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Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
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Anthelmintic drugs differ significantly from antiparasitic therapies targeting protozoa, primarily due to differences in parasite biology. Whereas most protozoal treatments act on proliferating cells, anthelmintics are typically directed against mature, nonproliferative helminths. The therapeutic approach considers the helminth's reliance on neuromuscular coordination, glucose metabolism, and microtubular integrity for survival, reproduction, and localization within the host. Most anthelmintics...
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Cholinergic antagonists—such as antimuscarinics—are available in oral, topical, ocular, parenteral, and inhalational formulations. Most antimuscarinics are oral formulations,  while scopolamine is available as a topical patch, and ipratropium and tiotropium are available as inhalation aerosols or powders. Atropine, tropicamide, and cyclopentolate are topically instilled in the eye. Most antimuscarinics are lipid-soluble and readily absorbed from the gastrointestinal tract and...
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Cheek Injection Model for Simultaneous Measurement of Pain and Itch-related Behaviors
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Current topical and systemic therapies for itch.

Tabi Anika Leslie1, Malcolm W Greaves, Gil Yosipovitch

  • 1Royal Free Hospital, London, UK, Tabi.Leslie@gstt.nhs.uk.

Handbook of Experimental Pharmacology
|April 12, 2015
PubMed
Summary

Itch, or pruritus, is a distressing symptom with diverse causes and significant quality of life impact. Effective treatments vary by cause, encompassing topical and systemic therapies targeting itch mediators.

Area of Science:

  • Dermatology
  • Pathophysiology
  • Pharmacology

Background:

  • Itch (pruritus) is a common, distressing symptom with multifactorial origins, including inflammatory skin diseases, systemic conditions, neuropathic issues, and psychogenic disorders.
  • Chronic itch can severely impact quality of life, comparable to chronic pain, and shares similar pathophysiological pathways.
  • Various mediators like histamine, leukotrienes, proteases, neuropeptides, cytokines, and opioids are implicated in activating itch pathways.

Purpose of the Study:

  • To summarize available topical and systemic therapies for itch.
  • To provide an overview of the current understanding of itch pathophysiology.

Main Methods:

  • Review of current literature on itch (pruritus) pathophysiology.
  • Summary of first-line topical treatments including emollients, mild cleansers, topical anesthetics, steroids, calcineurin inhibitors, and coolants.

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  • Overview of systemic therapies based on itch etiology, including antihistamines, anticonvulsants, antidepressants, opioid antagonists/agonists, and phototherapy.

    • Main Results:

    • No single universally effective anti-itch treatment exists due to multifactorial etiologies.
    • Topical therapies are considered first-line treatments for itch management.
    • Systemic treatments are tailored to the specific cause of chronic itch, with varying efficacy depending on the underlying mechanisms.

    Conclusions:

    • Effective management of itch requires understanding its diverse causes and underlying pathophysiological mechanisms.
    • A range of topical and systemic treatments are available, with treatment selection dependent on the specific etiology of pruritus.
    • Further research into itch pathways may lead to more targeted and effective therapeutic strategies.