Antihistamines for the treatment of urticaria in Mexico

Autor: Désirée Larenas-Linnemann, Mario Sánchez-Borges, Blanca Estela Del Río-Navarro, María de Lourdes Alonzo-Romero Pareyón, César Alfonso Maldonado-García, Enrique Mendoza-López, José Antonio Ortega-Martell, Juan José Luis Sienra-Monge, Miguel Alejandro Medina-Ávalos, María Isabel Rojo-Gutiérrez, Angélica María Beirana-Palencia, Jorge Bernardo Vargas-Correa, Carlos Báez-Loyola, Ruth Ivonne Mireya Ramírez-Segura, María Graciela Guzmán-Perea
Jazyk: English<br />Spanish; Castilian
Rok vydání: 2015
Předmět:
Zdroj: Revista Alergia México, Vol 62, Iss 3, Pp 157-174 (2015)
Druh dokumentu: article
ISSN: 0002-5151
2448-9190
DOI: 10.29262/ram.v62i3.103
Popis: There are four types of histamine receptors. Allergic symptoms, especially those in rhinoconjunctivitis and urticaria, are mainly caused by activation of histamine receptor 1 (H1). Consequently, oral H1-antihistamines form and integral part of the treatment of these diseases. Antihistamines are inverse agonists that stabilize the non-active configuration of the histamine receptor. First generation H1-antihistamines cause a variety of adverse effects via several mechanisms: sedation (accumulation in the central nervous system), dry mouth, urinary retention, weight gain (low selectivity: stimulation of serotonin/muscarinic/alpha-adrenergic receptors) and drug interactions (substrate of CYP450-3A4). Generally second generation H1-antihistamines have a better safety profile. New guidelines on allergic rhinitis and urticaria recommend second generation H1-antihistamines as first line drugs, with –if necessary– four-times updosing to obtain control in urticaria. The enhanced efficacy of quadruple doses in urticaria, while maintaining a good safety profile, has been shown for bilastine, desloratadine and levocetirizine (rupatadine). For ebastine and fexofenadine only the safety of quadruple doses has been shown till now. Extreme precaution should be taken with astemizol and terfenadine that never should be up-dosed, as high serum concentrations can cause potentially fatal ventricular tachycardia. First generation antihistamines are not recommended as first line treatment and updosing is not safe.
Databáze: Directory of Open Access Journals
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