title: Chronic idiopathic urticaria treatment.
abstract: Chronic idiopathic urticaria (CIU) is a common skin condition that affects 0.1-3 % of people in the USA and Europe and accounts for nearly 75 % of all chronic urticaria cases. Up to 40 % of patients who have chronic urticaria for more than 6 months still have urticarial wheals 10 years later. The therapeutic management should first be oriented towards palliation of symptoms. A 2 % solution of ephedrine as a local spray is very useful for oropharyngeal edema. H1 antihistamines with a low potential for sedation are the most important first-line treatment. Combinations of various antihistamines may be useful in suppressing symptomatology. These include: a) First generation H1 antihistamines; b) Combinations of first and second generations using non-sedating agents in the morning and first generation drugs at night; c) Combinations of second generation antihistamines; d) Combination of doxepin with a first or second generation antihistamine; e) Combination of an H2 anti-receptor antihistamine (eg, cimetidine or ranitidine) with a first or second generation antihistamine. Preliminary reports suggest that desloratadine and anti-leukotrienes may be effective in treating some patients with chronic idiopathic urticaria.
authors.affiliation: Allergy Section. "Virgen de la Arrixaca" University Hospital. Associated Professor of Allergy. University of Murcia. Murcia. Spain. jnegroa@meditex.es
authors.forename: J M
authors.initials: JM
authors.lastname: Negro-Alvarez
authors.forename: J C
authors.initials: JC
authors.lastname: Miralles-López
mesh_terms: D000328:Adult; D000707:Anaphylaxis / Q000188:drug therapy; D000799:Angioedema / Q000188:drug therapy; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D002648:Child; D002908:Chronic Disease; D004311:Double-Blind Method; D004316:Doxepin / Q000627:therapeutic use; D016527:Drug Costs; D004809:Ephedrine / Q000627:therapeutic use; D005060:Europe / Q000453:epidemiology; D005938:Glucocorticoids / Q000627:therapeutic use; D006634:Histamine H1 Antagonists / Q000009:adverse effects / Q000145:classification / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015337:Multicenter Studies as Topic; D010166:Palliative Care; D010956:Plasmapheresis; D015995:Prevalence; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D013256:Steroids; D014481:United States / Q000453:epidemiology; D014581:Urticaria / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology / Q000628:therapy
chemical_list: D000893:Anti-Inflammatory Agents; D000929:Antidepressive Agents, Tricyclic; D005938:Glucocorticoids; D006634:Histamine H1 Antagonists; D007166:Immunosuppressive Agents; D013256:Steroids; D004316:Doxepin; D004809:Ephedrine