cimetidine用于urticaria case的处方讨论.ppt

Category ? Cimetidine Histamine H 2-receptor antagonist Antiulcer agent Gastric acid secretion inhibitor Urticaria therapy adjunct URTICARIA - CHRONIC 1. OVERVIEW: Cimetidine FDA APPROVAL: Adult, no; pediatric, no EFFICACY: Adult, effective DOCUMENTATION: Adult, good 2. SUMMARY: - Cimetidine is effective in resolving manifestations of chronic idiopathic urticaria - Cimetidine in combination with H1-antagonist has been effective 臨床證據 ? Cimetidine 200 milligrams (mg) doses significantly increased the minimal time required to produce urticaria compared to control or two H2-antihistamines in a 25-year-old woman with SOLAR URTICARIA (Tokura et al, 1986). Cimetidine has also reported to allow the woman to resume her normal activities. D. IMMUNOMODULATING EFFECTS  2. There is some limited data to suggest that cimetidine improves colorectal cancer tumor-infiltrating lymphocytes (TIL). TIL has been associated with survivql in human colorectal and breast cancer. Future studies are likely to determine the role of cimetidine in the adjunctive treatment of cancer (Morris, 1996). 3. The immunologic effects of cimetidine on suppressor T-cells and its potential uses in this area, including hypogammaglobulinemia, cancer, and herpes virus infections have been reviewed (Mavligit, 1987). 4. Cimetidine 800 mg daily for 7 days significantly increased the T-helper/inducer to T-cytotoxic/suppressive lymphocyte ratio in 11 healthy volunteers compared to pretreatment levels (Brockmeyer et al, 1989a). WARTS OVERVIEW: FDA APPROVAL: Adult, no; pediatric, no EFFICACY: Pediatric, effective DOCUMENTATION: Pediatric, good □ SUMMARY: According to several reports, cimetidine is effective for cutaneous warts in children[小兒多發性疣] - Combination cimetidine-levamisole was effective for treatment of pediatric warts - Improvement shown in 1 case of recurrent respiratory PAPILLOMATOSIS CONCLUSION: cimetidine具有調節免疫系統的功能，可以增加nitrogen以促進淋巴球增生，可以經由阻斷T suppressor細