Drug Interaction:
Antihistamines Include:
First Generation ( Non-selective )
Ethanolamine- Carbinoxamine. Clemastine, Diphenhydramine.
Ethylenediamines- Pyrilamine, Triplennamine
Akylamines- Brompheneramine, Chlorpheniramine, Dexchlor pheniramine,Pheniramine,Triprolidine
Phenothiazines- Methidilazine, Promethizine, trimeprazine Piperidines- Azatadine, Cyproheptadine, Phenindamine
Miscellaneous- Astemazole, Loratadine, Terfenadine
Second Generation ( Peripherally selective )-
Phthalazinone - Azelastine Piperazine - Cetrizine
Refer - Chlorpheniramine maleate
MAO inhibitors enhance antichollinergic side effects of azatidine
, Enhancement of depressent action of anxiolytic and sedating drugs.
Potentiates CNS depression with other CNS depressants and alcohol.
Auguments depressive action of alcohol.
Indication:
Antihistamines Include:
First Generation ( Non-selective )
Ethanolamine- Carbinoxamine. Clemastine, Diphenhydramine.
Ethylenediamines- Pyrilamine, Triplennamine
Akylamines- Brompheneramine, Chlorpheniramine, Dexchlor pheniramine,Pheniramine,Triprolidine
Phenothiazines- Methidilazine, Promethizine, trimeprazine Piperidines- Azatadine, Cyproheptadine, Phenindamine
Miscellaneous- Astemazole, Loratadine, Terfenadine
Second Generation ( Peripherally selective )-
Phthalazinone - Azelastine Piperazine - Cetrizine
Refer - Chlorpheniramine maleate
Adverse Reaction:
Drowsiness, dizziness, gastritis, antichlolinergic effects, paradoxical excitement,
blood dyscrasisas.increased appetite, impaired reactions, anorexia, nausea, headache.
Contra-Indications:
Prostatic hypertrophy, urinary retension. Glaucoma.
Hypersens to ingredients.Infants & newborn.
Patients receiving MAO inhibit therapy, pregnancy and lactation.
Special precautions:
In patients with narrow angle glaucoma. Increased intra-ocular pressure, stenosing peptic ulcer, pyloroduodenal obstruction, cardiovascular disease including .hypertension & hyperthyroidism.
Patients warnEd about engaging in activities requiring mental alertness.
Dosages/ Overdosage Etc:
Indications:
Antihistamine
Dosage:
Individualise dosage. Adults- 1 or 2mg twice a day.
Not intended for children below 12 years
Patient Information:
1. Inform patients of a history of glaucoma, peptic ulcer, urinary retention, or pregnancy before starting antihistamine therapy
2. May cause nervousness, insomnia, and dry mouth
3. May cause drowsiness, or dizziness(except astemazole,loratadine, and tefenadine)
4. Patients should observe caution while driving or performing other tasks requiring alertness, coordination or physical dexterity.
5. Avoid alcohol and other CNS depressants (eg,. sedatives, hypnotics, tranquilizers)
6. May cause GI upset, take with food. Take Astemazole on an empty stomach, at least 2 hours after or 1 hour before a meal. Take Lorantidine on an empty stomach.
7. Avoid prolonged exposure to sunlight, may cause photosentivity.
8. Do not crush or chew sustained release preparations
9.Astemazole/ Terfenadine: Patients should not take these agents if they have hepatic dysfunction or if they are also receiving ketoconazole, itraconazole or erythromycin
10. Phenothiazines- Patients should report any involuntary muscle movements or unusual sensitivity to sunlight.
Pharmacology/ Pharmacokinetics:
Antihistamines Include:
First Generation ( Non-selective )
Ethanolamine- Carbinoxamine. Clemastine, Diphenhydramine.
Ethylenediamines- Pyrilamine, Triplennamine
Akylamines- Brompheneramine, Chlorpheniramine, Dexchlor pheniramine,Pheniramine,Triprolidine
Phenothiazines- Methidilazine, Promethizine, trimeprazine Piperidines- Azatadine, Cyproheptadine, Phenindamine
Miscellaneous- Astemazole, Loratadine, Terfenadine
Second Generation ( Peripherally selective )-
Phthalazinone - Azelastine Piperazine - Cetrizine
Refer - Chlorpheniramine maleate
Interaction with Food:
May be taken with food or after meals if stomach upset occurs
Pregnancy and lactation:
Antihistamines Include:
First Generation ( Non-selective )
Ethanolamine- Carbinoxamine. Clemastine, Diphenhydramine.
Ethylenediamines- Pyrilamine, Triplennamine
Akylamines- Brompheneramine, Chlorpheniramine, Dexchlor pheniramine,Pheniramine,Triprolidine
Phenothiazines- Methidilazine, Promethizine, trimeprazine Piperidines- Azatadine, Cyproheptadine, Phenindamine
Miscellaneous- Astemazole, Loratadine, Terfenadine
Second Generation ( Peripherally selective )-
Phthalazinone - Azelastine Piperazine - Cetrizine
Refer - Chlorpheniramine maleate