Antidepressants Blog

АТРОПИНОВЫЙ КОНЪЮНКТИВИТ
Атропиновый конъюнктивит является одним из вариантов реакции на прием лекарств, может развиться после продолжительного применения глазных капель, а у особо чувствительных людей даже после однократной инсталляции. Появляются светобоязнь, слезотечение, выраженная конъюнктивальная инъекция, отек и покраснение кожи век, возможны высыпания на коже.
Применение лекарственных средств в виде капель и мазей обычно ухудшает состояние глаза. Заболевание может продолжаться длительное время, до тех пор, пока не прекращается действие на глаз веществ, вызвавших заболевание.
Лечение заключается в прекращении употребления вызвавших раздражение капель. Применяют суспензию гидрокортизона, офтан-дексаметазона, внутрь – десенсибилизирующие препараты (димедрол по 0,05 г 3 раза в день, 5% раствор хлорида кальция и др.).
Профилактика медикаментозного конъюнктивита заключается в строгом соблюдении назначений медицинского персонала, контроле за реакцией на лекарства у больных с предрасположенностью к аллергии.
Уход за больными с подобными конъюнктивитами включает контроль за соблюдением отмены применения всех лекарственных средств, вызывающих аллергическую реакцию у больного, и выполнение лечебных процедур, назначенных врачом.

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The proteins in wheat flour – which include gluten – are what makes wheat good for bread-making. Trying to make bread without wheat involves finding a substitute for this protein.

Gluten-free bread is available in some healthfood shops – at a price. Or you can buy a gluten-free flour and make your own. Those with coeliac disease can get some gluten-free products on prescription.

Gluten-free flours are made from a mixture of different flours, eg maize flour, potato flour, soya flour, split pea flour, rice flour, rice bran, carob flour, corn starch and ground almonds. You can improvise with simple mixtures of your own – eg one part rice flour, to one part soya or gram flour, to one part potato flour. The mixture must always include at least one type of high-protein flour, such as soya, gram or lentil. Use yeast and make in the ordinary way, but without kneading the bread. It will have a heavier

texture than ordinary bread, and may taste better toasted. If you have to avoid yeast as well, it is possible to make soda bread using gluten-free flour. The manufacturers of gluten-free flour usually supply recipes for use with their particular flour mix, and these should be followed for good results.

Bear in mind that most gluten-free mixes contain soya flour or other bean-derived flours. Make sure you are not eating soya and related foods too regularly, especially if you are vegetarian – they feature in most commercial meat substitutes, ‘vegeburgers’ and instant meals.

Rye bread may be a useful substitute for some people, because rye is also rich in protein, though it cannot rival wheat. Because the two are closely related, those who are sensitive to wheat quite often react to rye as well. If you buy rye bread from a local bakery be sure to check that it is 100 per cent rye – speak to the manager, and ask to be notified if they change the composition of the bread. Rye flour often contains some wheat anyway, because wheat grows as a weed in fields of rye.

Rye crispbread can be eaten as long as it is pure rye – some now have wheat bran added.

Oatcakes are available from most good supermarkets, delicatessans and healthfood shops. Oats are preferable to rye since they are less likely to cross-react with wheat. Check the label, as some contain milk or sugar.

Rice cakes and rice crackers are available from healthfood shops. The ‘cakes’ are actually savoury – something like a crispbread, but made from puffed grains of rice. They taste much nicer than they look.

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Allowed:

Wholemeal brefiad

Milk, butter, most types of cheese

Shredded wheat, puffed wheat, and other cereals that have no sugar or

colouring Any fresh, unprocessed meat Any fresh, unprocessed fish Potatoes Rice

Beans and lentils

Any vegetables – eat plenty of green leafy vegetables and salads

Any fresh fruit, except pineapple and papaya

Pastry – if homemade

Any unsweetened fruit juice

Herb teas, except mate and redbush

Not allowed:

Alcoholic drinks, including alcohol-free beers and wines

Food cooked in beer, wine etc

Coffee

Tea, including green tea, jasmine tea etc

Cola drinks

Chocolate

Sugar and all sugar-containing foods Artificial sweeteners

Vinegar and pickles (except in small quantities)

Margarine

All food additives

Smoked fish or meat

Bacon and ham

Continental sausages

Very ripe cheeses

Take-away food

Restaurant food (except very occasionally) Bran

Any very salty food

Aspirin and related drugs

Curries and other very spicy food

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In some people, certain enzymes are either in short supply, or they fail to work properly because their structure is abnormal. Such people are said to have ‘enzyme deficiencies’. Some deficiencies have no obvious effects, because there are other enzymes that can ‘cover’ for the missing one – the body often has more than one option, especially when it comes to digestion and detoxification. Other deficiencies are far more damaging, because the enzyme is the only one that can do that particular job, and toxic substances build up in the body if it is ineffectual.

Enzyme deficiencies have been known for many years. The more serious ones become noticeable soon after a child is born, or after it is weaned, and can kill or severely disable the child unless treated. The usual treatment is a special diet, which excludes foods that the child cannot deal with. The most widespread enzyme deficiency of this type is phenylketonuria; all babies are tested for this soon after they are born. Another example of a major enzyme deficiency is a shortage of the enzyme lactase, which breaks down the sugar in milk. Both of these enzyme defects are very rare – phenylketonuria only affects one baby in 12,000.

In recent years, it has become clear that there may be other, less noticeable, forms of enzyme deficiency. Some of these have come to light when certain patients reacted very badly to particular medicinal drugs – it turned out that they were less able to detoxify them than most people. Special chemical ‘probes’ have been developed in an effort to detect such patients – these are non-toxic compounds that are processed by the same enzymes, and which can readily be measured. The ‘probe’ is given to the patient, and the level is later measured (in the blood or urine) to see how thoroughly well the drug has been broken down.

When these probes are tried out on people with food intolerance, they produce interesting results. Such people are much more likely to be deficient/or some enzymes than healthy people are – they do metabolize the drugs, but more slowly. However, there Js no single enzyme which is defective in all food-intolerant individuals – or if there is, it has yet to be found. With enzyme defects, as with everything else, it looks as if food intolerance is a ‘mixed bag’.

One interesting factor to emerge from these experiments concerns patients who are sensitive to man-made chemicals, as well as food. In this group, an even higher percentage are enzyme-deficient than among those with food intolerance alone. For one enzyme, 90 per cent of such patients were deficient, compared with 80 per cent of those with food intolerance, and 20 per cent of the population at large. Interestingly enough, a high proportion of those with food allergy – 64 per cent – also showed a deficiency.

The fact that some apparently healthy people are deficient for these same enzymes is revealing. This clearly shows that a single enzyme defect of this type could not be the sole cause of food intolerance. Those who suffer from food intolerance must have other underlying problems as well – perhaps a shortage of another enzyme, or a leaky gut wall, or some other problem entirely. It is tempting to speculate that people with multiple sensitivities (foods and chemicals) are defective for a whole range of enzymes, making them much more susceptible to environmental factors. But at present, there are too few studies of enzyme deficiency to know if this is likely.

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If there is little or no improvement on the diet, then it may be because there is a general yeast sensitivity, due to candidiasis. Continue with the diet as before, but cut out all yeast-containing foods. These are listed in Table 6.

It is sometimes claimed that the Candida derives nourishment from yeasts in food, but this is not the case. The reason for avoiding yeast is simply that you may be sensitive to it. The distinction is important, because if you are very sensitive to yeast, even the smallest amount can make you ill, so scrupulous avoidance is necessary, especially at first.

If there is a partial reponse to this diet, then it is a positive sign, and you should consider going on to Step 4. If there is no reponse at all, the most likely explanation is that Candida is not a factor, and it might be a good idea to try an elimination diet instead at this point, if food intolerance is suspected. But keep in mind the possibility that Candida is the culprit – some cases of candidiasis need far more stringent treatment than that described so far.

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Henceforth, a disease could only be described as an allergy if the immune system was demonstrably involved.

The way to demonstrate immune system involvement was by a skin-prick test. This involved making a purified extract of the allergen. A small amount of the extract was then inserted under the skin, by scratching or pricking it. If the area came up in a bump with a large area of red itchy skin around it, then an immune reaction had occurred.

It had become clear that patients with certain diseases were likely to give positive skin-prick tests. These diseases were hay-fever, asthma (breathlessness with wheezing episodes), and non-seasonal or perennial rhinitis (constant runny or congested nose). Also linked with positive skin-prick tests, although to a lesser extent, were urticaria or hives (a rash that resembles nettle-stings) and one type of eczema (areas of red, itchy, flaky skin). Moreover, these five disorders often seemed to go together, either in individuals or in families.

These became the only legitimate subjects for study as far as orthodox allergists were concerned, and they are still described as the classical allergic disorders. Included in their ranks was a type of reaction to food that was very violent and came on rapidly after eating the allergen, often within minutes. The symptoms produced included swelling of the lips, mouth and tongue, urticaria (nettle-rash), vomiting and, in severe cases, collapse or anaphylactic shock – the reaction that Jane experienced when she ate peanuts in the restaurant cheesecake. In these cases, too, there was almost always a positive reaction to a skin-prick test with the suspect food.

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You’ve probably noticed ads for cosmetics or grooming products that claim to be hypoallergenic, implying that they are safe for people with skin allergies. At one time or another, though, you’ve probably heard someone say, ‘I’m allergic to hypoallergenic products.’ Perhaps that’s even true for you.

So what’s the story?

There is no official standard for hypoallergenic claims in the UK other than that such a product must be less likely to cause adverse reactions than other similar products. For some manufacturers, that simply means omitting fragrance, the single biggest cause of cosmetic allergies. Others go to great pains to find safe substitutes for as many of the other common allergenic chemicals as they can. The ingredients, then, will vary from one manufacturer to the next, so that one hypoallergenic mascara, for example, may cause no difficulty, while another is a problem.

Even the so-called hypoallergenic products contain lists of ingredients that read like the index of a high school chemistry text – and any of them can start trouble for you. One of the leading brands of hypoallergenic cosmetics, for instance, contains parabens. So hypoallergenic obviously doesn’t imply a product is free of all possible troublemakers.

Since the cosmetics are less than pure, manufacturers marketing their products as hypoallergenic must also test them on people. One of the major distributors of such products told us that they test their products by repeatedly applying the product to the skin of 600 people, under the supervision of a dermatologist. Only those products which produce no reaction within the test period are marketed as hypoallergenic.

But as you can see, hypoallergenic is a relative term. What’s hypoallergenic for you may not be hypoallergenic for your friend. The best approach is to read labels carefully, follow directions for use, and conduct a patch test if you tend to react to cosmetics.

The following tips will also help enormously when it comes to using any cosmetics, whether they’re hypoallergenic or not.

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Mild local reactions require little or no treatment. Allergic or toxic reactions, however, demand appropriate care.

• Scrape out the stinger, if one is present, with your fingernail or a dull knife. Do not try to pull the stinger out – squeezing it will only inject more venom into the wound. (Bumblebees, wasps and hornets leave behind no stinger since their stingers are not barbed. Mosquitoes and flies have no stinger.)

• Wash the site well with soap and water. Follow with application of an antiseptic if bitten by a fly.

• Apply an ice pack and/or a paste of baking soda and water to relieve pain.

• Elevate the arm or leg to reduce oedema (fluid retention) and swelling.

• Be alert for symptoms of systemic reaction or unusual swelling, especially swelling that extends far beyond the sting site. If reaction looks at all serious, use an insect-sting kit as directed, and then rush the victim to the nearest doctor or hospital.

• Avoid using tourniquets, sucking venom from the wound or cutting at fang marks.

• If possible, take the dead insect along with you to the doctor so that the insect can be correctly identified.

Note: Allergic or not, consult a doctor without delay if you are stung on the face, nose, mouth or throat, areas which are especially susceptible to sting injuries.

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