Glucocorticosteroid, has anti-inflammatory, anti-allergic, anti-shock, immunosuppressive effect.
Interaction with intracellular glucocorticoid receptors leads to the formation of dimers of the glucocorticoid-glucocorticoid receptor complex.
The steroid hormone complex with the receptor is transported to the cell nucleus. In the nucleus, this complex interacts with effector elements localized on acceptor sites of chromatin (genes). As a result of the interaction, stimulation or inhibition of gene expression occurs; This leads to a change in the synthesis of messenger RNA and proteins.
The anti-inflammatory effect of prednisone is due to several factors.
- The drug induces the synthesis of lipocortin, which inhibits the activity of phospholipase A2. Inhibition of phospholipase A2 mediated hydrolysis of membrane phospholipids of damaged tissues prevents the formation of arachidonic acid. Violation of the formation of arachidonic acid actually means inhibition of prostaglandin synthesis, since arachidonic acid is a substrate for further metabolism along the cyclooxygenase pathway, as well as along the lipoxygenase pathway with a corresponding inhibition of leukotriene synthesis.
- The anti-inflammatory effect of prednisone is potentiated by its ability to inhibit the expression of COX-2 genes, which also leads to a decrease in the synthesis of prostaglandins in the focus of inflammation, including the pro-inflammatory prostaglandins E2 and I2.
- Prednisone inhibits the expression of intercellular adhesion molecules in the endothelium of blood vessels, disrupting the penetration of neutrophils and monocytes into the focus of inflammation. After the introduction of glucocorticoids, an increase in the concentration of neutrophils in the blood (due to their receipt from the bone marrow and due to restriction of migration from the blood vessels) is noted. This causes a decrease in the number of neutrophils at the site of inflammation.
Prednisone inhibits the transcription of cytokine genes that stimulate the inflammatory and immune response (IL-1, IL-2, IL-6, IL-8), as well as tumor necrosis factor (and some others). Also note a decrease in the rate of transcription and increased degradation of receptor genes for IL-1 and IL-2, inhibition of transcription of metalloproteinase genes (collagenase, elastase, etc.) involved in increasing the permeability of the vascular wall, in the processes of scarring and destruction of cartilage tissue in diseases of the joints.
The immunosuppressive effect is due to the inhibition of DNA transcription, which encodes the major histocompatibility complex, pro-inflammatory cytokines (IL-1, IL-2) and the suppression of T-lymphocyte proliferation. It leads to a decrease in the number of T-lymphocytes and their effect on B-lymphocytes, inhibits the production of immunoglobulins. Reduces education and increases the breakdown of components of the compliment system.
The antiallergic effect is associated with inhibition of the synthesis of mediators of allergy, degranulation of mast cells and the release of mediators of allergy, and therefore it is effective in allergic reactions of the immediate type.
Restores the sensitivity of adrenergic receptors to catecholamines. Accelerates the breakdown of proteins and reduces their concentration in plasma, inhibits glucose utilization by peripheral tissues and stimulates gluconeogenesis in the liver, potentiates the formation of enzyme proteins in the liver, erythropoietin, fibrinogen, surfactant, lipomodulin. It leads to the redistribution of fat, increases the formation of triglycerides and higher fatty acids. Reduces absorption and potentiates calcium excretion; retains sodium and water.
The mechanism of the anti-shock effect of prednisolone is associated with a decrease in the synthesis of platelet activating factor (shock mediator), as well as a decrease in extraneuronal uptake and an increase in the pressor action of catecholamines.
It has an effect on various types of metabolism: it increases blood glucose levels, promotes the redistribution of adipose tissue, contributes to the retention of sodium ions and water, increases blood pressure. Modulates the inflammatory processes in the connective tissue and reduces the likelihood of scar tissue formation.
Absorbed in the gastrointestinal tract. Bioavailability - 80 ± 11%. The volume of distribution is 0.97 ± 0.11 l / kg. The maximum concentration in the blood plasma is observed after 1-2 hours. Metabolized in the liver to the active metabolite, prednisolone. Communication with plasma proteins is 90%, biotransformed in the liver, bronchi and kidneys. Excreted by the kidneys mostly unchanged.
With rectal administration, more than 20% of the drug is absorbed. This number may increase in the presence of inflammation or damage to the mucous membrane of the rectum.
- Rheumatism, rheumatoid arthritis.
- Nodular periarteritis.
- Ankylosing spondylitis
- Bronchial asthma, allergic diseases.
- False croup in children.
- Acute insufficiency of the adrenal cortex.
- Addison's Disease.
- Adrenogenital syndrome.
- Hypoglycemic states.
- Hepatic coma.
- Lipoid nephrosis.
- Various forms of leukemia.
- Thrombocytopenic purpura.
- Hemolytic anemia.
- Exfoliative dermatitis.
- Seborrheic dermatitis.
- Lupus erythematosus.
- Peptic ulcer and duodenal ulcer in acute phase
- Itsenko-Cushing disease
- Tendency to thromboembolism
- Renal failure
- Systemic mycoses
- Severe arterial hypertension
- Vaccination period
- Active tuberculosis
- Viral infections
- Active tuberculosis
- Productive symptoms in mental illness
There may be withdrawal syndrome, as well as exacerbation of the disease, about which the drug is prescribed; diabetes mellitus, non-specific infections, latent forms of tuberculosis, pregnancy (especially the first trimester).
Pregnancy and lactation
Category FDA - C. Adequate and well-controlled studies in humans have not been conducted. In pharmacological doses it causes placental insufficiency, fetal body weight deficiency, stillbirth. Teratogenic effect is not confirmed. Hormone replacement therapy does not adversely affect the fetus and the newborn. Animal studies have revealed an increase in the incidence of cleft of the upper palate, placental insufficiency, spontaneous abortions and intrauterine growth retardation.
Penetrates into breast milk. There are no violations. When prescribing physiological or low pharmacological doses (equivalent to no more than 25 mg of cortisone or 5 mg of prednisone) do not cause disturbances in the development of the child. It is not recommended to prescribe higher doses due to possible violations in the development of the child (growth retardation, impaired production of its own glucocorticoids).
Dosage and administration
Dosage regimen is individual. The initial dose for adults - 20-30 mg (if necessary, can range from 15-100 mg) per day, maintenance dose - 5-10 mg (5-15 mg) per day. Reducing the daily dose should be gradual. The initial dose for children is 1-2 mg / kg per day in 4-6 doses, the maintenance dose is 300-600 mcg / kg per day.
Rectal: for suppression of coughing and choking, one suppository per day is administered to children (corresponding to 100 mg of prednisolone). If necessary, another introduction of the suppository on this day or on the second day is possible. The total dose should not exceed two suppositories per day (corresponding to 200 mg of prednisone).
Of the nervous system: steroid cataract, mental disorders, latent glaucoma.
On the part of the endocrine system: an increase in body weight, Itsenko-Cushing syndrome, depletion of the adrenal cortex, steroid diabetes, a negative nitrogen balance, hyperglycemia.
From the side of water and electrolyte balance: hypokalemia, hypernatremia.
Since the cardiovascular system: arterial hypertension.
On the part of the gastrointestinal tract: ulcerogenic effects, increasing the acidity of gastric juice.
On the part of the musculoskeletal system: aseptic necrosis of bones, osteoporosis.
When administered rectally: itching, burning, irritation at the injection site. Allergic reactions are possible.
Symptoms: increased side effects, vomiting, nausea, sleep disorders, euphoria, depression, agitation.
Treatment: gradual withdrawal of the drug.
Salicylates - increase the likelihood of bleeding.
Diuretics - electrolyte abnormalities.
Hypoglycemic drugs - reducing the rate of decrease in blood glucose levels.
Cardiac glycosides - the risk of glycosidic intoxication.
Enzyme inducers (barbiturates, phenytoin, primidone, rifampicin) can reduce the effect of glucocorticosteroids.
Antihypertensive drugs - reducing their effectiveness.
Rafampicin, barbiturates and phenytoin - reducing the effect of the drug.
Hormonal contraceptives, estrogens - enhancing the action of the drug.
Glucocorticosteroids can reduce the concentration of salicylates and praziquantel in the blood.
Antipsychotics, azathioprine, carbutamide - the risk of developing cataracts.
M-holinoblokatory, nitrates, antihistamines, tricyclic antidepressants - an increase in intraocular pressure.
The action of insulin, oral hypoglycemic and antihypertensive drugs, as well as oral anticoagulants (coumarin derivatives) can be weakened while using prednisone.
Increase the risk of side effects of glucocorticosteroids: nonsteroidal anti-inflammatory drugs (erosive-ulcerative lesions and bleeding from the gastrointestinal tract), androgens, estrogens, oral contraceptives, steroid anabolic steroids (hirsutism, acne); diuretics and laxatives (hypokalemia).
In the case of simultaneous use with ACE inhibitors, changes in the blood formula are possible. Possible weakening of the somatotropin. Chloroquine, hydroxochloroquine, mefloquine - an increased risk of myopathy and cardiomyopathy.
Cyclosporine is an increased risk of cerebral seizures.
During treatment, it is necessary to observe an oculist, control blood pressure and water-electrolyte balance, pictures of peripheral blood.
With psoriasis - take under the strict supervision of a physician.
For diabetes, use only with absolute indications.
Impact on the ability to drive vehicles and control mechanisms have been identified.
What everyone should know about inflammation
Inflammation is both "good" and "bad": it plays a huge role in the development of deadly diseases. Heart diseases, cancer, diabetes, Alzheimer's disease are associated with inflammation. For many years, it lurks without showing itself, and then catastrophe happens. How to detect latent inflammation?
"Bad" doctors call latent, chronic inflammation. Thousands of years ago, when our ancestors did not have antibiotics and antiseptics, the mechanism of inflammation was of great importance. It is thanks to him that the homo sapiens biological species survived in the difficult conditions of our planet. Moreover, even nowadays, inflammation can do a good job, but only if it occurs in an acute form - with high fever and heat, redness, pain and swelling. This is a reliable way to protect the body from external interventions. Knowing this, we can recall the recommendations of therapists about the fact that antipyretic drugs like aspirin or ibuprofen are not always good and even interfere with recovery. But today we will focus on "harmful" chronic inflammation - after all, it is in many cases life-threatening.
Chronic inflammation, as a rule, is hidden - you will not notice it with the naked eye due to classic symptoms like fever or throbbing pain around the injured or infected place. And only after some time, and sometimes after many years, does it make itself known by terrible consequences. Recall how many friends you have who have died of a heart attack, but until the moment of death, neither the doctors nor they themselves showed signs of cardiovascular disease. It seems that they were not there! In fact, the body has had a latent inflammatory process for a long time. The latest medical research shows that the cause of a heart attack is the sudden destruction of a cholesterol plaque that clogs arteries going to the heart. And the culprit is inflammation. But if you detect inflammation in time and start fighting it, changing your lifestyle and going to doctors, you can effectively confront the main killers of modern man - heart attacks and strokes, oncology, diabetes, dementia (starting with loss of short-term memory, dementia - or illness Alzheimer's - gradually leads to the disintegration of mental activity, loss of orientation in space and time, the inability to care for oneself and live fully, as well as the loss of various functions of the body, which eventually He dies for a death).
Early diagnosis of inflammation: analysis of CRP
The main indicator of chronic inflammation is C-reactive protein (CRP), which is synthesized in the liver and plays a protective role in the body. C-reactive protein is one of the most reliable indicators of hidden inflammatory processes: the higher its level, the more likely the presence of infections, injuries, tumors, diabetes, problems with the heart and blood vessels, other serious diseases. Of course, the concentration of CRP may also increase with certain medications, as well as after surgery. This should be remembered when you will undergo research. It has been proven that high levels of CRP are directly related to the risk of developing a heart attack in the near future. The easiest way to diagnose is to do a blood test. As a rule, blood is taken in the morning, on an empty stomach; It is recommended not to get involved in food on the eve of the survey, so that the results are more accurate.
The ideal indicators of CRP (hs CRP) are below one. If your performance is higher, then it is worth resorting to the program to combat inflammation, which includes a special diet, lifestyle correction, taking food supplements and medicines (we will describe it in more detail below). C-reactive protein allows to identify diseases associated with chronic inflammation:
- gastrointestinal tract diseases
- heart attack
- postoperative complications, including graft rejection,
- blood poisoning in adults and newborns,
- infectious diseases of bones and joints,
- Alzheimer's disease,
- vascular disease.
Essential Fatty Acids
Data on the content in your body of essential fatty acids (EFA) - invaluable information: inflammation directly correlates in the level and ratio of various EFAs. These indicators can be determined using laboratory research. I must say that not all doctors of a traditional school prescribe these tests to their patients, however, if you have a predisposition to heart disease or oncology, you should either ask your doctor to give you a referral or go to a private specialized clinic or research institute. Also, nutritionists are familiar with the analyzes of NLC, so you can go to the reception immediately to them. Believe me, these efforts will pay off a hundredfold - having taken care of yourself in advance, you will be able to live another ten to twenty years.
First, the total fat content, saturated and unsaturated, is measured, and then - the ratio of different categories of fats, such as omega-3 (the main component of brain tissue, forms anti-inflammatory prostaglandins - substances found in all mammalian cells and having different physiological effects, including painkillers and euphoric), omega-6 (the fats that make up prostaglandins, which just increase inflammation, but nevertheless, these fats are important for us), omega-9 (just like omega-6, these are conditionally beneficial fatty kis lots). Despite the fact that human fats are necessary for survival of omega-6 fats, they provoke inflammation in the body, which contributes to the emergence of a number of degenerative processes and chronic diseases. Omega-3 fats, on the other hand, counteract inflammation. Because inflammation underlies many diseases, maintaining a healthy balance between these fats is crucial for longevity and good health. If the analysis shows a "poor" ratio of fats, it can be easily corrected with changes in diet and supplementation.
How to deal with latent inflammation
It is possible and even necessary to manage latent inflammation. Nutrition, lifestyle, medications and nutritional supplements are the cornerstones of a building called "The Body Without Inflammation."
The diet should adjust the content of essential fatty acids (EFA), the main ones, as mentioned above, are omega-3 and omega-6. Just 100 years ago, they were present in the diet of people in equal amounts, which made it possible to maintain a balance. Today, the use of new agricultural technologies and scientific achievements has worsened the situation, and very seriously. We consume omega-6, which provoke inflammation, 25 times (!) More than those that prevent omega-3 from inflammation. Now you understand one of the reasons why cancer and heart disease have become the most common diseases that kill millions of people every year. What to do? It's simple: eat more foods that include omega-3. These are fish and flaxseed, fish oil, nuts. But soybean and sunflower oil, as well as sweets should be used less frequently. Also, do not get involved in red meat and egg yolks - it is rich in arachidonic acid, which is the precursor of prostaglandin E2, which increases inflammation.
Lifestyle - the next important step of the system to combat chronic inflammation. Obesity, smoking, poor nighttime sleep and lack of physical activity lead to an increase in C-reactive protein, and hence the level of inflammation. By the way, there is scientific evidence regarding the connection of general inflammation and its local foci like gingivitis (gum disease). So do not forget to regularly visit the dentist: our body is like a big house built of thousands of bricks. To avoid cracks, you need to carefully monitor each of them and in time to "put the patch."
Drugs and dietary supplements also play a rather big role in reducing inflammation. However, of course, you can not assign them yourself. However, there are well-known supplements, which are, in principle, harmless (and even vice versa). And yet it is better to be safe and enlist the support of a doctor. The most valuable of these supplements is fish oil. Women are recommended to take 1100 mg daily, men - 1600 mg each. For those who do not like the taste of fish oil, capsules have long been invented. Vegetarians can replace fish oil with flaxseed oil. By the way, good news for those who love Indian cuisine: many Indian dishes have an anti-inflammatory effect due to curcumin, a spice that is part of curry. One of the traditionally recommended drugs to reduce latent inflammation (and at the same time blood thinning to prevent the formation of blood clots) is aspirin. We remind you that before taking any dietary supplements and drugs, it is better to consult with your doctor.
What is allergy
Speaking the dry language of doctors, allergy is a pathological reaction of the immune system associated with hypersensitivity to certain substances - allergens. However, in order for you to become allergic, it is not enough to eat some new fruit or rub your cheek against a cat. Sensitization is necessary - increasing the body's sensitivity to any substance, which subsequently will be an allergen.
Allergens are classified into two types. If they enter the body from the outside, they are called exoallergens (from the Greek ἔζω (exo) - from the outside, outside). If allergens arise inside the body, they are called endoallergens (Greek ἔνδον (endo) - from the inside, inside) or autoallergens (from the Greek αὐτόζ - itself). For example, such an allergy often develops on proteins secreted by the body during the rheumatic process.
Examples of the most typical exoallergens
- house and street dust
- plant pollen
- animal hair and human hair
- household chemicals
- waste products of insects and animals
- bacteria, viruses and their toxins
The mechanism of the development of an allergic reaction
Every day we are faced with thousands of substances that are foreign to the body: viruses, bacteria, pollen, waste products of insects and animals, food, drugs, industrial emissions and many others.
When such a substance enters the body, the process of producing antibodies is launched - special protein compounds that are designed to neutralize the effects of foreign substances. That is, antibodies are a kind of guards inside us. In addition, each antibody is responsible for neutralizing a single foreign substance.
If the immune system fails, then antibodies are produced in excess. When the allergen enters the body again, they are activated and trigger a cascade of biochemical reactions, which result in the production of special substances, including histamine. His sharp release, in particular, leads to the development of allergy symptoms, and their various manifestations.
In order to make it clearer what allergies are and what are its causes, we will find out what types of allergic reactions exist. There are four of them. However, some allergic reactions can be combined, combining 2-3 types of allergies.
Type I - Allergic reactions of reagin type or IgE-mediated. In response to the ingress of the allergen and the development of sensitization to it, the production of specific antibodies of the IgE class occurs. There is an active release of substances (histamine, leukotrienes, etc.) causing acute allergic reactions from the vessels, skin and other organs and body systems. For example, allergic rhinitis (runny nose), allergic conjunctivitis (symptoms are clearly manifested in the mucous membrane of the eye - conjunctiva), bronchial asthma, etc.
Type II - cytotoxic. Cells are damaged as a result of the formation of antibodies, damage can occur due to:
- activation of complement and the damaging effects of its fragments;
- damage and dissolution of cells with antibodies by specific NK cells - the so-called antibody-dependent cellular cytotoxicity.
Allergic reactions can lead to complications after the transfusion of blood and its components, blood diseases associated with the immune response.
Type III - the so-called immune complex allergic reactions. The antibodies either react incorrectly to the tissues of the body, or the tissues themselves change in such a way that they become alien. As a result, the immune system rapidly and mercilessly attacks them, and diseases such as serum sickness, systemic lupus erythematosus, rheumatoid arthritis and other systemic autoimmune diseases develop.
Type IV - delayed-type allergic reactions. They are associated with the activity of immunity and develop due to changes in lymphocytes. Most often possible with contact dermatitis, rejection of transplanted tissue, manifestations of tuberculosis, brucellosis, leishmaniasis, etc.
Allergy symptoms depending on its type
Allergy as many-sided as insidious. There are a lot of manifestations and forms of allergic diseases, and the symptoms of the reaction of the same type in different people can vary greatly. In addition, the symptoms are easily confused with signs of other diseases, which often interferes with making an accurate diagnosis.
This diversity is due to several reasons. For example, the place of an allergen entering the body, where the difference can be significant between the introduction through the respiratory tract or the skin, with food, etc. The most favorite allergy targets are respiratory tract mucosa, including the nose and nasopharynx, eyes, and skin. Also influenced by the individual features of immunity and immune response. And, finally, the state of health of the body that has become a target for the allergen.
The most dangerous allergic reaction is anaphylactic shock, that is, an immediate-type reaction that develops, as a rule, at lightning speed or very quickly, within a few minutes, rarely - a few hours. Very often, such a shock is caused by allergies to drugs. According to some sources, about 0.65–2% of cases of anaphylactic shock are fatal3. In addition to drug, anaphylactic shock can develop with food allergies, as a reaction to the ingress of proteins, poisons, insects and reptiles. Remember a few symptoms that are worth paying close attention to, because each of them may indicate the development of anaphylactic shock, and emergency measures must be taken. So: itching on the skin, abdominal pain with food allergies; shortness of breath, feeling short of breath; suffocation; pale skin; convulsions; drop in blood pressure; fainting or loss of consciousness; vomiting.
Respiratory or respiratory allergy. It is caused by household and street dust, smoke, industrial emissions, car emissions, pollen, and animal waste products. Such substances are called aeroallergens, they penetrate through the respiratory tract. Once in the body, they can cause a sensation of itching in the nose, nasal pharynx, sneezing, and a copious runny nose. With severe allergies of this type, cough develops, and wheezing is heard in the bronchi. In severe cases, the development of asphyxiation is possible.
Often, allergies manifest as skin rashes or dermatoses. Spots, redness and irritation, itching, dryness with peeling, swelling and much more. Such reactions are a response to the penetration of the allergen through the skin or mucous membranes. And the reason may be hidden in cosmetic or household products on the skin, medicines, ointments, as well as food, contact with animals or household items.
Allergic conjunctivitis (inflammation of a thin transparent membrane that covers the eye) can be a separate reaction, and can accompany other types of allergies - for example, allergic rhinitis. (rhinoconjunctivitis). Such an allergy is often accompanied by conjunctivitis, copious runny nose, since anatomically the eye and the nasal cavity are closely related. The reason for the development of allergic conjunctivitis: household dust, desquamated epidermis of animal skin, insect waste products, pollen, mold - everything that can be in the air and get on the mucous membrane of the eyes. However, the reason is not always covered in aeroallergens. Allergic conjunctivitis may well develop in the case of reactions III and IV types.
And finally, there is still allergic enteropathy - associated with the ingress of an allergen from food. Allergy enteropathy can manifest as nausea, vomiting, constipation or diarrhea, as well as abdominal pain.
Consequences and complications
In addition to symptoms that significantly impair our lives, allergies are dangerous with a variety of consequences. For example, eczema, bronchial asthma, and atopic skin diseases often develop on its background. In addition, allergy is a background for the development of other pathologies that can affect almost all organs and systems.
Against the background of an allergy, other somatic and infectious diseases are more severe. Moreover, it is more difficult to diagnose them, since their manifestations often overlap with the manifestations of allergy, and, as a result, it is rather difficult for doctors to prescribe drug therapy so as not to cause an allergic reaction to it.
And, of course, one must remember the high risk of anaphylactic shock, which is directly life-threatening. Moreover, to predict the background of the impact of what allergen it will develop, it is almost impossible.
The diagnosis is established
For the diagnosis used a large number of studies and analyzes. One of the first studies that are conducted when allergies are suspected is skin tests. Diagnosis is carried out by introducing a small amount of suspected allergens into the upper layer of the skin. If the test is positive, then local reactions such as redness, swelling or slight swelling, itching develop at the site of allergen injection.
A skin test or patch test is similar to skin tests. In this case, a mixture of allergens is applied to a special plate that is attached to the skin. Next, doctors look at whether there is a local reaction or not. Also effective is a blood test for IgE antibodies. To carry out this study, blood is taken from a vein, and then in laboratory conditions, the total number of antibodies is determined and the number of specific IgE antibodies is counted. There are also so-called provocative tests that not only confirm that the patient has allergies, but also help to understand what type of allergy it is. The provocative test is carried out in places that are most typical for the penetration of allergens: the mucosa of the nasopharynx, oral cavity, digestive system. This study takes place exclusively in the hospital, as it causes a bright allergic reaction with the full manifestation of symptoms.
If you feel that this or that allergic reaction has started, then this is what needs to be done first. To leave the place where there is an allergen. If it is possible to remove the allergen from the place of contact, wash it off the skin, rinse the nose, rinse the mouth. Take one of the antihistamines. If the reaction is very strong or the first aid turned out to be ineffective, then an urgent need to contact the hospital or call an ambulance. Signs of severe allergies or complications cannot be confused with the lungs. These include a feeling of lack of air, difficulty breathing, cramping in the throat or chest. It is worth paying attention to the change of voice - hoarseness, hoarseness, absence. A sure sign of heart palpitations, dizziness and general weakness. And finally, fainting.
Considering that the causes of allergy are not yet known exactly, the prevention of its exacerbation is aimed at preventing the allergen from entering the body, as well as avoiding contact with it as much as possible. First of all, you should try to support the body, not allowing immunity disorders: to lead a healthy lifestyle, not to take medication without a doctor's prescription, to carry out a thorough cleaning at home, to eat healthy and high-quality food.
Treatment and types of drugs
How and what to treat allergies can only decide the doctor. The same type proceeds differently even in people with similar living conditions.2 But, as a rule, treatment begins with the exclusion of the influence of the allergen. But then connects drug therapy, which will help reduce the amount of histamine in the body or block its release.
Allergy treatment is an antihistamine medication that a doctor prescribes, depending on the characteristics of the allergy in a particular patient. - Block in a yellow frame
They are in the form of syrups or tablets, as well as nasal drops (for respiratory allergies) or injections. In severe cases, the doctor may prescribe an additional intake of corticosteroids - hormonal drugs that reduce the severity of the processes accompanying allergies.