Itching to go to WMCARES PRIDE!

 

5 Days until the inaugural acronymic mash up that is WMCARES PRIDE. We have some serious shapes to make on the dance floor of research. To alleviate the pruritis and alloknesis of anticipation here is some medications to consider…

 

Itching Meds

 

(If an emollient alone does not provide adequate relief, consider a trial of an emollient with an active ingredient (for example menthol 0.5% or 1% in aqueous cream) or topical crotamiton (Eurax®).

 

Nalfurafine Kappa opioid receptor agonist Pruritic (uraemic)
Cromolyn sodium

 

Leukotriene receptor antagonist Pruritis (uraemic) (prevent Mast cell degranulation)
Gabapentin Interacts with GABA –  unclear. Maybe voltage gated calcium channels. Also interacts with NMDA, protein kinase C. and inflammatory cytokines Prurities (Uraemic) and everything else
Rifampicin Antibiotic (inhibits bacterial DNA-dependent RNA synthesis) Most powerful inducer of cP450 Hepatic Pruritis
flumecinol

Flumenizol

Selective benzodiazepine receptor antagonist Hepatic pruritis
Doxepin TCA with H1 antagonism Dialysis patients pruritis
Paroxetine

 

SSRI (more anticholinergic effects) Any pruritis
Any antihistamine (cetirizine, fexofenidine, piriton, loratadine) Anti histamines

No difference between them, ? fexofenadine dermatology choice

Type 1 Hypersensitivity and allergic, urticarial, dermatitis, ? eczematous
Cimetadine H2 antagonist Lymphoma
Ondansetron 5HT3 receptor antagonist Opioid induced Pruritis
Cholestyramine

 

Bile acid sequesterant Cholestasis Pruritus
Naltrexone 6βnaltrexol are antagonists at the μ-opioid receptor (MOR), the κ-opioid receptor (KOR)

 

Uraemic itch
Mirtazapine Atypical antidepressant, Mirtazapine has antihistamine α2-blocker and antiserotonergic activity

 

The drug which solves everything. Aka Vitamin M
Steroids Epigenetic nucleaolar effects Any itch, any symptom, have we tried steroids yet?

 

 

References:

 

  1. Low-dose doxepin for treatment of pruritus in patients on hemodialysis https://www.ncbi.nlm.nih.gov/pubmed/19357442
  2. Scottish Guidelines http://www.palliativecareguidelines.scot.nhs.uk/guidelines/symptom-control/Pruritis.aspx
  3. Cochrane review http://www.cochrane.org/CD008320/SYMPT_drugs-itching-adult-palliative-care-patients
  4. The Leviticus of Pall https://www.palliativedrugs.com
  5. NICE https://cks.nice.org.uk/itch-widespread#!scenario
  6. This is one of the references I havnt actually really read http://www.pcds.org.uk/clinical-guidance/pruritus-without-a-rash
Matt Doré

Author Matt Doré

I used to think impossible was said I’m possible. Not sure if thats motivational or just being dumb.

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