montelukast and Anaphylaxis

Topics: Acetates; Anaphylaxis; Chemical and Drug Induced Liver Injury; Chromones; Cyclopropanes; Drug Interactions; Enzyme Inhibitors; Hematologic Diseases; Humans; Indoles; Leukotriene Antagonists; Lipoxygenase Inhibitors; Lung Diseases, Interstitial; Membrane Proteins; Phenylcarbamates; Quinolines; Receptors, Leukotriene; Sulfides; Sulfonamides; Tosyl Compounds

Local reactions (LRs) are a very frequent side effect of specific immunotherapy with allergens and can impair patients' adherence. Antihistamine pretreatment--originally introduced as a safety measure to reduce anaphylactic side effects--has been the only treatment option for LRs so far, although these swellings usually do not appear immediately but after hours. We were interested whether pretreatment with the leukotriene antagonist montelukast would be better suited for preventing those reactions than pretreatment with the antihistamine desloratadine.. Fifteen patients with a history of severe anaphylactic reactions to hymenoptera stings were enrolled into a prospective, double-blind, randomized, placebo-controlled pilot study. We selected a rush immunotherapy protocol consisting of 19 injections of hymenoptera venom administered over 5 consecutive days, where the majority is developing LRs, and counted the number of injections until an LR of >3 cm occurred. The patients were randomized to 3 treatment groups: premedication with placebo, 10 mg montelukast and 5 mg of the antihistamine desloratadine.. Compared with placebo, the occurrence of LRs (>3 cm) was significantly delayed by montelukast (p < 0.01, analysis of variance) but not by desloratadine (p = 0.19). The difference between montelukast and desloratadine was close to significant (p = 0.054). Itching, recorded on a scale from 0 to 5, did not differ between the 3 groups.. Montelukast can be useful in the prevention of LRs after specific immunotherapy.

Topics: Acetates; Adult; Aged; Allergens; Anaphylaxis; Animals; Cyclopropanes; Desensitization, Immunologic; Double-Blind Method; Drug Therapy, Combination; Female; Histamine H1 Antagonists, Non-Sedating; Humans; Insect Bites and Stings; Leukotriene Antagonists; Loratadine; Male; Middle Aged; Premedication; Quinolines; Sulfides; Wasp Venoms; Wasps

Topics: Acetates; Allergens; Anaphylaxis; Anti-Infective Agents; Antibiotic Prophylaxis; beta-Lactams; Cetirizine; Cyclopropanes; Cystic Fibrosis; Desensitization, Immunologic; Drug Hypersensitivity; Extracorporeal Membrane Oxygenation; Famotidine; Female; Humans; Immune Tolerance; Male; Quinolines; Respiratory Insufficiency; Sulfides

Topics: Acetates; Adult; Anaphylaxis; Cyclopropanes; Delayed Diagnosis; Drug Therapy, Combination; Epinephrine; Fatigue; Flushing; Histamine Antagonists; Humans; Leukotriene Antagonists; Loratadine; Male; Mastocytosis; Quinolines; Ranitidine; Recurrence; Sulfides

Topics: Acetates; Anaphylaxis; Cyclopropanes; Diagnosis, Differential; Hot Temperature; Humans; Leukotriene Antagonists; Male; Quinolines; Sulfides; Urticaria; Young Adult

Topics: Acetates; Adolescent; Anaphylaxis; Anti-Allergic Agents; Anti-Asthmatic Agents; Cetirizine; Cyclopropanes; Drug Therapy, Combination; Exercise; Food Hypersensitivity; Humans; Male; Prunus; Quinolines; Sulfides

Topics: Acetates; Anaphylaxis; Anti-Asthmatic Agents; Asthma; Child, Preschool; Conjunctivitis, Allergic; Cyclopropanes; Dermatitis, Atopic; Humans; Infant; Leukotriene Antagonists; Male; Prognosis; Quinolines; Respiratory Hypersensitivity; Sulfides

Topics: Acetates; Adult; Anaphylaxis; Anti-Inflammatory Agents, Non-Steroidal; Aspirin; Cyclopropanes; Diclofenac; Drug Hypersensitivity; Humans; Leukotriene Antagonists; Male; Quinolines; Sulfides; Treatment Failure