Abstract
Second generation antihistamines are recognised as being highly effective treatments for allergy-based disease and are among the most frequently prescribed and safest drugs in the world. However, consideration of the therapeutic index or the benefit/risk ratio of the H-1 receptor antagonists is of paramount importance when prescribing this class of compounds as they are used to treat non-life threatening conditions. Then are many second generation antihistamines available and at first examination these appear to be comparable in terms of safety and efficacy. However, the newer antihistamines in fact represent a hererogeneous group of compounds, having markedly differing chemical structures, adverse effects, half-life, tissue distribution and metabolism, spectrum of antihistaminic properties, and varying degrees of anti-inflammatory effects. With regard to the latter, there is growing awareness that some of these compounds might represent useful adjunct medications in asthma therapy. In terms of safety issues, the current second generation grouping includes compounds with proven cardiotoxic effects and others with the potential for adverse drug interactions, Moreover, some of the second generation H1 antagonists have given cause for concern regarding their potential to cause a degree of somnolence in some individuals. It can be argued, therefore, that the present second generation grouping is too large and indistinct since this was based primarily on the concept of separating the first generation sedating compounds from nonsedating H1 antagonists. Although it is too early to talk about a third generation grouping of antihistamines, future membership of such a classification could be based on a low volume of distribution coupled with a lack of sedating effects, drug interactions and cardiotoxicity.
| Original language | English |
|---|---|
| Pages (from-to) | 207-236 |
| Number of pages | 29 |
| Journal | Drugs |
| Volume | 61 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2001 |
Keywords
- SEASONAL ALLERGIC RHINITIS
- CHRONIC IDIOPATHIC URTICARIA
- PLATELET-ACTIVATING-FACTOR
- NASAL EPITHELIAL-CELLS
- LATE-PHASE REACTIONS
- HISTAMINE H-1-RECEPTOR ANTAGONISTS
- CELLULAR INFLAMMATORY RESPONSES
- PSYCHOMETRIC TEST-PERFORMANCE
- PLACEBO-CONTROLLED TRIAL
- POLLEN-INDUCED ASTHMA
Cite this
New insights into the second generation antihistamines. / Walsh, Garry Michael; Annunziato, L.; Knol, K.; Nicolas, J. M.; Taglialatela, M.; Tharp, M. D.; Tillement, J. P.; Timmerman, H.; Frossard, N.; Levander, S.
In: Drugs, Vol. 61, No. 2, 2001, p. 207-236.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - New insights into the second generation antihistamines
AU - Walsh, Garry Michael
AU - Annunziato, L.
AU - Knol, K.
AU - Nicolas, J. M.
AU - Taglialatela, M.
AU - Tharp, M. D.
AU - Tillement, J. P.
AU - Timmerman, H.
AU - Frossard, N.
AU - Levander, S.
PY - 2001
Y1 - 2001
N2 - Second generation antihistamines are recognised as being highly effective treatments for allergy-based disease and are among the most frequently prescribed and safest drugs in the world. However, consideration of the therapeutic index or the benefit/risk ratio of the H-1 receptor antagonists is of paramount importance when prescribing this class of compounds as they are used to treat non-life threatening conditions. Then are many second generation antihistamines available and at first examination these appear to be comparable in terms of safety and efficacy. However, the newer antihistamines in fact represent a hererogeneous group of compounds, having markedly differing chemical structures, adverse effects, half-life, tissue distribution and metabolism, spectrum of antihistaminic properties, and varying degrees of anti-inflammatory effects. With regard to the latter, there is growing awareness that some of these compounds might represent useful adjunct medications in asthma therapy. In terms of safety issues, the current second generation grouping includes compounds with proven cardiotoxic effects and others with the potential for adverse drug interactions, Moreover, some of the second generation H1 antagonists have given cause for concern regarding their potential to cause a degree of somnolence in some individuals. It can be argued, therefore, that the present second generation grouping is too large and indistinct since this was based primarily on the concept of separating the first generation sedating compounds from nonsedating H1 antagonists. Although it is too early to talk about a third generation grouping of antihistamines, future membership of such a classification could be based on a low volume of distribution coupled with a lack of sedating effects, drug interactions and cardiotoxicity.
AB - Second generation antihistamines are recognised as being highly effective treatments for allergy-based disease and are among the most frequently prescribed and safest drugs in the world. However, consideration of the therapeutic index or the benefit/risk ratio of the H-1 receptor antagonists is of paramount importance when prescribing this class of compounds as they are used to treat non-life threatening conditions. Then are many second generation antihistamines available and at first examination these appear to be comparable in terms of safety and efficacy. However, the newer antihistamines in fact represent a hererogeneous group of compounds, having markedly differing chemical structures, adverse effects, half-life, tissue distribution and metabolism, spectrum of antihistaminic properties, and varying degrees of anti-inflammatory effects. With regard to the latter, there is growing awareness that some of these compounds might represent useful adjunct medications in asthma therapy. In terms of safety issues, the current second generation grouping includes compounds with proven cardiotoxic effects and others with the potential for adverse drug interactions, Moreover, some of the second generation H1 antagonists have given cause for concern regarding their potential to cause a degree of somnolence in some individuals. It can be argued, therefore, that the present second generation grouping is too large and indistinct since this was based primarily on the concept of separating the first generation sedating compounds from nonsedating H1 antagonists. Although it is too early to talk about a third generation grouping of antihistamines, future membership of such a classification could be based on a low volume of distribution coupled with a lack of sedating effects, drug interactions and cardiotoxicity.
KW - SEASONAL ALLERGIC RHINITIS
KW - CHRONIC IDIOPATHIC URTICARIA
KW - PLATELET-ACTIVATING-FACTOR
KW - NASAL EPITHELIAL-CELLS
KW - LATE-PHASE REACTIONS
KW - HISTAMINE H-1-RECEPTOR ANTAGONISTS
KW - CELLULAR INFLAMMATORY RESPONSES
KW - PSYCHOMETRIC TEST-PERFORMANCE
KW - PLACEBO-CONTROLLED TRIAL
KW - POLLEN-INDUCED ASTHMA
U2 - 10.2165/00003495-200161020-00006
DO - 10.2165/00003495-200161020-00006
M3 - Article
VL - 61
SP - 207
EP - 236
JO - Drugs
JF - Drugs
SN - 0012-6667
IS - 2
ER -