Itch/Pruritis

Not all itch mediated by histamine. Central nervous system component involved in kidney and liver failure pruritis.

Treatment

  1. Treat dry skin
  2. Lidocaine 2-10% ointment/lotion used for localized itch. Toxicity possible if used over large areas
  3. Camphor 0.5% Menthol 0.5% in ointment base PRN
  4. Paroxetine 10-20mg po daily (works in 24-48 hours, sedation)
  5. Mirtazepine 7.5-30mg po daily (weight gain, sedation possible)
  6. Ondansetron 4-8mg po/sc bid (constipation)