Mechanism of action Histamine H1-Receptor Antagonists:

Subgroups 1st Generation

Adverse Effects

Drug Names

Specific Effects

Adverse Effects

Contraindicatiors

Strong inhibition of edema formation and itching strong sedative effects

sedation, tinnitus, fatigue, dizziness, lassitude, uncoordination, blurred vision, tremors, dry mouth/nose/throat, urinary retention, tachycarida, hypotension, vertigo

Partial inhibition of histamine induced hypotension Strong inhibition of bronchiolar and GI smooth muscle contraction

more likely to block autonomic receptors

Normal 4-6 hour effective duration,

Motion sickness(nausea, vomiting Dimenhydrinate vertigo), Meniere disease, antiparkinsonism effects, Topical application(local anesthesia, and relief from itching) allergic rhinitis, Hallucinations, excitement, ataxia, allergic dermatosis, relief of convusions, coma, allergic symptoms: urticaria, cardiorespiratory collapse due to anaphylaxis, insomnia, motion OD Diphenhydramine sickness, antitussive, nasal admin: seasonal allergic rhinitis >5yrs, Ophthalamic admin: allergic conjuctivitis Olopatadine

AE for 1st gen

Low respiratory disease(asthma), preemies/ neonates, nursing women. Category B

AE for 1st gen, agranuloctyosis, thrombocytopenia, topica:photosenistivity, rash, sunburn

Bitter tasted

Low respiratory disease(asthma), preemies/ neonates, nursing women, MAOI - Category B Nasal admin: Category, Ophthalmic: wearing contact lens and Category C

Can have effect on muscarinic cholinoceptors, alpha-adrenoceptors, Inhibition of nausea, vomiting and vertigo serotonin receptors and local anesthetic receptors sedations Can be used as sleep aids aswell anticholinoceptor actions: can have atropine like affects such as lowers parasympathetic activity of all muscles and glands regulated by the PNS. Urinary retention and blurred vision 2nd Generation

Promethazine

AE for 1st gen, Respiratory depression, extravasation.tissue damage, extrapyramidal symptom, pseudoparkinsonism, tardive dyskinesa, agranulocytosis, leuopenia, BLACKBOX Pre-op/post-op sedation/Local WARINING: respiratory anesthesia, Allergic contions, depression risk and server nausea, vomiting, motion sickness, tissue injury, gangrene Meniere desease risk with IV admin

Children< 2 years old, comatose patients, severe respiratory depression, SC injuection: intra or periaterial admin, narrow angle glaucoma, pyloroduodenal obstruction, stenosing peptic ulcer disease, bladder neck obstruction, severe CNS depression. Category C

Less sedation due to less distribution into CNS

Hallucinations, excitement, ataxia, convusions, coma, cardiorespiratory collapse due to OD Cetirizine

Perennial allergic rhinitis, season allergic rhinitis, relieft symptoms of colds, urticaria, angioedema, anaphylactic reactions, pruritus, allergic conjunctivitis

Somnolence, Headache

hypersensitivity to hydroxyzine, preganacy/lactation rating category B or C

Can have longer duration 12-24hrs

Fexofenadine

Perennial allergic rhinitis, seasonal allergic rhinitis, chronic idiopathic urticaria, relief: cold symptoms, urticaria, angioedema, anaphylactic reactions, pruritus, allergic conjunctivitis Vomiting and Headache Perennial allergic rhinitis, seasonal allergic rhinitis, chronic idopathic urticaria, relief symptoms of: colds, urticaria, angioedema, anaphylactic reactions, pruritus allergic conjuctivitis Headache

Pregnancy/Lacation Rating Category C

inihibit histamine release from mast cells and baso phils

Loratadine

Pregnancy/Lacation Rating Category B