Contemporary principles of pharmacotherapy urticaria

Abstract

Introduction: Chronic urticaria represents 25% of cases of urticaria, and is twice as common in women, especially in people between the ages of 25 and 50 years. Resulting from incidence of this disease in Republic of Moldova, it is required to effectuate a clinical study with the elucidation of the etiology, symptomatology and pharmacotherapy of patients with urticaria. Materials and methods: The trial was conducted at Republican Clinical Hospital l.M.P.S, Department of Allergology. Working methodology consisted in the creation and registration of 97 cases of urticaria and angioedema hospitalizations in 2013 year in Allergology Departament. Results and discussions: In the Department of Allergology, 97 patients were admitted with the diagnosis of urticaria and angioedema, including 53 women and 44 men. Regarding the employment status, 68 patients were employed in different sectors, three students of 12th class, 6 don't work, and 10 were retired by age and had the degree of disability. It is found that in 37.1% of cases, patients are diagnosed with chronic urticaria with mixed forms of angioedema; in 36.08% of cases patients are diagnosed with chronic relapsing urticaria; in 11.3% of cases, patients are diagnosed with angioedema, and in 5.15% of cases are hospitalized with acute urticaria. The etiology, recognized or presumed, is: the drug (62%), food (22%), and infections (16%). Proceeding from studies I found that the frequency of clinical symptoms (complaints) presented by patients may be distributed as follows: 54% o f cases presented maculopapular rash all over the body, sometimes confluent, accompanied by intense itching; 26% of cases accuse marked asthenia, maculopapular, erythematous rash, mainly on the chest, abdomen, upper limbs and in 11% of cases - weakness, 37.50 °C fever. The most common concomitant diseases in patients with urticaria and angioedema are: chronic cholecystitis in flare (45%), chronic pancreatitis (25%), vegetative disorders (27%), chronic gastritis in flare (H. pylori) (15%), anxious-depressive neurosis (15%), hepatic steatosis (13 %), chronic hepatitis (12%). From the analysis based on the patients treatment records of Allergology Department we can conclude that glucocorticoids are first-line drugs in antiallergic treatment of acute urticaria and angioedema (76%). Prescribing rate of Dexamethasone solution 8 and 4 mg constituting 84% and Betamethasone Solution (Diprophos)l. O ml constituing 16%. In this study, I found that antihistamines of 1st generationas chloropyramine is prescribed in 88% of cases, less frequently is prescribed Levocetirizine in tablets (Xilaz) - third-generation antihistamine (22%) and in 8% of cases Cetirizine tablets - second generation antihistamine and tablets Bilastine. Conclusion: The therapeutic results are often modest. About 40% of cases that have evoluted over six months are present during 10 years and 20% are found even after 20 years from the onset.