Проблеми екології та медицини

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https://repository.pdmu.edu.ua/handle/123456789/87

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Перегляд Проблеми екології та медицини за Автор "Avramenko, Ya. M."

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    Personalized desensitization with acetylsalicylic acid in patients with hypersensitivity to non-steroidal anti-inflammatory drugs
    (Ukrainian Medical Stomatological Academy, 2020) Lavrenko, A. V.; Avramenko, Ya. M.; Borzykh, O. A.; Kaidashev, I. P.; Лавренко, Анна Владимировна; Авраменко, Яніна Миколаївна; Борзих, Оксана Анатоліївна; Кайдашев, Ігор Петрович
    Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) has various mechanisms and represents different clinical syndromes from anaphylaxis to severe bronchospasm. The prevalence o f aspirin hypersensitivity among patients with asthma and nasal polyps reaches 25.6%. Respiratory reactions associated with aspirin or other NSAIDs are not immunological. The basis o f these reactions is non-a/iergic hypersensitivity o f the cross-reactive type. Desensitization followed by long-term aspirin therapy is an effective method o f treating hypersensitivity to aspirin or other NSAIDs. Using aspirin 600-1200 mg/day can significantly alleviate the symptoms o f asthma; allergic rhinitis. We successfully applied aspirin desensitization for method o f patients with hypersensitivity to NSAIDs. According to them e th o d a n hour before the desensitization, daily montelukast 10 mg was taken orally, then aspirin every 3 hours. Results: Three patients underwent desensitization o f aspirin. The dose was selected individuaiy depending on the clinical manifestations o f drug-induced adverse reactions (AR). ARs during desensitization were treated by iv dexamethasone administration. Subsequent doses did not cause AR. Doses o f aspirin were increased to a maximum o f 1250 mg daily, and were continued for the long-term use. Conclusion: It is possible to conclude that the initial dose o f aspirin should be 16-40mg; it is possible to increase the dose if the initial dosage is well tolerated; symptoms o f moderate intolerance are treated by 4-8 mg iv dexamethasone; prior to desensitization, we recommended to use montelukast 10 mg, it is safe to practice desensitization o f aspirin according to a personalized technique by a specialist in an intensive care unit.