How is pollinosis in children treated?

For effective treatment of pollinosis, along with rational pathogenetic therapy, an important role is played by the regime of maximum possible limitation of the level of antigen stimulation. During the period of remission, the main and most effective method of treating patients with pollinosis is specific hyposensitization.

Pollen elimination is not possible.

Oral antihistamines

Name of the drug		Release form	Doses and frequency of administration
Trading	Generic (chemical)
1st generation drugs
Diazolin	Mebhydrolin	Tablets of 0.05 and 0.1	Up to 2 years - 50-150 mg; from 2 to 5 years - 50-100 mg; from 5 to 10 years - 100-200 mg per day
Peritol	Cyproheptadine	Tablets 0.004; syrup (1ml - 400 mg)	From 6 months to 2 years (for special indications!) - 0.4 mg/kg per day; from 2 to 6 years - up to 6 mg per day; from 6 to 14 years - up to 12 mg per day; frequency of administration - 3 times per day
Suprastin	Chloropyramine	Tablets 0.025	Up to 1 year - 6.25 mg; from 1 to 6 years - 8.3 mg; from 6 to 14 years - 12.5 mg per dose; frequency of administration - 2-3 times a day
Tavegil	Clemastine	Tablets 0.001	From 6 to 12 years old - 0.5 - 1.0 mg; over 12 years old - 1 mg per dose; frequency of administration - 2 times a day
Finestil	Dimetindene maleate	Drops for oral administration (1 ml = 20 drops = 1 mg); capsules 0.004	From 1 month to 1 year - 3-10 drops; from 1 year to 3 years - 10-15 drops; over 3 years - 15-20 drops per dose; frequency of administration 3 times a day; children over 12 years - 1 capsule 1 time per day
Fenkarol	Quinuclidil	Tablets 0.01; 0.025	Up to 3 years - 5 mg; from 3 to 7 years - 10-15 mg; from 7 years and older - 15-25 mg per dose; frequency of administration 2-3 times a day
Second generation drugs
Zaditen, ketof, astafen, etc.	Ketotifen	Tablets 0.001; syrup (1 ml = 0.2 mg)	From 1 year to 3 years - 0.0005 mg; over 3 years - 0.001 mg per dose; frequency of administration - 2 times a day
Zyrtec	Cetirizine	Tablets 0.01; drops 10 ml (1 ml = 20 drops = 10 mg)	For children over 2 years old - 0.25 mg/kg, frequency of administration - 1-2 times a day
Claritin	Loratadine	Tablets 0.01; syrup (5 ml = 0.005)	For children over 2 years old and weighing up to 30 kg - 5 mg; with a body weight over 30 kg - 10 mg; frequency of administration - 1 time per day
Third generation drugs
Telfast	Fexofenadine	Tablets 0.12-0.18	Children over 12 years old - 0.12 g or 0.18 g once a day

Antihistamines are widely used in the treatment of all allergic diseases, and in particular pollinosis. First-generation antihistamines have a sedative and anticholinergic effect and can cause tachyphylaxis. However, these side effects are not observed in all patients. These drugs are effective in cases of severe itching and vagotonic autonomic dysfunction. Fenkarol and peritol have an antiserotonin effect. Dimedrol and pipolfen are currently almost never used in children due to the high risk of side effects.

Second-generation antihistamines do not penetrate the blood-brain barrier and do not have a pronounced sedative effect. They have a high affinity for H2 receptors, a rapid onset of action, a long-term therapeutic effect, without causing tachyphylaxis. In addition to selective inhibition of histamine H2 receptors, second-generation drugs inhibit the early and late phases of an allergic reaction, and have a combined antiallergic and anti-inflammatory effect. They are able to inhibit the release of histamine from mast cells and basophils, inhibit the production and release of leukotrienes, the formation of adhesion molecules of different classes, slow the flow of calcium into the cell, and the activation of eosinophils and platelets.

The third-generation antihistamine Telfast does not have the cardiotoxic effect characteristic of some second-generation drugs, is not subject to biotransformation in the liver and, therefore, does not interact with other drugs metabolized in the liver by the cytochrome P450 system. The antihistamine effect begins after 1 hour, reaches a maximum after 6 hours and lasts for 24 hours. The drug is used prophylactically during the flowering season of etiologically significant plants. Telfast, Zyrtec and Claritin are prescribed once a day.

Treatment of allergic rhinitis symptoms is described in the chapter on allergic diseases of the respiratory tract. For allergic conjunctivitis, use opticrom, cromogling (a solution of cromoglicic acid for eye drops).

Specific immunotherapy (SIT) is used in patients with polyvalent pollen sensitization (e.g., trees and grasses-weeds) who require long-term daily antihistamines and topical treatment of rhinitis and conjunctivitis symptoms. SIT can prevent the transformation of hay fever into more severe forms of respiratory allergy.

Climate therapy with a change in geographic zone for the flowering season of causative plants is shown.

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