Classification of Sedating Antihistamines
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چکیده
BACKGROUND Allergic conditions affect about 20-30% of individuals. A survey of hay fever sufferers found, that 54% were self medicating with over the counter preparations and one third of these patients had experienced drowsiness because of their therapy. Antihistamines are one of the options for the symptomatic treatment of allergic disorders such as seasonal and perennial allergic rhinitis and chronic urticaria. However, the use of traditional antihistamines such as diphenhydramine, chlorpheniramine, triprolidine and promethazine is often associated with a number of adverse effects, of which sedation is the most pronounced. These adverse effects can interfere with the performance of daytime activities and place the patient at risk of accidents in situations such as driving and operation of machinery. Drivers killed in car accidents due to their own error were found 1.5x more likely to have used a first generation antihistamine than other drivers, who died in MVAs and who were not found responsible for the accident. Clinical trials have demonstrated, that as a group, the second generation antihistamines have a much more favourable therapeutic index and a significantly lower incidence of sedative effects than their predecessors. Unlike the classical antihistamines, many of the newer agents have a greater affinity for the H 1 receptor but do not readily cross the blood brain barrier and are thus relatively devoid of undesirable central effects such as sedation, fatigue, etc. However there are differences between the individual newer antihistamines.
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