microbes in the intestine improve the absorption of hormones. That is, hormones stay in the body longer and protect against unwanted pregnancy longer. Antibiotics destroy intestinal microbes, hormones are not absorbed, so a large amount of hormones are simply lost with calla.
2. Many antibiotics stimulate the work of liver enzymes, so they begin to intensively destroy hormones.As a result, the concentration of contraceptives in the blood decreases, and with it the effectiveness of preventing pregnancy.

What to do
If you must take antibiotics and contraceptives at the same time, then use condoms.

Assuta Hospital Moscow is the official representative of the Israeli clinic Assuta. Find out the cost of treatment in Israel http://assuta-moscow.com/tseny/ prices

Loperamide and Calcium

Loperamide (Imodium) is the most common medicine for diarrhea.It is sold without a prescription under various brands. It reduces motor skills and soothes the gut, so you use the toilet less often. It is worth emphasizing that loperamide should not be used if the diarrhea is associated with an infection (that is, when there is a fever, chills, feeling unwell). In this case, microbes will linger in the intestine, which is fraught with aggravation of the infection.

Calcium is a part of two groups of OTC drugs:
1. Bone preparations (in combination with vitamin D).It is taken by women after menopause to reduce their risk of osteoporosis.
2. Antacids (drugs for heartburn) – calcium is a part of some drugs that lower the acidity of gastric juice.

Why is it dangerous to combine these drugs?
The main action of loperamide is inhibition of intestinal motility. But calcium has a similar side effect! Therefore, the combination of these two drugs can lead to very severe, excruciating constipation.

What to do
If you start taking loperamide for diarrhea, take a break from calcium supplements, otherwise your diarrhea may change to constipation.

Verapamil and beta-blockers

Verapamil belongs to the group of calcium blockers. Calcium constricts blood vessels. Verapamil blocks its action – the vessels dilate, which leads to two important effects: blood pressure decreases and blood supply to the heart improves, ischemic pains pass.

The potential danger of verapamil is that it also blocks calcium channels in the cardiac conduction system, therefore it can lead to bradycardia and intracardiac blockade.
Beta-blockers (atenolol, metholol and other drugs with the ending “-ol”) are essential drugs for the treatment of heart failure. In heart failure, the heart has difficulty pumping blood throughout the body. Beta blockers, on the one hand, slow down the heartbeat, but on the other hand, their effectiveness increases.

Fly in the ointment: These drugs also make it difficult for an electrical impulse to travel through the conduction system of the heart.

Why is it dangerous to combine these drugs?
Both verapamil and beta-blockers slow down the contraction of the heart.Therefore, their combination can lead to a strong slowing of the heartbeat (bradycardia and intracardiac blockade). In the worst case, it can stop the work of the heart.

What to do
Monitor the pulse several times a day, write it down in a diary. In case of severe bradycardia (less than 50 / min), consult a doctor.

Medicines for colds and allergies

Antihistamines are the most common allergy medications. They reduce the release of histamine, which causes all the unpleasant effects of allergies: itching, redness, tearing, etc.Antihistamines can effectively treat all of these symptoms.
Preparations for colds consist of several active ingredients. As a rule, these are:
1. Paracetamol – to reduce headache and fever
2. A substance for narrowing the blood vessels to reduce swelling of the nasal mucosa, thereby reducing the runny nose.
3. Antihistamine – in this case, it reduces the phenomena of the inflammatory reaction (sneezing, tearing, etc.)
Thus, these drugs are very effective in eliminating the symptoms of colds and flu.However, they do not fight the virus, do not forget about it!

IMPORTANT

These preparations are not just “delicious seagulls”! They can be easily overdose! More than four sachets a day is not recommended.

Why is it dangerous to combine these drugs?
Antihistamines are a part of medicines for allergies and colds.
A side effect of these drugs is drowsiness. Therefore, after drinking both that, and another, you risk losing vigor for the whole day.
In addition, this problem can be very dangerous if, for example, you drive the car that day.

What to do
If you are taking cold medications, temporarily stop using antihistamines OR take second or third generation drugs (Telfast, Erius, Claritin, etc.), which have less effect on the nervous system.

Warfarin and pain relievers

Warfarin is a drug that reduces blood clotting. It reduces the production of coagulation factor proteins. Therefore, the blood becomes thinner and the risk of blood clots is reduced.Most often, warfarin is prescribed for atrial fibrillation, in which blood clots form in the heart, which can “come off”, fly into the brain and cause a stroke.
The main danger is that an overdose of warfarin increases bleeding and the risk of intracranial hemorrhage.

Why is it dangerous to combine these drugs?
Decreased blood clotting is a known side effect of NSAIDs. Therefore, the combination of NSAIDs with warfarin significantly increases the risk of dangerous bleeding.

What to do
If you have to take warfarin, avoid NSAID pain relievers. Use parazatamol instead – it is a good substitute for NSAIDs in most cases.

Cardiac aspirin and pain relievers

Heart Aspirin is one of the most revolutionary drugs of all time. Its use can significantly reduce the risk of death in case of heart attack and angina pectoris. Cardiac aspirin (low-dose aspirin) inhibits the production of the substance thromboxane, which contributes to the formation of blood clots.As a result, the process of thrombus formation slows down.

The most common pain relievers are non-steroidal anti-inflammatory drugs (ibuprofen, nise and many others). These drugs block the production of prostaglandins, substances that cause inflammation and pain. Therefore, NSAIDs are extremely effective for almost all types of pain (headache, joint pain, muscle pain, etc.)

Why is it dangerous to combine these drugs?
Firstly, both cardiac aspirin and NSAIDs have side effects on the gastric mucosa, therefore, if taken together, they can cause ulcers and gastric bleeding.
Second, NSAIDs compete with aspirin for the same enzyme. But at the same time they block it worse than aspirin. Therefore, when used together, it is possible to reduce the effectiveness of cardiac aspirin.

What to do:
1. Do not take these drugs on an empty stomach.
2. Take NSAIDs either at least 30 minutes after cardiac aspirin or 8 hours before.
3. If you are taking cardiac aspirin, try not to take NSAIDs at all. In many cases, the drug paracetamol helps with pain, which does not interact in any way with aspirin.

Statins and fluconazole

Statins are the main drugs for lowering cholesterol levels. They disrupt the production of cholesterol by the liver, so the liver is forced to process the cholesterol already present in the blood.
Fluconazole (Flucostat, Diflucan) is one of the key antifungal drugs. First of all, it is effective against candidiasis – thrush, which most often affects the genital tract and oral mucosa.

Why is it dangerous to combine these drugs?
Statins are processed by liver enzymes.Fluconazole inhibits the action of these enzymes, which leads to excessive accumulation of statins in the body. In large quantities, statins can cause rhabdomyolysis – muscle damage.

What to do
Since fluconazole is usually drunk in short courses (from one to several days), it is advisable to discontinue statins for this period.

ACE inhibitors and spironolactone

ACE inhibitors (lisinopril, captopril, and other drugs with the “-pril” ending) are the most important drugs for combating high blood pressure.
ACE is an enzyme involved in the production of a substance called angiotensin II, which constricts blood vessels. ACE inhibitors block the production of this enzyme, as a result of which the vessels dilate and the pressure decreases.

Spironolactone (Veroshpiron) is one of the most important drugs for combating heart failure. With heart failure, the heart does not work well, and it is difficult for it to pump large volumes of fluid. Spironolactone removes excess salt and fluid from the body, blood volume decreases, and the load on the heart decreases.In addition, this drug reduces the replacement of normal heart tissue with scar tissue that won’t work.

Why is it dangerous to combine these drugs?
Both ACE inhibitors and spironolactone increase the concentration of potassium in the blood. This can lead to hyperkalemia. It is dangerous by disturbances in rhythm and conduction in the heart.

What to do:
1. Regularly take a blood test for potassium.
2. Limit consumption of foods high in potassium (bananas, lentils, parsnips, Brussels sprouts, sweet potatoes)

Source zdorovieinfo.ru

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