How to fit an antihistamine, taking into account the individual characteristics of the patient: From pharmacokinetics to profiling

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The authors of the article describe the dependence of the effectiveness of any drug on the "correctness" of its choice for the patient and conclude that patient profiling can serve as an effective clinical method for selecting optimal therapy. When prescribing antihistamines, it is suggested to use the following main patient profiles: children, working adults, elderly patients. Each profile has its own specific purpose.

The article presents own clinical experience of using fexofenadine based on patient profiling. Cases of fexofenadine therapy in patients with allergic rhinitis and chronic urticaria are given as specific examples. Fexofenadine has an optimal safety profile with minimal impact on concentration and cognitive abilities. In this regard, it can be recommended to employees whose activities are associated with the speed of psychomotor reactions, schoolchildren and university students, elderly patients with high drug load and comorbidity.

The article discusses approaches to choosing the optimal second-generation antihistamine in patients of these groups seeking primary medical care when symptoms of urticaria and allergic rhinitis occur.

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About the authors

Natalia M. Nenasheva

Russian Medical Academy of Continuous Professional Education

ORCID iD: 0000-0002-3162-2510
SPIN-code: 3363-6170

MD, Dr. Sci. (Med.), Professor

Russian Federation, 2/1 Barrikadnaya street, 125993 Moscow

Oksana V. Sebekina

Russian Medical Academy of Continuous Professional Education; City Clinical Hospital No. 24

ORCID iD: 0000-0002-3508-9602
SPIN-code: 2922-9398
Scopus Author ID: 6503913655

MD, Cand. Sci. (Med.)

Russian Federation, 2/1 Barrikadnaya street, 125993 Moscow; Moscow

Marina Yu. Peredelskaya

Russian Medical Academy of Continuous Professional Education; City Clinical Hospital No. 24

Author for correspondence.
ORCID iD: 0000-0003-2682-8108
SPIN-code: 3363-5507
Scopus Author ID: 57210586164

MD, Cand. Sci. (Med.)

Russian Federation, 2/1 Barrikadnaya street, 125993 Moscow; Moscow

Kristina A. Akmalova

Russian Medical Academy of Continuous Professional Education

ORCID iD: 0000-0003-3505-8520
SPIN-code: 2604-1922
Scopus Author ID: 57216550550

Assistant of the Department of Clinical Pharmacology

Russian Federation, 2/1 Barrikadnaya street, 125993 Moscow


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Supplementary files

Supplementary Files
1. Fig. 1. Employment of H1-histamine receptors of the brain after taking antihistamines according to positron emission tomography[1].

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2. Fig. 2. Patient L., 36 years old (clinical case 2) with chronic spontaneous urticaria of moderate severity: Pink urticaria, not prone to fusion, on the skin of the trunk (а) and extremities (b).

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3. Fig. 3. The same patient on the background of cetirizine therapy at a dose of 20 mg (1 tablet 10 mg 2 times a day): Single pink rashes.

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4. Fig. 4. Patient K., 67 years old, with a diagnosis of chronic spontaneous urticaria of moderate severity (clinical case 3) at the time of hospitalization: skin with rashes and swelling in the right auricle (а); urticary elements in the lower extremities (b).

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5. Fig. 5. The same patient: skin with urticar elements on the background of Bilastin therapy.

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