Allergy and Clinical Immunology Department, Centro Medico-Docente La Trinidad, Caracas, Venezuela.
J Investig Allergol Clin Immunol. 2013;23(3):141-4; quiz 2 p preceding 145.
Nonsedating antihistamines are the first-choice treatment for all forms of urticaria. In patients with recalcitrant urticaria who do not respond to conventional doses of antihistamines, current guidelines recommend increasing doses by up to 4 times in order to obtain better control of the disease. Although few studies have been conducted, there are convincing data from controlled trials for cetirizine, levocetirizine, and desloratadine that support the use of increased doses of such drugs in unresponsive patients. The use of higher doses of antihistamines has not been associated with increased adverse effects or somnolence. More studies with other second-generation antihistamines are required in order to improve the treatment of patients with severe, recalcitrant urticaria.
非镇静抗组胺药是治疗所有类型荨麻疹的首选药物。对于那些对抗组胺药物常规剂量反应不佳的顽固型荨麻疹患者，目前的指南建议将剂量增加 4 倍，以更好地控制疾病。尽管进行的研究很少，但来自对照试验的令人信服的数据支持在无反应的患者中使用此类药物的更高剂量。使用更高剂量的抗组胺药并未与不良反应或嗜睡增加相关。需要更多的研究来评估其他第二代抗组胺药，以改善严重和顽固型荨麻疹患者的治疗。
