Book ChapterDOI
H1-antihistamines in children.
TLDR
Their use should be restricted to two uncommon situations: children with urticaria or atopic dermatitis whose pruritus is so severe that the sedation produced by an old H1-antagonist, such as hydroxyzine, is a benefit rather than a risk; and children with anaphylaxis who require intravenous diphenhydramine as adjunctive treatment to epinephrine and other modalities.Abstract:
In children, as in adults, H1-antagonists are useful in the treatment of allergic rhinoconjunctivitis. Level 1 evidence for their efficacy in this disorder has been obtained in many well-designed pediatric studies. The widespread use of H1-antagonists in upper respiratory tract infections or otitis media in children is not supported by a strong scientific rationale. H1-antagonists are not harmful in children with asthma and, indeed, may have some beneficial effects in children with mild asthma. Their role in delaying or preventing asthma from developing in high-risk infants and toddlers is currently an important area of clinical investigation. The evidence base for their use in children with urticaria or atopic dermatitis still contains large gaps. First-generation H1-antagonists are presumed to be safe for use in infants and children. While they have undoubtedly been administered without apparent harm to millions in this age group, they impair CNS function far more commonly than is generally realized. Their use should be restricted to two uncommon situations: children with urticaria or atopic dermatitis whose pruritus is so severe that the sedation produced by an old H1-antagonist, such as hydroxyzine, is a benefit rather than a risk; and children with anaphylaxis who require intravenous diphenhydramine as adjunctive treatment to epinephrine and other modalities. Apart from these exceptions, in patients of all ages, second-generation H1-antagonists free from CNS adverse effects are clearly the medications of choice. Pediatric formulations of the new H1-antagonists cetirizine, fexofenadine, and loratadine are now available for use.read more
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Journal ArticleDOI
Allergic rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen)
Jean Bousquet,N. Khaltaev,Alvaro A. Cruz,Judah A. Denburg,W. J. Fokkens,Alkis Togias,T. Zuberbier,Carlos E. Baena-Cagnani,Giorgio Walter Canonica,C. van Weel,Ioana Agache,Nadia Aït-Khaled,Claus Bachert,Michael S. Blaiss,Sergio Bonini,L.-P. Boulet,Philippe-Jean Bousquet,Paulo Augusto Moreira Camargos,K-H. Carlsen,Y. Z. Chen,Adnan Custovic,Ronald Dahl,Pascal Demoly,H. Douagui,Stephen R. Durham,R. Gerth van Wijk,O. Kalayci,Michael A. Kaliner,You Young Kim,Marek L. Kowalski,Piotr Kuna,L. T. T. Le,Catherine Lemière,Jing Li,Richard F. Lockey,S. Mavale-Manuel,Eli O. Meltzer,Y. Mohammad,J Mullol,Robert M. Naclerio,Robyn E O'Hehir,K. Ohta,S. Ouedraogo,S. Palkonen,Nikolaos G. Papadopoulos,Gianni Passalacqua,Ruby Pawankar,Todor A. Popov,Klaus F. Rabe,J Rosado-Pinto,G. K. Scadding,F. E. R. Simons,Elina Toskala,E. Valovirta,P. Van Cauwenberge,De Yun Wang,Magnus Wickman,Barbara P. Yawn,Arzu Yorgancioglu,Osman M. Yusuf,H. J. Zar,Isabella Annesi-Maesano,E.D. Bateman,A. Ben Kheder,Daniel A. Boakye,J. Bouchard,Peter Burney,William W. Busse,Moira Chan-Yeung,Niels H. Chavannes,A.G. Chuchalin,William K. Dolen,R. Emuzyte,Lawrence Grouse,Marc Humbert,C. M. Jackson,Sebastian L. Johnston,Paul K. Keith,James P. Kemp,J. M. Klossek,Désirée Larenas-Linnemann,Brian J. Lipworth,Jean-Luc Malo,Gailen D. Marshall,Charles K. Naspitz,K. Nekam,Bodo Niggemann,Ewa Nizankowska-Mogilnicka,Yoshitaka Okamoto,M. P. Orru,Paul Potter,David Price,Stuart W. Stoloff,Olivier Vandenplas,Giovanni Viegi,Dennis M. Williams +95 more
TL;DR: The ARIA guidelines for the management of allergic rhinitis and asthma are similar in both the 1999 ARIA workshop report and the 2008 Update as discussed by the authors, but the GRADE approach is not yet available.
Journal ArticleDOI
Allergic Rhinitis and Its Impact on Asthma
TL;DR: This systematic review and meta-analyses confirmed the findings of a previous study published in “Rhinitis and Asthma: Causes and Prevention, 2nd Ed.” (2015) as well as new findings of “Mechanisms of Respiratory Disease and Allergology,” which confirmed the role of EMTs in the development of these diseases.
Journal ArticleDOI
Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 Revision
Jan Brozek,Jean Bousquet,Carlos E. Baena-Cagnani,Sergio Bonini,G. Walter Canonica,Thomas B. Casale,Roy Gerth van Wijk,Ken Ohta,Torsten Zuberbier,Holger J. Schünemann +9 more
TL;DR: These are the most recent and currently the most systematically and transparently developed recommendations about the treatment of allergic rhinitis in adults and children and patients are encouraged to use these recommendations in their daily practice and to support their decisions.
Journal ArticleDOI
Advances in H1-Antihistamines
TL;DR: There are clinically relevant differences among H1-antihistamines in their pharmacology and safety profiles in allergic rhinoconjunctivitis and chronic urticaria.
Journal ArticleDOI
Pharmacology of antihistamines
Martin K. Church,Diana S. Church +1 more
TL;DR: The newer second-generation H1-antihistamines are safer, cause less sedation and are more efficacious and three drugs widely used for symptomatic relief in urticaria, desloratadine, levocetirizine and fexofenadine are highlighted in this review.
References
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Journal ArticleDOI
The Pharmacology and Use of H1-Receptor-Antagonist Drugs
F. E. R. Simons,K. J. Simons +1 more
TL;DR: The second-generation H1-antagonist drugs are supplanting their predecessors in the treatment of allergic rhinoconjunctivitis and chronic urticaria and an even more favorable therapeutic index may be developed with the cloning of the gene encoding the H1 receptor and increased understanding of the precise structural requirements for H 1-receptor activity.