Office-based management of urticaria
ABSTRACT Urticaria is a common pruritic skin disorder that is often seen in the office and varies in severity and chronicity. The etiologic cause is frequently not identifiable. Urticaria may be associated with physical factors and triggers, including foods or medications. A significant percentage of patients with chronic urticaria have circulating autoantibodies directed toward immunoglobulin-E or the high-affinity receptor for immunoglobulin-E (FcepsilonRI), or have antithyroid antibodies that might play a role in the activation of the final common pathway in urticaria: mast cell activation and degranulation. Management begins with a careful investigation and elimination of eliciting factors when identified, followed by treatment of underlying disease. Antihistamines are the current mainstay of pharmacotherapy for urticaria, which provide symptomatic relief in most cases. In severe cases, corticosteroids, hydroxychloroquine sulfate (Plaquenil; Sanofi-Synthelabo, New York, NY), and immunosuppressive agents, including cyclosporin, are sometimes used by specialists.
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ABSTRACT: The prevalence of food allergies in the inmate population is a relatively unknown and perhaps underreported health issue. An inmate with an undetected food allergy is at risk for anaphylaxis or less serious complications and is becoming an increasing concern to correctional facilities. Allergic responses to foods cause many symptoms, including cutaneous, gastrointestinal, respiratory, cardiovascular, and anaphylactic. These nonspecific symptoms are often first thought to be related to other conditions. Cell-mediated disorders, food intolerances, and pharmacologic conditions should be considered in the differential diagnosis and appropriately ruled out. The symptoms may mimic other problems, and allergic reactions would not be among the first conditions considered in the differential diagnosis. Consideration of food allergies and recognition of the symptoms should prompt a diagnostic evaluation. Not all correctional institutions have access to a dietitian or conduct allergy testing and the need to prepare special meals may create challenges.Journal of Correctional Health Care 05/2012; 18(2):105-10. DOI:10.1177/1078345811435473
Article: Urticaria and Angioedema[Show abstract] [Hide abstract]
ABSTRACT: Urticaria and angioedema are common disorders that can severely impair the quality of a patient's life and can be extremely difficult to treat. Symptoms can persist for years to decades. The causes of urticaria and angioedema are varied and may be immunologic, nonimmunologic, or idiopathic. This article reviews the literature and provides primary care physicians with up-to-date information of the epidemiology, basic pathophysiology, diagnosis, and management of this common and often debilitating condition. Additionally, clinical manifestations of acute and chronic urticaria, hereditary and acquired angioedema, as well as the physical urticarias will be discussed.Mount Sinai Journal of Medicine A Journal of Translational and Personalized Medicine 09/2011; 78(5):784-802. DOI:10.1002/msj.20288 · 1.56 Impact Factor
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ABSTRACT: BackgroundA new, simple and accurate stability-indicating reverse phase high performance liquid chromatography method was developed and validated during the early stage of drug development of an oral lyophilizate dosage form of cetirizine dihydrochloride.Methods For RP-HPLC analysis it was used an Eclipse XDB C8 column 150 mm × 4.6 mm, 5 ¿m (Agilent columns, Barcelona, Spain) as the stationary phase with a mobile phase consisted of a mixture of 0.2 M K2HPO4 pH 7.00 and acetonitrile (65:35, v/v) at a flow rate of 1 mL min ¿1. Detection was performed at 230 nm using diode array detector. The method was validated in accordance with ICH guidelines with respect to linearity, accuracy, precision, specificity, limit of detection and quantification.ResultsThe method results in excellent separation between the drug substance and its stress-induced degradation products. The peak purity factor is >950 for the drug substance after all types of stress, which confirms the complete separation of the drug substance peak from its stress induced degradation products.Regression analysis showed r2¿>¿0.999 for cetirizine dihydrochloride in the concentration range of 650 ¿g mL ¿1 to 350 ¿g mL¿1 for drug substance assay and a r2¿>¿0.999 in the concentration range of 0.25 ¿g mL¿1 to 5 ¿g mL¿1 for degradation products. The method presents a limit of detection of 0.056 ¿g mL ¿1 and a limit of quantification of 0.25 ¿g mL¿1. The obtained results for precision and accuracy for drug substance and degradation products are within the specifications established for the validation of the method.Conclusions The proposed stability-indicating method developed in the early phase of drug development proved to be a simple, sensitive, accurate, precise, reproducible and therefore useful for the following stages of the cetirizine dihydrochloride oral lyophilizate dosage form development.DARU-JOURNAL OF FACULTY OF PHARMACY 12/2014; 22(1):82. DOI:10.1186/PREACCEPT-2325316221462835 · 1.11 Impact Factor