Ranitidine is a widely used histamine-2-receptor antagonist and it is usually well tolerated by patients with an excellent safety record. Anaphylactic reaction to ranitidine is rare event. We report here on 2 cases with anaphylactic reaction after the intravenous administration of ranitidine in an emergency medical center. Awareness of this rare, but life threatening adverse reaction to a commonly used ranitidine can help physicians avoid being caught unaware when they experience this medical situation. Although the incidences of anaphylactic reactions induced by these drugs are low, clinicians should be aware of this possibility of life threatening risk of anaphylactic reaction when administering ranitidine. Furthermore, the possibility of cross reactivity between drugs in the same antihistamine group should be considered. (ED note: please check the part in the yellow.)
Administration, Intravenous ; Anaphylaxis ; Emergencies ; Histamine H2 Antagonists ; Humans ; Incidence ; Ranitidine

Histamine Antagonists ; administration & dosage ; therapeutic use ; Humans ; Phthalazines ; administration & dosage ; therapeutic use ; Rhinitis, Allergic, Perennial ; drug therapy

Anti-Allergic Agents ; therapeutic use ; Drug Therapy, Combination ; Glucocorticoids ; administration & dosage ; therapeutic use ; Histamine Antagonists ; administration & dosage ; therapeutic use ; Humans ; Rhinitis, Allergic ; drug therapy

BACKGROUND/AIMS: Proton pump inhibitors (PPI) and H2-receptor antagonists (H2RA) are commonly prescribed for the treatment of mild to moderate reflux esophagitis (MMRE). There remains great controversy in their usefulness as the first choice and the appropriateness. We prospectively compared the efficacy and safety of the 8-week low-dose PPI vs. standard-dose H2RA in MMRE. METHODS: One hundred patients with MMRE were randomized to receive either low-dose of omeprazole (L-OMP: 10 mg, q.d.) or standard-dose of ranitidine (S-H2RA: 150 mg, b.i.d.) for 8 weeks. The H. pylori status using rapid urease test, histological examination and culture, reflux esophagitis (RE) grading, gastrointestinal symptoms using 4-point scale, adverse event and the standard laboratory examination were assessed at baseline and 8-week end point of therapy. RESULTS: Improvement rate of RE [intention to treat (n=82)/per protocol (n=72)] were shown in 69.1%/63.9% for L-OMP and 65.0%/63.9% for S-H2RA group (p=0.697, p=1.000). Complete healing rates of RE were 54.7%/50.0% for L-OMP and 42.5%/41.7% for S-H2RA. No significant difference in healing rate, the rapidity of symptom resolution, adverse events, and laboratory monitoring was found between the two groups. CONCLUSIONS: The low-dose omeprazole therapy produced similar healing rates and safety in the treatment of MMRE. In addition, L-OMP is advantageous in its once-a-day dosing and might be an alternative to S-H2RA, especially in Korean patients with MMRE.
Adolescent ; Adult ; Aged ; Anti-Ulcer Agents/*administration & dosage ; Comparative Study ; English Abstract ; Esophagitis, Peptic/*drug therapy/pathology ; Female ; Histamine H2 Antagonists/*administration & dosage ; Humans ; Male ; Middle Aged ; Omeprazole/*administration & dosage ; Ranitidine/*administration & dosage

OBJECTIVE: To determine if greater efficacy could be achieved with the intranasal antihistamine azelastine and the intranasal corticosteroid fluticasone propionate used concurrently in the treatment of nasal obstruction of persistent non-allergic rhinitis. METHOD: A total of 162 persistent non-allergic rhinitis cases with moderate to severe nasal obstruction were randomized to treatment with the following: the combination therapy or nasal corticosteroids monotherapy. Efficacy was assessed by change from baseline in nasal obstruction score at week 2 and week 6 visits. The perceptions of global treatment satisfaction(convenience, side effects, cost and effectiveness) in both groups were analyzed. RESULT: In both groups, the nasal obstruction score assessment descended significantly at week 2 and week 6 visits versus at baseline (all P < 0.01). At week 2 and week 6 visits, the nasal obstruction score in the combination therapy groups were significantly improved than that in nasal corticosteroids monotherapy groups (all P < 0.01). The perceptions of global treatment satisfaction in the combination therapy groups were significantly better (P < 0.05). CONCLUSION Azelastine nasal spray and intranasal corticosteroid in combination may provide a substantial therapeutic benefit for patients with persistent non-allergic rhinitis, especially nasal obstruction. The combination therapy was well tolerated and safety.
Administration, Intranasal ; Adrenal Cortex Hormones ; therapeutic use ; Drug Therapy, Combination ; Histamine H1 Antagonists ; therapeutic use ; Humans ; Nasal Obstruction ; Phthalazines ; therapeutic use ; Rhinitis ; drug therapy

No abstract available.
Administration, Cutaneous ; Blood Pressure Monitoring, Ambulatory/*adverse effects/instrumentation ; Dermatitis, Contact/diagnosis/drug therapy/*etiology ; Female ; Histamine Antagonists/administration & dosage ; Humans ; Hypertension/*diagnosis/physiopathology ; Middle Aged ; Steroids/administration & dosage ; Treatment Outcome

OBJECTIVE: To evaluate cardiovascular safety of loratadine, a second generation H1-antagonist, in treatment of patients with allergic rhinitis. METHOD: A total of 50 patients with persistent allergic rhinitis were enrolled, of which 19 cases (38.0%) had a history of cardiovascular diseases and/or presented abnormal electrocardiogram (ECG) findings without prolonged QT-interval. For all patents, 10 mg loratadine tablet was oral administrated once-daily for 30 days. ECG examinations were carried out both before and after treatment. Cardiovascular effects of loratadine were determined by the comparison of two ECGs. RESULT: All patients had no alterations in sinus rhythm after administration of loratadine for 30 days. There were no significant differences of heart rates, P durations, PR or QRS intervals between the baseline and end-point ECGs (P > 0.05), as well as no significant prolongation of the QT or QTc corrected for heart rate using Bazett' formula (P > 0.05). CONCLUSION Cardiovascular safety of loratadine, a second generation H1-antagonist, is confirmed in long-term treatment of persistent allergic rhinitis at a recommended dose.
Administration, Oral ; Adult ; Aged ; Aged, 80 and over ; Female ; Heart Rate ; Histamine H1 Antagonists, Non-Sedating ; administration & dosage ; adverse effects ; therapeutic use ; Humans ; Loratadine ; administration & dosage ; adverse effects ; therapeutic use ; Male ; Middle Aged ; Rhinitis, Allergic, Seasonal ; drug therapy ; physiopathology ; Young Adult

OBJECTIVE: To investigate the behavior difference of allergic rhinitis with adenoid hypertrophy between study group and control group. METHOD: One hundred and seventeen children diagnosed as allergic rhinitis with adenoid hypertrophy were enrolled in our study were divided into study group and control group. Forty-two children treated with local steroid nasal spray for two to three months and antihistamine were control group. Seventy-five children treated with endoscopic adenoidectomy and drug treatment were study group; All children' parents were inquired for their clinical presentation. RESULT: No distinctive differences were found between the two groups (P > 0.05) in adenoid hypertrophy, accompanying nasal problems and clinical questionnaire scoring. Significant statistical distinction were found (P < 0.05) in snoring, sleep disturbance and frequent arousal, nasal obstructive moth-breathing, and recurrent respiratory tract infection between the two groups after three-month follow up. CONCLUSION Endoscopic adenoidectomy should be taken into account for allergic rhinitis with adenoid hypertrophy in children. Adenoidectomy would be useful for the improvement of behavior symptoms.
Adenoidectomy ; methods ; Adenoids ; pathology ; Anti-Allergic Agents ; administration & dosage ; Case-Control Studies ; Child ; Combined Modality Therapy ; Endoscopy ; Female ; Histamine H1 Antagonists ; administration & dosage ; Humans ; Hypertrophy ; complications ; therapy ; Male ; Rhinitis, Allergic ; complications ; therapy ; Steroids ; administration & dosage

INTRODUCTIONFew reports have documented allergic hypersensitivity reactions after barium gastrointestinal studies. Of these, the barium suspension, its additives or intravenous glucagon given for bowel relaxation has been implicated as possible allergens. We report a patient with delayed hypersensitivity reaction after barium enema and discuss the reasons supporting glucagon as the possible allergen.

CLINICAL PICTUREA 74-year-old Chinese woman presented with pruritic rashes, 1 day after a barium enema. Intravenous glucagon (GlucaGen, Novo Nordisk, Denmark) was administered during the barium enema. Physical examination revealed palpable purpuric rashes on the legs with erythematous papules and plaques on the arms and trunk. Skin biopsy demonstrated superficial perivascular infiltrates of lymphocytes and eosinophils, consistent with a drug eruption.

TREATMENT AND OUTCOMEThe rashes resolved with antihistamines and topical corticosteroids.

CONCLUSIONThis report highlights the potential of glucagon to cause hypersensitivity reactions. Awareness of this entity is important for the prevention and recognition of complications during barium gastrointestinal studies.

Adrenal Cortex Hormones ; therapeutic use ; Aged ; Barium Compounds ; Drug Hypersensitivity ; etiology ; Enema ; Female ; Glucagon ; administration & dosage ; adverse effects ; Histamine H1 Antagonists ; therapeutic use ; Humans ; Hypersensitivity, Delayed ; etiology ; Injections, Intravenous ; Parasympatholytics ; administration & dosage ; adverse effects ; Time Factors

OBJECTIVETo assess the therapeutic effects on acupuncture preventive treatment of no-aura migraine and its influence on the QOL (quality of life) of the patients.

METHODSRandomized controlled, double-blind and double-dummy research methods were adopted, 60 cases were randomly divided into an observation group and a control group, 30 cases in each group. The observation group was treated with acupuncture combined with oral administration of Flunarizine Hydrochloride vacuity capsules, and Baihui (GV 20), Shenting (GV 24) and Benshen (GB 13) were selected as main points. The control group was treated with oral administration of Flunarizine Hydrochloride capsules combined with acupuncture at placebo-points, thrice each week, for 4 weeks. The SF-36 QOL Scale and effective rate were used for assessment of therapeutic effects before treatment, after treatment and 3 months later.

RESULTSThere were significant differences in each dimension scores of SF-36 at 3 time points between the two groups (all P < 0.05). The dimension of the physiological function in the observation group was superior to that of the control group after treatment (P < 0.05), and there was no significant difference in other 7 dimensions between the two groups (all P > 0.05). After treatment and 3 months later, the effective rates were 68.0%, 68.0% in the observation group and 24.0%, 32.0% in the control group, respectively, with significant differences between the two groups (all P < 0.05).

CONCLUSIONAcupuncture preventive treatment can effectively improve the life quality of the patients with migraine and reduce the migraine attack. There is no significant difference in improving the physical and psychological health of the migraine patients between acupuncture and Flunarizine Hydrochloride, and acupuncture is more effective in reducing the migraine attack days.

Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Double-Blind Method ; Female ; Flunarizine ; administration & dosage ; therapeutic use ; Histamine H1 Antagonists ; administration & dosage ; therapeutic use ; Humans ; Male ; Middle Aged ; Migraine without Aura ; prevention & control ; therapy ; Quality of Life ; Surveys and Questionnaires ; Treatment Outcome ; Young Adult