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Mt s thuc khng histamin

H1 thng dung

Histamin tp trung trong cc t bo mast cells.

Cc thuc khng histamin H1 c s dng trong iu tr rt a dng.


N lm gim cc trng thi pht ban, m ay, d ng mi, lm du cc triu
chng nga, bun nn v nn. N rt hay c s dng phi hp trong iu
tr cc triu chng cm, ho, st hoc d ng vi thi tit nh: vim mi d
ng, chy nc mi, ht hi, vim kt mc mt, cn trng t. Mt s thuc
c dng lm thuc chng say tu xe do c tc dng c ch thn kinh trung
ng, an thn nh, lm gim cc ri lon tin nh, chng mt v bun nn.

C ch hot ng ca histamin
Khi c th con ngi chng ta b d ng vi cc tc nhn bao gm thuc,
ha cht, mi trng m c th tip xc s gii phng ra histamin. Trong c th,
histamin c sn trong cc m nh: da, phi, nim mc ming, d dy. Mt s vi
khun khi b nhim vo ng rut gy bnh dch nguy him cng c th to ra
histamin. trng thi bnh thng, cc t bo cha sn histamin nhng khng c
hot tnh v n ang dng phc hp vi protein. Khi c th b d ng, mn cm
vi thuc, ha cht hay cc tc nhn ngoi cnh khc, cc cht khng nguyn tc
ng ln phc hp protein ny v gii phng ra histamin, gy ra nhng phn ng
d ng t trm trng nh: sc phn v cho n cc trng thi d ng khc nh: pht
ban, da, ph n, kh th, nga, ho, bun nn... Khi , chng ta phi s dng
cc thuc khng histamin iu tr.

Cc thuc khng histamin H1 l nhng thuc c tc dng tt trong cc phn


ng d ng cp tnh, vi cc triu chng nh: s mi, ni ban , vim m lin
kt, vim mao mch d ng, vim da... Nhm thuc ny c kh nhiu hot cht,
thng c phn loi theo th h hoc theo cu trc ha hc. Thng c chia
thnh 6 nhm l ethanolamin, ethylenediamin, piperazin, alkylamin, piperidin v
phenothiazin.

Mt s cht khng histamin H1 thng dng

Cc ethanolamin: vi nhiu dn cht nh: carbinoxamin, clemastin,


dimenhydrynat, diphenhydramin... c tc dng lm du v tc dng khng cm
cholin. Trn th trng hin nay c mt s thuc chng say tu xe nh vomina,
nautamin c nhiu ngi hay s dng, cn lu l n c tc dng an thn gy
ng nn phi s dng ng liu trnh nhng tc dng ph nguy him. Dng
thuc dimedrol ng tim 10mg/1ml thng ch s dng trong bnh vin. Thuc
nh mt daiticol c phi hp vi km sulfat cn c k trc khi s dng v thn
trng vi nhng ngi c c a qu mn.

Cc ethylendiamin: l cc cht i khng chn lc ca th th H1. Hay


dng cc thuc tng hp nh: pyrilamin v tripelennamin. Thuc ny c tc dng
an thn v gy t ti ch, c s dng iu tr nhiu loi d ng thc n hoc
d ng thuc, ezecma, phn ng sau khi tim huyt thanh. Cng nh tt c cc
thuc khng histamin H1 khc, thuc ny gy bun ng, trnh dng khi vn hnh
my mc, lm vic trn cao, li tu xe. Tuyt i khng ung ru khi dng thuc.

Cc piperazin: c tc dng lm du v chng nn nh: cyclizin, meclozin,


hydroxyzin, cetirizin. Tuy nhin, chng li khng c tc dng an thn v chng
tit cholin. Thng c dng iu tr d ng h hp, vim mi d ng dai dng
mn tnh hoc theo ma, cc bnh ngoi da nga hoc m ay mn tnh.
Cc alkylamin: vi tc dng chng d ng nh rt hay c s dng nh:
rompheniramin, chlopheniramin. Hot cht c th c s dng ring r hoc phi

hp vi cc cht gim au, h st, chng vim khc. Trn th trng c cc bit
dc phi hp ca chlopheniramin vi paracetamol thng rt hay s dng tr
cm cm, ho, au hng... Cn lu khng c dng cho ngi c tin s b bnh
tim mch, cao huyt p. Hin nay, c th h mi l acrivastin dng vin nang 8mg
dng iu tr vim mi d ng, m ay mn tnh, nga, mn Ch khng
dng thuc ny cho ph n c thai hoc ang cho con b.
Cc phenothiazin: m in hnh l promethazin c tc dng lm du r rt
v chng nn, khng tit cholin mnh. y l thuc khng histamin tng hp
mnh nht hin nay. N cn c tc dng gy ng, gim au, an thn, gim lo u v
chng nn. Ch dng thuc tim c cha cht sulfit nn c th gy sc phn v.
Khng c tim di da v tuyt i khng dng cho tr em di 2 tui v c th
gy ngng th t ngt. Hot cht ny c kh nhiu dng thuc nh kem bi da
2%, si-r ung 0,1%, ng tim 50mg/2ml hoc vin nn ung 25mg. Promethazin
cn c nhiu tn khc nh: pipolphen hoc phenergan.

Cc piperidin: c tc dng lm du mc trung bnh v c tc dng chn


lc cao vi cc th th H1, hin nay rt hay c s dng nh astemizon,
levocabastin, loratadin, azatadin, cycloheptadin, terfenadin. y l nhm thuc
khng histamin H1 c rt nhiu tn bit dc, c s dng trong nhiu bnh d
ng khc nhau. Ch cc dng thuc khng histamin ny c tc dng nhanh v
ko di nn mi ngy ch dng 1 ln.

Tt c cc thuc khng histamin H1 u c nhiu tc dng ph nn phi


dng ng quy nh v liu lng v thi gian dng thuc. Ch cc i tng
dng thuc, c bit nh: tr em, ph n c thai, cho con b, ngi cao tui.
Nhm thuc ny c nhiu bit dc, c ngi s dng mua trc khi i du lch
(nh say tu xe hoc d ng vi thi tit, thc n, cm st...). Phi xa tm tay
ca tr em, nu khng dng ht v thuc th loi b. Khng t s dng thuc nu
khng tht cn thit.