Book ChapterDOI
Histamine and antihistamines in anaphylaxis.
TLDR
The unavailability of parenterally administered second-generation H1-antagonists limits their usefulness in acute anaphylaxis and perioperative prophylaxis, and should lead to a reevaluation of the usefulness of antihistamines.Abstract:
Anaphylaxis and anaphylactoid reactions are potentially fatal. These disorders are sometimes iatrogenic, and increase with increased exposure to drugs, synthetic substances, and medical procedures. Non-IgE-mediated anaphylactoid reactions are common in medical settings and are clinically indistinguishable from anaphylaxis. These reactions may be unrecognized if a rigid classic definition of anaphylaxis is used. Histamine is a primary mediator of anaphylaxis and signs and symptoms of anaphylaxis can be reproduced by histamine infusion. Histamine triggers a cascade of inflammatory mediators and modulates its own release. H1-antihistamines are adjunctive treatment therapy for acute anaphylaxis and anaphylactoid reactions, in which many mediators of inflammation are involved. Compared with epinephrine, the first-response medication of choice, antihistamines have a slow onset of action, and they cannot block events that occur subsequent to histamine binding to its receptors. Antihistamines are an important component of regimens for the prevention of anaphylaxis and anaphylactoid reactions in patients at risk, and may eventually have more widespread application in the perioperative setting. In some instances, such as with exercise-induced anaphylaxis and reactions to latex in sensitized individuals, prophylaxis regimens are not always effective. H2-antagonists are not detrimental in the therapy of anaphylaxis and many studies show a favorable outcome when combining H1- and H2-antagonist therapy for prophylaxis. They should be added to therapy at the discretion of the treating physician. Because of decreased antimuscarinic and central nervous system side effects, the newer antihistamines can be given in high doses, allowing more complete blockade of histamine receptors. These agents should lead to a reevaluation of the usefulness of antihistamines in both the treatment of acute anaphylaxis and in prophylactic regimens. The unavailability of parenterally administered second-generation H1-antagonists limits their usefulness in acute anaphylaxis and perioperative prophylaxis.read more
Citations
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Journal ArticleDOI
European Resuscitation Council guidelines for resuscitation 2005. Section 7. Cardiac arrest in special circumstances.
Jasmeet Soar,Charles D. Deakin,Jerry P. Nolan,Gamal Abbas,A. Alfonzo,Anthony J. Handley,David Lockey,Gavin D. Perkins,K Thies +8 more
TL;DR: Electrolyte abnormalities can cause cardiac rrhythmias or cardiopulmonary arrest, and precise values that trigger treatment deciions will depend on the patient’s clinical conition and the rate of change of the electrolyte alues.
European Resuscitation Council (ERC) Guidelines for Resuscitation 2005
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
Basophils Play a Pivotal Role in Immunoglobulin-G-Mediated but Not Immunoglobulin-E-Mediated Systemic Anaphylaxis
Yusuke Tsujimura,Kazushige Obata,Kaori Mukai,Hideo Shindou,Masayuki Yoshida,Hideto Nishikado,Yohei Kawano,Yoshiyuki Minegishi,Takao Shimizu,Hajime Karasuyama +9 more
TL;DR: It is shown that basophils, the least common blood cells, were dispensable for IgE-mediated anaphylaxis but played a critical role in IgG-mediated, passive and active systemic anaphYLaxis in mice, and two major, distinct pathways leading to allergen-induced systemic anphylaxis are contrasted.
Journal ArticleDOI
H1-antihistamines for the treatment of anaphylaxis: Cochrane systematic review
TL;DR: This work sought to assess the benefits and harm of H1‐antihistamines in the treatment of anaphylaxis and found them to be safe and effective.
References
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Journal Article
Nature and extent of penicillin side-reactions, with particular reference to fatalities from anaphylactic shock.
TL;DR: An appraisal is made of toxic, microbiogenic, and allergic side effects occurring in man as a result of large amounts of penicillin increasingly used in medical and veterinary practice, including a study of 151 anaphylactic fatalities reported to have followedPenicillin administration.
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