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Angioedema Therapy |
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In allergic angioedema, avoidance of the allergen and use of antihistamines may prevent future attacks. Cetirizine, marketed as Zyrtec, is a commonly prescribed antihistamine for angioedema. Severe angioedema cases may require desensitization to the putative allergen, as mortality can occur. Chronic cases require steroid therapy, which generally leads to a good response.
In ACE inhibitor use, the medication needs to be discontinued, and all similar drugs need to be avoided. There is a certain degree of controversy whether angiotensin II receptor antagonists are safe in patients with a previous attack of angioedema.
In hereditary angioedema, specific stimuli that have previously luxated attacks may need to be avoided in the future. Severe cases receive replacement therapy with purified vapor-heated C1-esterase inhibitor (as described by Waytes et al 1996), while danazol (an androgen) relieves symptoms somewhat. In the absence of C1inh concentrate, fresh frozen plasma is used. DX-88 is an inhibitor of kallikrein that is due to be marketed as an orphan drug for hereditary angioedema.
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