Risk of first-generation H1-antihistamines: a GA2LEN position paper

被引:310
作者
Church, M. K. [2 ]
Maurer, M.
Simons, F. E. R. [3 ]
Bindslev-Jensen, C. [4 ]
van Cauwenberge, P. [5 ]
Bousquet, J. [6 ]
Holgate, S. T. [2 ]
Zuberbier, T. [1 ]
机构
[1] Charite, Allergie Ctr Charite, Secretary Gen GA2 LEN, Dept Dermatol & Allergy, D-10117 Berlin, Germany
[2] Univ Southampton, Southampton, Hants, England
[3] Univ Manitoba, Dept Pediat & Child Hlth, Allergy & Clin Immunol Sect, Winnipeg, MB R3T 2N2, Canada
[4] Odense Univ Hosp, Dept Dermatol, DK-5000 Odense, Denmark
[5] Univ Ghent, Dept Otorhinolaryngol, B-9000 Ghent, Belgium
[6] Univ Hosp, Clin Malad Resp, Montpellier, France
基金
英国医学研究理事会;
关键词
adverse event; allergic rhinitis; cognitive function; sedation; OVER-THE-COUNTER; SEASONAL ALLERGIC RHINITIS; PLACEBO-CONTROLLED TRIAL; HERG K+ CHANNEL; H-1-RECEPTOR ANTAGONISTS; COLD MEDICATIONS; DIPHENHYDRAMINE OVERDOSE; H-1; ANTIHISTAMINE; HEALTHY-SUBJECTS; BRAIN HISTAMINE;
D O I
10.1111/j.1398-9995.2009.02325.x
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
P>Background: First-generation H-1-antihistamines obtained without prescription are the most frequent form of self-medication for allergic diseases, coughs and colds and insomnia even though they have potentially dangerous unwanted effects which are not recognized by the general public. Aims: To increase consumer protection by bringing to the attention of regulatory authorities, physicians and the general public the potential dangers of the indiscriminate use first-generation H-1-antihistamines purchased over-the counter in the absence of appropriate medical supervision. Methods: A GA2LEN (Global Allergy and Asthma European Network) task force assessed the unwanted side-effects and potential dangers of first-generation H1-antihistamines by reviewing the literature (Medline and Embase) and performing a media audit of US coverage from 1996 to 2008 of accidents and fatal adverse events in which these drugs were implicated. Results: First-generation H-1-antihistamines, all of which are sedating, are generally regarded as safe by laypersons and healthcare professionals because of their long-standing use. However, they reduce rapid eye movement (REM)-sleep, impair learning and reduce work efficiency. They are implicated in civil aviation, motor vehicle and boating accidents, deaths as a result of accidental or intentional overdosing in infants and young children and suicide in teenagers and adults. Some exhibit cardiotoxicity in overdose. Conclusions: This review raises the issue of better consumer protection by recommending that older first-generation H-1-antihistamines should no longer be available over-the-counter as prescription- free drugs for self-medication of allergic and other diseases now that newer second- generation nonsedating H-1-antihistamines with superior risk/benefit ratios are widely available at competitive prices.
引用
收藏
页码:459 / 466
页数:8
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