(1) systemic therapy
Acute urticaria can generally choose chlorpheniramine, cyproheptadine, ketotifen and other first-generation antihistamines; Some drivers who are more concerned about the drowsiness of antihistamines than those who work and study at high altitude in sensitive groups choose the second generation antihistamines, such as cetirizine hydrochloride, terfenadine and astemizole loratadine. Generally, the combination of ~ antihistamines with vitamin C and calcium can reduce vascular permeability. Propofol, atropine and other antispasmodic drugs can be given to patients with abdominal pain that have synergistic effect with antihistamines. Those patients caused by sepsis or septicemia should be treated with antibiotics immediately. In case of severe illness, shock, laryngeal edema and dyspnea,% epinephrine M should be injected subcutaneously immediately, promethazine hydrochloride ~ mg should be injected intramuscularly with oxygen quickly, and hydrocortisone -g and vitamin C g should be added to M% ~% glucose solution. After intravenous drip for minutes, epinephrine ml can be injected repeatedly. Adrenaline should be used with caution in patients with cardiovascular diseases, and aminophylline G (added to% ~% glucose solution) can be given slowly by intravenous drip in patients with bronchospasm. When laryngeal edema occurs, tracheotomy is generally not recommended because it is sensitive to adrenaline and adrenaline.
Chronic urticaria should actively seek the cause, and glucocorticoid should not be used. Generally, antihistamines are the main drugs, and the medication time should be adjusted according to the time when wheal occurs. For example, if you get up more in the morning, you should give a slightly larger dose before going to bed. If you fall asleep many times, you can continue to take the medicine for more than a month after dinner and gradually reduce it. When an antihistamine fails, multiple antihistamines can be used in combination alternately.
For patients with intractable urticaria, if the curative effect of H receptor antagonist alone is not good, Ranitidine and other H receptor antagonists can be combined. Besides antihistamines, reserpine, aminophylline, chloroquine and tripterygium wilfordii can be taken orally as appropriate.
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Drugs with anti-serotonin and anti-acetylcholine effects are often selected for special types of urticaria, such as hydroxyzine dechlorination, which has a better effect on physical urticaria, and cyproheptadine, which has a more prominent effect on cold urticaria.
(2) Topical drugs can be antipruritic liquid, calamine lotion and zinc oxide lotion in summer, and emulsion with antipruritic effect such as diphenhydramine cream can be selected in winter.
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