Glucocorticoids: Baseline Antiallergic Therapy
Glucocorticoids (GCs) serve as foundational baseline therapy. Their spectrum of activity is particularly prominent in the treatment of immediate-type hypersensitivity reactions.
The mechanism of the antiallergic action of glucocorticoids is realized through a sequential biochemical cascade that reliably suppresses the development of the allergic response:
- First and foremost, phospholipase A2 enzyme blockade occurs, which is the starting point of their pharmacological effect.
- As a result, there is a marked decrease in the production of arachidonic acid, a crucial precursor of inflammatory mediators.
- At the cellular level, the drugs prevent mast cell degranulation by stabilizing their membranes.
- Ultimately, there is a complete blockade of the release of allergy mediators into surrounding tissues, which halts the progression of the pathological process.
Dependence of GC Formulation on Severity
The choice of a specific glucocorticoid formulation depends strictly on the localization of the pathological process and the severity of the patient's condition. A correctly selected route of administration ensures maximum clinical efficacy.
| Dosage form | Indications | Severity |
|---|---|---|
| Injections | Anaphylactic shock, angioedema | Severe and moderate conditions |
| Inhalations | Bronchial asthma | Local action in the airways |
| Ointments and topical forms | Atopic dermatitis, insect bite reactions | Skin manifestations of varying severity |
Symptomatic Drugs in Life-Threatening Conditions
Symptomatic antiallergic agents are first-line medications for managing acute, life-threatening conditions. The primary and irreplaceable drug in this scenario is Epinephrine (Adrenaline).
The main indication for its immediate administration is anaphylactic shock. This critical condition is traditionally accompanied by two life-threatening factors: a sharp drop in blood pressure (hypotension) and pronounced bronchospasm. The routes of administration to achieve the most rapid effect are intramuscularly or intravenously.
Pharmacodynamics of Epinephrine in Anaphylaxis
The action of adrenomimetics, particularly adrenaline, in anaphylactic shock aims to immediately reverse the pathophysiological mechanisms of shock through action on various types of adrenergic receptors.
- Combating hypotension: The drug stimulates α-adrenergic receptors of blood vessels. The clinical effect of this action is a powerful vasoconstrictor response and, consequently, an increase in blood pressure (BP), which helps reverse shock-induced hypotension.
- Combating respiratory failure: Simultaneously, β2-adrenergic receptors of the bronchi are stimulated. The result of this activation is relaxation of the smooth muscle of the airways and complete relief of bronchospasm, restoring adequate pulmonary ventilation.