Management Of Urticaria
1.Avoidance of allergens/trigger factors.
2.Treatment of Underlying Medical condition.
3.Pharmacological Treatment:
Antihistamine:
H1 receptor blockers : Cetrizine,loratidine and
chlorpheniramine
Combination of H1 receptor blockers and H2 receptor blockers
in severe cases.
Leukotriene receptor antagonists:
Montelukast and Zafirlukast
Oral Corticosteroids maybe used in very severe eruptions.
Intramuscular adrenaline in life threatening scenarios and
anaphylactic shock.
Clinical History in Urticaria:
This is of primary significance.
It is important to ask about onset,duration and course of
lesions and associated rash and swelling.
Urticaria is very itchy and
angioedema is painful.
Patients with urticarial complain of itcy spots and rashes
lasting minutes or hours. Usually less than 24 hours
and that resolve leaving
no scars or marks.
In angio-edema,there may be swelling of face and lips and
tongue that may last for hours and days.
Incase the lesions last for more than 24 hours and is painful
and resolves with bruising,urticarial vasculitis is more likely than ordinary urticaria.
Pateints may occasionally feel unwell before the onset of
rash or swelling and in severe reactions,anaphylaxis may result.
It is important to find out about any possible trigger
before onset of rash,eg any food eaten,medications taken,insect
stings,infections etc.
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