Clinical Immunotherapeutics

, Volume 2, Issue 5, pp 352–375 | Cite as

H1-Receptor Antagonists in the Management of Allergic Rhinitis

A Comparative Review
  • Kalliopi Kontou-Fili
Review Article Comparative Review
  • 3 Downloads

Summary

Allergic rhinitis, the most common clinical expression of atopy, is caused by: (a) the action of various mediators and other cell-derived substances released during the acute phase of the allergic reaction; and (b) the inflammatory response that follows hours later. Histamine, a mediator of major importance in eliciting the signs and symptoms of allergic rhinitis, is known to act via a number of distinct receptors (H1, H2, H3 and possibly H4). It appears that H1-receptors are functionally most important in the nose, and hence H1-receptor antagonists have been the mainstay of rhinitis treatment for over 50 years.

Classic first-generation antihistamines freely cross the blood-brain barrier and also exhibit significant anticholinergic activity, causing sedation and other adverse effects that restrict their use. Second-generation nonsedating H1-antagonists have fewer adverse effects, are longer acting, permitting a more convenient dosage schedule, and also exhibit additional antiallergic properties. Such features are probably more important in the chronic forms of rhinitis, where second-generation agents should preferentially be employed.

No single H1-antagonist, old or new, controls nasal blockage adequately. As a consequence, the demand for combining antihistamines with sympathomimetic vasoconstrictors has been more or less constant, despite the introduction of the improved second-generation H1-antagonists. Several of the nonsedating antihistamines are presently available in fixed combinations with pseudoephedrine and might be used in cases of persistent nasal blockage. Combination of H1- and H2-antagonists, even when applied locally, does not appear to alleviate the symptoms of rhinitis more than monotherapy with H1-antagonists.

Caution must be observed when considering H1-antagonist therapy for special groups of patients. These situations include extremes of age, pregnancy, lactation, individuals with impaired renal or hepatic function, and those who are receiving drugs known to interact with particular antihistamines.

Asthma coexisting with rhinitis does not constitute a contraindication for the use of H1-antagonists. Second-generation antihistamines are particularly appropriate in this situation, not only because they are free of anticholinergic adverse effects such as drying of mucous membranes, but also because some of them exhibit additional antiallergic properties and/or mild anti-inflammatory activity.

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References

  1. 1.
    Broder I, Higgins MW, Mathews KP, et al. Epidemiology of asthma and allergic rhinitis in a total community, Tecumseh, Michigan. J Allergy Clin Immunol 1974; 54: 100–10CrossRefPubMedGoogle Scholar
  2. 2.
    Emanuel MB. Hay fever, a post industrial revolution epidemic: a history of its growth during the 19th century. Clin Allergy 1988; 18: 295–304CrossRefPubMedGoogle Scholar
  3. 3.
    Varney V. Hayfever in the United Kingdom. Clin Exp Allergy 1991; 21: 757–62CrossRefPubMedGoogle Scholar
  4. 4.
    Kaliner M, Lemanske R. Rhinitis and asthma. JAMA 1992; 268: 2807–29CrossRefPubMedGoogle Scholar
  5. 5.
    Sibbald B. Epidemiology of allergic rhinitis. In: Burr ML, editor. Epidemiology of clinical allergy. Monographs in allergy. Basel: Karger, 1993: 61–79Google Scholar
  6. 6.
    Smith JM. Epidemiology. In: Mygind N, Naclerio RM, editors. Allergic and non-allergic rhinitis. Copenhagen: Munksgaard, 1993: 15–22Google Scholar
  7. 7.
    McGrath KG, Patterson R. Allergic rhinitis jeopardizing the careers of professional singers, justifies intense therapy. Allergy Proc 1988; 9: 665–67CrossRefPubMedGoogle Scholar
  8. 8.
    International Rhinitis Management Working Group. International consensus report on the diagnosis and management of rhinitis. Allergy 1994; 49 Suppl. 19: 5–34Google Scholar
  9. 9.
    Siraganian RP. Mechanism of IgE-mediated hypersensitivity. In: Middleton Jr E, Reed CE, Ellis EF, editors. Allergy principles and practice. St Louis: Mosby, 1993: 105–34Google Scholar
  10. 10.
    DeLisi C, Siraganian RP. Receptor cross-linking and histamine release. I. The quantitative dependence of basophil degranulation on the number of receptor doublets. J Immunol 1979; 122: 2286–92PubMedGoogle Scholar
  11. 11.
    Kane PM, Holowka D, Baiard B. Cross-linking of IgE-receptor complexes by rigid bivalent antigens greater than 200Å in length triggers cellular degranulation. J Cell Biol 1988; 107: 969–80CrossRefPubMedGoogle Scholar
  12. 12.
    Benhamou M, Gutkind JS, Robbins KC, et al. Tyrosine phosphorylation coupled to IgE receptor mediated signal transduction and histamine release. Proc Natl Acad Sci USA 1990; 87: 5327–30CrossRefPubMedGoogle Scholar
  13. 13.
    Eiseman E, Bolen JB. Engagement of the high-affinity IgE receptor activates src protein-related tyrosine kinases. Nature 1992; 355: 78–80CrossRefPubMedGoogle Scholar
  14. 14.
    Naclerio RM, Proud D, Togias AG, et al. Inflammatory mediators in late antigen-induced rhinitis. N Engl J Med 1985; 313: 65–70CrossRefPubMedGoogle Scholar
  15. 15.
    Bascom R, Pipkorn U, Lichtenstein LM, et al. The influx of inflammatory cells into the nasal washings during the late response to antigen challenge. Am Rev Respir Dis 1988; 138: 406–12PubMedGoogle Scholar
  16. 16.
    Okuda M, The pathophysiology of allergic rhinitis. Allergy Clin Immunol News 1989; 1(6): 531–45Google Scholar
  17. 17.
    Iliopoulos O, Proud D, Adkinson Jr NF, et al. Relationship between the early, late and challenge reaction to nasal challenge with antigen: observations on inflammatory mediators and cells. J Allergy Clin Immunol 1990; 86: 851–61CrossRefPubMedGoogle Scholar
  18. 18.
    Georgitis JW, Stone BD, Gottschlich G. Nasal inflammatory mediator release in ragweed allergic rhinitis: correlation with cellular influx into nasal secretions. Int Arch Allergy Appl Immunol 1991; 96: 231–7CrossRefPubMedGoogle Scholar
  19. 19.
    White MV, Kaliner MA. Mediators of allergic rhinitis. J Allergy Clin Immunol 1992; 90: 699–704CrossRefPubMedGoogle Scholar
  20. 20.
    Klememtsson H. Eosinophils and the pathophysiology of allergic rhinitis. Clin Exp Allergy 1992; 22: 1058–64CrossRefGoogle Scholar
  21. 21.
    Varney VA, Jacobson, MR, Sudderick RM, et al. Immunohistology of the nasal mucosa following allergen-induced rhinitis. Identification of activated T lymphocytes, eosinophils and neutrophils. Am Rev Respir Dis 1992; 146: 170–6PubMedGoogle Scholar
  22. 22.
    Del Prete GF, De Carli M, D’Elios MM, et al. Allergen exposure induces the activation of allergen-specific Th2 cells in the airway mucosa of patients with allergic respiratory disorders. Eur J Immunol 1993; 23: 1445–9CrossRefPubMedGoogle Scholar
  23. 23.
    Pastorello EA, Riario-Sfortza GG, Incorvaia C, et al. Comparison of rhinomanometry, symptom score and inflammatory cell counts in assessing the nasal late-phase reaction to allergen challenge. J Allergy Clin Immunol 1994; 93: 85–92CrossRefPubMedGoogle Scholar
  24. 24.
    Karnushina IL, Palacios JM, Barbin G. et al. Studies on capillary-rich fraction isolated from brain: histamine components and characterization of the histaminic receptors linked to adenylate cyclase. J Neurochem 1980; 34: 1201–8CrossRefPubMedGoogle Scholar
  25. 25.
    Schwartz JC, Barbin G, Duchemin AM, et al. Histamine receptors in the brain: characterization by binding studies and biochemical effects. Adv Biochem Psychopharmacol 1980; 21: 169–82PubMedGoogle Scholar
  26. 26.
    Panula P, Airaksen MS, Pirvola U, et al. A histamine containing neuronal system in human brain. Neuroscience 1990; 34: 127–32CrossRefPubMedGoogle Scholar
  27. 27.
    White MV. The role of histamine in allergic diseases. J Allergy Clin Immunol 1990; 86: 599–605CrossRefPubMedGoogle Scholar
  28. 28.
    Proud D, Bailey GS, Naclerio RM, et al. Tryptase and histamine as markers to evaluate mast cell activation during the response to nasal challenge with allergen, cold air and hyperosmolar solutions. J Allergy Clin Immunol 1992; 89: 1098–110CrossRefPubMedGoogle Scholar
  29. 29.
    Beaven MA. Physiology in medicine: histamine. N Engl J Med 1976; 294: 30–6CrossRefPubMedGoogle Scholar
  30. 30.
    Panula P, Yang HYT, Costa E. Histamine containing neurons in the rat hypothalamus. Proc Natl Acad Sci USA 1984; 81: 2572–6CrossRefPubMedGoogle Scholar
  31. 31.
    Watanabe T, Taguchi Y, Shiosaka S, et al. Distribution of the histaminergic neuron system in the CNS of rats: a fluorescent immunocytochemical analysis with histamine decarboxylase as a marker. Brain Res 1984; 295: 13–25CrossRefPubMedGoogle Scholar
  32. 32.
    Arrang JM, Garbarg M, Schwartz JC. Autoregulation of histamine release in brain by presynaptic H3-receptors. Nature 1985; 15: 553–62Google Scholar
  33. 33.
    Arrang JM, Garbarg M, Lancelot JC, et al. Highly potent and selective ligands for histamine H-3 receptors. Nature 1987; 327: 117–23CrossRefPubMedGoogle Scholar
  34. 34.
    Arrang JM, Garbarg M, Lancelot JC, et al. The third histamine receptor. Int Arch Allergy Appl Immunol 1989; 88: 79–81CrossRefPubMedGoogle Scholar
  35. 35.
    Beer DJ, Matloff SM, Rocklin RE. The influence of histamine on immune and inflammatory response. Adv Immunol 1984; 35: 209–68CrossRefPubMedGoogle Scholar
  36. 36.
    Tedeschi A, Lorini M, Arquati M, et al. Regulation of histamine release from human basophil leukocytes: role of H1, H2 and H3 receptors. Allergy 1991; 46: 626–31CrossRefPubMedGoogle Scholar
  37. 37.
    Bury TB, Corhay JL, Radermecker MF. Histamine-induced inhibition of neutrophil Chemotaxis and T-lymphocyte proliferation in man. Allergy 1992; 47: 624–9CrossRefPubMedGoogle Scholar
  38. 38.
    Dachman WD, Bedaride G, Blaschke TF, et al. Histamine-induced venodilatation in human beings involves H1 and H2 receptor subtypes. J Allergy Clin Immunol 1994; 93: 606–14CrossRefPubMedGoogle Scholar
  39. 39.
    Hill SJ. Distribution, properties and functional characteristics of three classes of histamine receptor. Pharmacol Rev 1990; 42: 45–83PubMedGoogle Scholar
  40. 40.
    Miadonna A, Tedeschi A, Leggieri E, et al. Behaviour and clinical relevance of histamine and leukotrienes C4 and B4 in grass pollen-induced rhinitis. Am Rev Respir Dis 1987; 136: 357–62CrossRefPubMedGoogle Scholar
  41. 41.
    Krayenbuhl MC, Hudspith BN, Brostoff J, et al. Nasal histamine release following hyperosmolar and allergen challenge. Allergy 1989; 44: 25–9CrossRefPubMedGoogle Scholar
  42. 42.
    Dieguez I, Sanz ML, Oehling A. Influence of seasonal variations on histamine release and other immunological parameters in pollinosis. J Invest Allergol Clin Immunol 1991; 1: 101–8Google Scholar
  43. 43.
    Naclerio RM, Togias AG. The nasal allergic reaction: observations on the role of histamine. Clin Exp Allergy 1991; 21 Suppl.: 13–9CrossRefPubMedGoogle Scholar
  44. 44.
    Klementsson H, Andersen M, Baumgarten CR, et al. Changes in non-specific nasal reactivity and eosinophil influx and activation after allergen challenge. Clin Exp Allergy 1990; 20: 539–47CrossRefPubMedGoogle Scholar
  45. 45.
    Bentley M, Jacobson MR, Cumberworth V, et al. Immunohistology of the nasal mucosa in seasonal allergic rhinitis: increases in activated eosinophils and epithelial mast cells. J Allergy Clin Immunol 1992; 89: 877–83CrossRefPubMedGoogle Scholar
  46. 46.
    Juliusson S, Pipkorn U, Karlsson G, et al. Mast cells and eosinophils in the allergic mucosal response to allergen challenges: changes in distribution and signs of activation in relation to symptoms. J Allergy Clin Immunol 1992; 90: 898–909CrossRefPubMedGoogle Scholar
  47. 47.
    Nishioka K, Saito C, Negano T, et al. Eosinophil cationic protein in the nasal secretions of patients with mite allergic rhinitis. Laryngoscope 1993; 103: 189–92CrossRefPubMedGoogle Scholar
  48. 48.
    Rasp G, Hochstrasser K. Tryptase in nasal fluid is a useful marker of allergic rhinitis. Allergy 1993; 48: 72–4CrossRefPubMedGoogle Scholar
  49. 49.
    Kawabori S, Nakamura A, Kanai N. Tissue density and state of activation of eosinophils in the nasal mucosa of allergic and nonallergic rhinopathia patients. Allergy 1994; 49: 81–5CrossRefPubMedGoogle Scholar
  50. 50.
    Volovitz V, Ascur SL, Bernstein JM, et al. Leukotriene D4 release in the upper respiratory mucosa during natural exposure to ragweed in ragweed-sensitive children. J Allergy Clin Immunol 1988; 82: 414–8CrossRefPubMedGoogle Scholar
  51. 51.
    Gordon JR, Galli SJ. Mast cells as a source of both preformed and immunologically inducible TNF-α cachectin. Nature 1990; 346: 274–6CrossRefPubMedGoogle Scholar
  52. 52.
    Howarth PH, Rajakulasingam K, Feather IH. Mediators and allergic rhinitis. Clin Exp Allergy 1991; 21 Suppl.: 262–6CrossRefPubMedGoogle Scholar
  53. 53.
    Sim TC, Alam R, Hilsmeier KA, et al. Detection of inflammatory cytokines in nasal secretions (NS) of allergic subjects following antigen challenge [abstract]. J Allergy Clin Immunol 1992; 89: 217CrossRefGoogle Scholar
  54. 54.
    Altman LC, Ayars GH, Baker C, et al. Cytokines and eosinophil-derived cationic proteins upregulate intercellular adhesion molecule-1 on human nasal epithelial cells. J Allergy Clin Immunol 1993; 92: 527–36CrossRefPubMedGoogle Scholar
  55. 55.
    Gosset P, Malaquin F, Delneste Y, et al. Interleukin-6 and interleukin-1α production is associated with allergen-induced late nasal response. J Allergy Clin Immunol 1993; 92: 878–90CrossRefPubMedGoogle Scholar
  56. 56.
    Proud D, Togias AG, Naclerio RM, et al. Kinins are generated in vivo following nasal airway challenge of allergic individuals with allergen. J Clin Invest 1983; 72: 1678–85CrossRefPubMedGoogle Scholar
  57. 57.
    Baumgarten CR, Nicols RC, Naclerio RM, et al. Plasma kallikrein during experimentally-induced allergic rhinitis: role in kinin formation and contribution to TAME-esterase activity in nasal secretions. J Immunol 1986; 137: 977–82PubMedGoogle Scholar
  58. 58.
    Pratt J, Mullol J, Ramis I, et al. Release of chemical mediators and inflammatory cell influx during early allergic reaction in the nose: effect of furosemide. J Allergy Clin Immunol 1993; 92: 248–54CrossRefGoogle Scholar
  59. 59.
    Lewis RA, Austen FK. Mediators of local homeostasis and inflammation by leukotrienes and other mast cell dependent compounds. Nature 1981; 293: 103–8CrossRefPubMedGoogle Scholar
  60. 60.
    Mygind N. Mediators of nasal allergy. J Allergy Clin Immunol 1982; 70: 149–59CrossRefPubMedGoogle Scholar
  61. 61.
    Naclerio RM, Meier HL, Kagey-Sobotka A, et al. Kinins are generated in vivo following nasal airway challenge with allergen. Am Rev Respir Dis 1983; 128: 597–602PubMedGoogle Scholar
  62. 62.
    Pipkorn U. Mediators of nasal allergy. Clin Exp Allergy 1989; 19: 585–9CrossRefPubMedGoogle Scholar
  63. 63.
    Polosa R. Role of the kinin-kallikrein pathway in allergic diseases. Allergy 1993; 48: 217–25CrossRefPubMedGoogle Scholar
  64. 64.
    Rajakulasingam K, Polosa R, Church MK, et al. Kinins and rhinitis. Clin Exp Allergy 1992; 22: 734–40CrossRefPubMedGoogle Scholar
  65. 65.
    Rajakulasingam K, Polosa R, Lau LCK, et al. The nasal effects of bradykinin and capsaicin: role of ‘C’ sensory nerve fibers. J Appl Physiol 1992; 72: 1418–24PubMedGoogle Scholar
  66. 66.
    Walker KB, Serwonska MH, Valone F, et al. Distinctive patterns of release of neuroendocrine peptides after nasal challenge of allergic subjects with rye grass antigen. J Clin Immunol 1988; 8: 108–13CrossRefPubMedGoogle Scholar
  67. 67.
    Mosimann BL, White MV, Hohman RJ, et al. Substance P, calcitonin gene related peptide and vasoactive intestinal peptide increase in nasal secretions after allergen challenge in atopic patients. J Allergy Clin Immunol 1993; 92: 95–104CrossRefPubMedGoogle Scholar
  68. 68.
    Baraniuk JN, Kaliner MA. Neuropeptides in the upper and lower respiratory tract. Immunol Allergy Clin North Am 1990; 10: 383–408Google Scholar
  69. 69.
    Baraniuk JN, Castellino S, Merida M, et al. Calcitonin gene related peptide in human nasal mucosa. Am J Physiol 1990; 258: 81–8Google Scholar
  70. 70.
    Baraniuk JN, Lundgren JD, Golf J, et al. Gastrin releasing peptide (GRP) in human nasal mucosa. J Clin Invest 1990; 85: 998–1005CrossRefPubMedGoogle Scholar
  71. 71.
    Baraniuk JN, Lundgren JD, Okayama M, et al. Vasoactive intestinal peptide (VIP) in human nasal mucosa. J Clin Invest 1990; 86: 825–31CrossRefPubMedGoogle Scholar
  72. 72.
    Carolan EJ, Casale TB. Effects of neuropeptides on neutrophil migration through noncellular and endothelial barriers. J Allergy Clin Immunol 1993; 92: 589–99CrossRefPubMedGoogle Scholar
  73. 73.
    Howarth PH. Allergic rhinitis: a rational choice of treatment. Respir Med 1989; 83: 179–88CrossRefPubMedGoogle Scholar
  74. 74.
    Aaronson DW. Comparative efficacy of H1 antihistamines. Ann Allergy 1991; 67: 541–7PubMedGoogle Scholar
  75. 75.
    Naclerio RM. Allergic rhinitis. N Engl J Med 1991; 325: 860–9CrossRefPubMedGoogle Scholar
  76. 76.
    Horak F. Seasonal allergic rhinitis: newer treatment approaches. Drugs 1993; 45: 518–27CrossRefPubMedGoogle Scholar
  77. 77.
    Rimer SJ, Church MK. The pharmacology and mechanisms of action of histamine H1-antagonists. Clin Exp Allergy 1990; 20 Suppl.: 3–17CrossRefGoogle Scholar
  78. 78.
    Simons FER, Simons KJ. Antihistamines. In: Middleton Jr E, Reed CE, Ellis EF, editors. Allergy principles and practice. St Louis: Mosby, 1993: 856–92Google Scholar
  79. 79.
    Simons FER, Simons KJ. Optimum pharmacological management of chronic rhinitis. Drugs 1989; 38: 313–31CrossRefPubMedGoogle Scholar
  80. 80.
    Bradbury MWB. The structure and function of the blood brain barrier. Fed Proc 1984; 43: 186–90PubMedGoogle Scholar
  81. 81.
    Roth T, Roehrs J, Koshorek G, et al. Sedative effects of antihistamines. J Allergy Clin Immunol 1987; 80: 94–8CrossRefPubMedGoogle Scholar
  82. 82.
    Ter Laak AM, Gabrieele M, den Kelder DO, et al. Is there a difference in the affinity of histamine H1 receptor antagonists for the CNS and peripheral receptors? An in vitro study. Eur J Pharmacol 1993; 232: 199–205CrossRefPubMedGoogle Scholar
  83. 83.
    Arisaka O, Shimura N, Nakayama Y, et al. Cyproheptadine and growth. Am J Dis Child 1988; 142: 914–5PubMedGoogle Scholar
  84. 84.
    Grant SM, Goa KL, Fitton A, et al. Ketotifen: a review of its pharmacodynamic and therapeutic use in asthma and allergic disorders. Drugs 1990; 40: 412–48CrossRefPubMedGoogle Scholar
  85. 85.
    Janssens MML, Howarth PH. The antihistamines of the nineties. Clin Rev Allergy 1993; 11: 111–53PubMedGoogle Scholar
  86. 86.
    Kaliner MA, Check WA. Non-sedating antihistamines. Allergy Proc 1988; 9: 649–63CrossRefPubMedGoogle Scholar
  87. 87.
    Vincet J, Sumner DJ, Reid JL. Ebastine: the effect of a new antihistamine on psychomotor performance and autonomic responses in healthy subjects. Br J Clin Pharmacol 1988; 28: 503–8CrossRefGoogle Scholar
  88. 88.
    Simons FER, Simons KJ. Second generation H1-receptor antagonists. Ann Allergy 1991; 66: 5–14PubMedGoogle Scholar
  89. 89.
    Brookhuis KA, De Vries G, De Waard D. Acute and subchronic effects of the H1-histamine receptor antagonist ebastine in 10, 20 and 30mg dose and triprolidine 10mg on car driving performance. Br J Clin Pharmacol 1993; 36: 67–70CrossRefPubMedGoogle Scholar
  90. 90.
    Simons FER. H1-receptor antagonists: comparative tolerability and safety. Drug Saf 1994; 10: 350–80CrossRefPubMedGoogle Scholar
  91. 91.
    Roman IJ, Kassem N, Gural RP, et al. Suppression of histamine-induced wheal and flare reactions by loratadine (SCH 29851) over 28 days in man. Ann Allergy 1986; 57: 253–6PubMedGoogle Scholar
  92. 92.
    Sidiropoulos J, Volonakis M, Kontou-Fili K. Inhibition of histamine-induced wheal and flare reactions by cetirizine 2HC and mequitazine, both in healthy and atopic subjects. Rev Clin Pharmacol Pharmacokinet 1988; 2: 110–20Google Scholar
  93. 93.
    Simons FER. H1-receptor antagonists: clinical pharmacology and therapeutics. J Allergy Clin Immunol 1989; 84: 845–62CrossRefPubMedGoogle Scholar
  94. 94.
    Wood-Baker R, Emanuel MB, Hutchinson K, et al. The time course of action of three differing doses of noberastine, a novel H1-receptor antagonist, on histamine-induced skin wheals and the relationship to plasma drug concentration in normal volunteers. Br J Clin Pharmacol 1993; 35: 166–70PubMedGoogle Scholar
  95. 95.
    Little MM, Casale TB. Azelastine inhibits IgE-mediated human basophil histamine release. J Allergy Clin Immunol 1989; 83: 862–5CrossRefPubMedGoogle Scholar
  96. 96.
    Charlesworth EN, Kagey-Sobotka A, Norman PS, et al. Effect of cetirizine on mast cell-mediator release and cellular traffic during the cutaneous late-phase reaction. J Allergy Clin Immunol 1989; 83: 905–13CrossRefPubMedGoogle Scholar
  97. 97.
    Naclerio RM, Kagey-Sobotka A, Lichtenstein LM, et al. Terfenadine, an H1 antihistamine, inhibits histamine release in vivo in the human. Am Rev Respir Dis 1990; 142: 167–71PubMedGoogle Scholar
  98. 98.
    Sheffer AL, Samuels LL. Cetirizine: antiallergic therapy beyond traditional antihistamines. J Allergy Clin Immunol 1990; 86: 1040–6CrossRefPubMedGoogle Scholar
  99. 99.
    Naclerio RM. Additional properties of cetirizine, a new H1 antagonist. Allergy Proc 1991; 12: 187–91CrossRefPubMedGoogle Scholar
  100. 100.
    Andersson M, Nolte H, Baumgarden C, et al. Suppressive effect of loratadine on allergen-induced histamine release in the nose. Allergy 1991; 46: 540–6CrossRefPubMedGoogle Scholar
  101. 101.
    Ciprandi G, Buscaglia S, Iudice A. et al. Protective effect of different doses of terfenadine on the conjunctival provocation test. Allergy 1992; 47: 309–12CrossRefPubMedGoogle Scholar
  102. 102.
    Faraj BA, Jackson RT. Effect of astemizole on antigen-mediated histamine release from the blood of patients with allergic rhinitis. Allergy 1992; 47: 630–4CrossRefPubMedGoogle Scholar
  103. 103.
    Wagenmann M, Barody FM, Kagey-Sobotka A, et al. The effect of terfenadine on unilateral nasal challenge with allergen. J Allergy Clin Immunol 1994; 93: 594–605CrossRefPubMedGoogle Scholar
  104. 104.
    Bousquet J, Lebel B, Chanal I, et al. Antiallergic activity of H1-receptor antagonists assessed by nasal challenge. J Allergy Clin Immunol 1988; 82: 881–7CrossRefPubMedGoogle Scholar
  105. 105.
    Campell AM, Channez P, Marty-Ane C, et al. Modulation of eicosanoid and histamine release from human dispersed lung mast cells. Allergy 1993; 48: 125–9CrossRefGoogle Scholar
  106. 106.
    Chand N, Pillar J, Nolan K, et al. Inhibition of allergic and nonallergic leukotriene C4 formation and histamine secretion by azelastine: implications for its mechanism of action. Int Arch Allergy Appl Immunol 1989; 90: 67–70CrossRefPubMedGoogle Scholar
  107. 107.
    Michel L, De Vos C, Rihoux JP, et al. Inhibitory effect of oral cetirizine on in vivo antigen-induced histamine and PAF-acether release and eosinophil recruitment in human skin. J Allergy Clin Immunol 1988; 82: 101–9CrossRefPubMedGoogle Scholar
  108. 108.
    Fadel R, Herpin-Richard N, Rihoux JP, et al. Inhibitory effect of cetirizine 2HC1 on eosinophil migration in vivo. Clin Allergy 1987; 17: 373–9CrossRefPubMedGoogle Scholar
  109. 109.
    Kontou-Fili K, Maniatakou G, Demaka P. et al. Therapeutic effects of cetirizine in delayed pressure urticaria. Part I. Effects on weight tests and skin window cytology. Ann Allergy 1990; 65: 517–9PubMedGoogle Scholar
  110. 110.
    Kontou-Fili K, Maniatakou G, Demaka P, et al. Therapeutic effects of cetirizine in delayed pressure urticaria. Part II. Skin biopsy findings. Ann Allergy 1990; 65: 520–2PubMedGoogle Scholar
  111. 111.
    Spyropoulou-Vlachou M, Stavropoulos-Giokas A, Filippou M, et al. Clinical and laboratory results confirm the efficacy of cetirizine 2HC1 in seasonal allergic rhinitis. Acta Ther 1990; 16: 71–8Google Scholar
  112. 112.
    Leung DYM, Poder JS, Cotran RS. Expression of endothelial-leucocyte adhesion molecule-1 in elicited late phase allergic reactions. J Clin Invest 1991; 87: 1805–9CrossRefPubMedGoogle Scholar
  113. 113.
    Ciprandi G, Buscaglia S, Pesce G, et al. Allergic subjects express intercellular adhesion molecule-1 (ICAM-1 or CD54) on epithelial cells of conjunctiva after allergen challenge. J Allergy Clin Immunol 1993; 91: 783–92CrossRefPubMedGoogle Scholar
  114. 114.
    Ciprandi G, Buscaglia S, Rihoux JP, et al. ICAM-1 (CD54) expression is reduced by cetirizine both in early and late phase events following allergen-specific conjunctival challenge [abstract]. Allergy 1993; 48: 1012CrossRefGoogle Scholar
  115. 115.
    Ciprandi G, Buscaglia S, Pesce GP, et al. Deflazacort protects against late-phase but not early phase reactions induced by the allergen-specific conjunctival provocation test. Allergy 1993; 48: 421–30CrossRefPubMedGoogle Scholar
  116. 116.
    Ciprandi G, Buscaglia S, Marchesi E, et al. Protective effect of loratadine on late phase reaction induced by conjunctival provocation test. Int Arch Allergy Appl Immunol 1993; 100: 185–9CrossRefGoogle Scholar
  117. 117.
    Bousquet J. Loratadine (Clarityne): une reduction de l’expression des molecules d’adhesion dans l’inflammation allergique. Cahiers d’ORL 1994; 29(2): 74Google Scholar
  118. 118.
    Dannenberg TB, Feinberg SM. The development of tolerance to antihistamines. J Allergy 1951; 22: 330–39CrossRefPubMedGoogle Scholar
  119. 119.
    Bye CE, Claridge R, Peck Aw, et al. Evidence for tolerance to the central nervous effects of the histamine antagonist, triprolidine, in man. Eur J Clin Pharmacol 1977; 12: 181–6CrossRefPubMedGoogle Scholar
  120. 120.
    Long WF, Taylor RJ, Leavengood DC, et al. Skin suppression by antihistamines and the development of subsensitivity. J Allergy Clin Immunol 1985; 76: 113–17CrossRefPubMedGoogle Scholar
  121. 121.
    Bantz EW, Dolen WK, Chadwick WE, et al. Chronic chlorpheniramine therapy: subsensitivity, drug metabolism and compliance. Ann Allergy 1987; 59: 341–6PubMedGoogle Scholar
  122. 122.
    Simons FER, Watson WTA, Simons KJ. Lack of subsensitivity to terfenadine during long-term terfenadine treatment. J Allergy Clin Immunol 1988; 81: 1068–75CrossRefGoogle Scholar
  123. 123.
    Bousquet J, Chanal I, Skassa-Brociek W, et al. Lack of subsensitivity to loratadine during long-term dosing during 12 weeks. J Allergy Clin Immunol 1990; 86: 248–53CrossRefPubMedGoogle Scholar
  124. 124.
    Rihoux JP, Van Neste DJJ. Quantitative time course study of the skin response to histamine and the effect of H1 blockers. Dermatologica 1989; 179: 129–34CrossRefPubMedGoogle Scholar
  125. 125.
    Maniatakou G, Paleologos G, Kontou-Fili K. Lack of tachyphylaxis during chronic administration of cetirizine 2HCl, an antagonist of peripheral Hi-antagonists [abstract]. Clin Exp Allergy 1990; 20 Suppl.: 97Google Scholar
  126. 126.
    Juniper EF, White J, Dolovitch J. Efficacy of continuous treatment with astemizole and terfenadine in ragweed pollen-induced rhinconjunctivitis. J Allergy Clin Immunol 1988; 82: 670–5CrossRefPubMedGoogle Scholar
  127. 127.
    Kemp JP, Meitzer EO, Orgel HA, et al. Evaluation of tolerance during 8 weeks of astemizole or terfenadine therapy in patients with perennial allergic rhinitis [abstract]. J Allergy Clin Immunol 1990; 85: 243Google Scholar
  128. 128.
    Snook J, Boothman-Burrell D, Watkins J, et al. Torsades de pointes ventricular tachycardia associated with astemizole overdose. Br J Clin Pract 1988; 42: 257–9PubMedGoogle Scholar
  129. 129.
    Monahan BP, Furguson CL, Killeavy ES, et al. Tosades de pointes occuring in association with terfenadine use. JAMA 1990; 264: 2788–90CrossRefPubMedGoogle Scholar
  130. 130.
    Stratmann HG, Kennedy HL. Torsades de pointes associated with drugs and toxins: recognition and management. Am Heart J 1987; 113: 1470–82CrossRefPubMedGoogle Scholar
  131. 131.
    Simons FER, Kesselman MS, Giddins NG, et al. Astemizole-induced torsade de pointes. Lancet 1988; ii: 624CrossRefGoogle Scholar
  132. 132.
    Jaekman WM, Friday K, Anderson JL, et al. The long QT syndromes: a critical review. Prog Cardiovasc Dis 1988; 31: 315–72Google Scholar
  133. 133.
    Honing PK, Woosley RL, Zamani K, et al. Changes in the pharmacokinetic and electrocardiographic pharmacodynamics of terfenadine with concomitant administration of erythromycin. Clin Pharmacol Ther 1992; 52: 231–8CrossRefGoogle Scholar
  134. 134.
    Venturini E, Borghi E, Maurini V, et al. Prolongation of QT interval and hyperkinetic ventricular arrhythmias probably induce by terfenadine use in liver cirrhosis patients. Rec Prog Med 1992; 83: 231–8Google Scholar
  135. 135.
    Honing PK, Worthman DC, Zamani K, et al. Terfenadine-keto-conazole interaction. JAMA 1993; 269: 1513–8CrossRefGoogle Scholar
  136. 136.
    Hendeles L. Efficacy and safety of antihistamines and expectorants in nonprescription cough and cold preparations. Pharmacotherapy 1993; 13: 154–8PubMedGoogle Scholar
  137. 137.
    Ahmad SR. USA: antihistamine alert. Lancet 1992; 340: 542CrossRefGoogle Scholar
  138. 138.
    Sanders RL, Dockhorn RJ, Aldeman JL, et al. Cardiac effects of acrivastine compared to terfenadine [abstract]. J Allergy Clin Immunol 1992; 89: 183CrossRefGoogle Scholar
  139. 139.
    Brogden RN, McTavish D. Acrivastine: a review of its pharmacological properties and therapeutic efficacy in allergic rhinitis, urticaria and related disorders. Drugs 1991; 41: 927–40CrossRefPubMedGoogle Scholar
  140. 140.
    Compoli-Richards DM, Buckley MMT, Fitton A. Cetirizine: a review of its pharmacological properties and clinical potential in allergic rhinitis, pollen-induced asthma and chronic urticaria. Drugs 1990; 40: 762–81CrossRefGoogle Scholar
  141. 141.
    Woosley RL, Barby JT, Yeh J, et al. Lack of electrocardiographic effects of cetirizine in healthy humans [abstract]. J Allergy Clin Immunol 1993; 91: 258Google Scholar
  142. 142.
    Blackhouse CI, Brewster BS, Lockhart JDF, et al. Terfenadine in allergic rhinitis: a comparative trial of a new antihistamine versus chlorpheniramine and placebo. Practitioner 1982; 226: 347–51Google Scholar
  143. 143.
    Howarth PH, Holgate ST. Comparative trial of two non-sedative H1-antihistamines, terfenadine and astemizole, for hayfever. Thorax 1984; 39: 668–72CrossRefPubMedGoogle Scholar
  144. 144.
    Johansen LV, Bjerrum P, Ilium P. Treatment of seasonal allergic rhinitis: a double blind, group comparative study of terfenadine and dexchlorpheniramine. Rhinology 1987; 25: 35–40PubMedGoogle Scholar
  145. 145.
    Weiler JM, Donnelly A, Campell B. Multicenter, double blind, multiple dose, parallel-groups efficacy and safety trial of azelastine, chlorpheniramine and placebo in the treatment of spring allergic rhinitis. J Allergy Clin Immunol 1988; 82: 801–11CrossRefPubMedGoogle Scholar
  146. 146.
    Kemp JP, Buckley CE, Gershwin ME, et al. Multicenter double-blind, placebo-controlled trial of terfenadine in seasonal allergic rhinitis and conjunctivitis. Ann Allergy 1985; 54: 502–9PubMedGoogle Scholar
  147. 147.
    Buckley CE, Buchman E, Falliers CJ, et al. Terfenadine treatment of fall hay fever. Ann Allergy 1988; 60: 123–8PubMedGoogle Scholar
  148. 148.
    Vanden Bussche G, Emmanuel MB, Rombaut N. Clinical profile of astemizole: a survey of 50 double-blind trials. Ann Allergy 1987; 58: 184–8Google Scholar
  149. 149.
    Dockhorn RJ, Bergner A, Connell JT, et al. Safety and efficacy of loratadine (Sch-29852): a potent new non-sedating antihistamine in seasonal allergic rhinitis. Ann Allergy 1987; 58: 407–11PubMedGoogle Scholar
  150. 150.
    Panayiotopoulos SM, Panayiotopoulou ES. The efficacy of cetirizine in the treatment of pollinosis: a correlation with the daily pollen count of atmospheric air. A double-blind placebo controlled study. Ann Allergy 1990; 65: 146–9Google Scholar
  151. 151.
    Falliers CJ, Brandon ML, Buchman E, et al. Double-blind comparison of cetirizine and placebo in the treatment of seasonal rhinitis. Ann Allergy 1991; 66: 257–66PubMedGoogle Scholar
  152. 152.
    Lockey RF, Findley S, Mitchell DQ, et al. Effects of cetirizine versus terfenadine in seasonal allergic rhinitis. Ann Allergy 70: 311–5, 1993PubMedGoogle Scholar
  153. 153.
    Rihoux JP, Mariz S. Cetirizine: an updated review of its pharmacological properties and therapeutic efficacy. Clin Rev Allergy 1993; 11: 65–88PubMedGoogle Scholar
  154. 154.
    Marks P, Manna VK, Gibson JR. Acrivastine: an evaluation of initial and peak activity in human skin. J Int Med Res 1989; 17 Suppl. 2: 3B–8BPubMedGoogle Scholar
  155. 155.
    Rolan PE, Phillips S, Adams J, et al. The onset of effect of the H1-antagonist acrivastine, assessed by histamine bronchial challenge in volunteers. Eur J Clin Pharmacol 1990; 39: 311–3CrossRefPubMedGoogle Scholar
  156. 156.
    Petersen LJ, Bindslev-Jensen C, Poulsen LK, et al. Time of onset of action of acrivastine in the skin of pollen-allergic subjects. Allergy 1994; 49: 27–30CrossRefPubMedGoogle Scholar
  157. 157.
    Gibbs TG, Irander K, Solo OP. Acrivastine in seasonal allergic rhinitis: two randomized crossover studies to evaluate efficacy and safety. J Int Med Res 1988; 16: 413–9PubMedGoogle Scholar
  158. 158.
    Gibbs TG, McDonnell KA, Stokes T, et al. Acrivastine in two doses compared with placebo in a multicentre, parallel group study for the treatment of seasonal allergic rhinitis. Br J Clin Pract 1989; 43: 11–4PubMedGoogle Scholar
  159. 159.
    Gervais P, Bruttman G, Pedrali P, et al. French multicentre double-blind study to evaluate the efficacy and safety of acrivastine as compared with terfenadine in seasonal allergic rhinitis. J Int Med Res 1989; 17 Suppl. 2: 47B–53BPubMedGoogle Scholar
  160. 160.
    Bruno G, D’Amato G, Del Giacco GS, et al. Prolonged treatment with acrivastine for seasonal allergic rhinitis. J Int Med Res 1989; 17 Suppl. 2: 40B–46BPubMedGoogle Scholar
  161. 161.
    Bojkowski CJ, Gibbs TG, Hellstern KH, et al. Acrivastine in allergic rhinitis: a review of clinical experience. J Int Med Res 1989; 17 Suppl. 2: 54B–68BPubMedGoogle Scholar
  162. 162.
    Ankier SI, Warrington SJ. A double-blind placebo-controlled study of the efficacy and tolerability of ebastine against hay fever in general practice patients. J Intern Med 1989; 226: 453–8CrossRefPubMedGoogle Scholar
  163. 163.
    de Molina M, Cadahia A, Cano L, et al. Efficacy and tolerance of ebastine at two dose levels in the treatment of seasonal allergic rhinitis. Drug Invest 1989; 1: 40–6CrossRefGoogle Scholar
  164. 164.
    Knight A, Drouin MA, Yang WH, et al. Clinical evaluation of the efficacy and safety of noberastine, a new H1-antagonist, in seasonal allergic rhinitis: a placebo-controlled dose-response study. J Allergy Clin Immunol 1991; 88: 926–34CrossRefPubMedGoogle Scholar
  165. 165.
    Simons FER, Watson WT, Simons KJ. Pharmacokinetics and pharmacodynamics of ebastine in children. J Pediatr 1993; 122: 641–6CrossRefPubMedGoogle Scholar
  166. 166.
    Wihl JA, Petersen BN, Petersen LN, et al. Effect of the nonsedative H1-receptor antagonist astemizole in perennial allergic and nonallergic rhinitis. J Allergy Clin Immunol 1985; 75: 720–7CrossRefPubMedGoogle Scholar
  167. 167.
    Boniver R, Borras J, Chalmagne J, et al. Evaluation of the therapeutic effect of astemizole in perennial allergic rhinitis. Cur Ther Res 1986; 39: 244–9Google Scholar
  168. 168.
    Bruttmann G, Charpin D, Germouty J, et al. Evaluation of the efficacy and safety of loratadine in perennial allergic rhinitis. J Allergy Clin Immunol 1989; 83: 411–6CrossRefPubMedGoogle Scholar
  169. 169.
    Valles CP, Garcia AC, Bahima AC. Ebastine in perennial allergic rhinitis. Ann Allergy 1991; 67: 615–8Google Scholar
  170. 170.
    Mansmann HC, Altman RA, Berman BA, et al. Efficacy and safety of cetirizine therapy in perennial allergic rhinitis. Ann Allergy 1992; 68: 348–53PubMedGoogle Scholar
  171. 171.
    Amat P, Novella A, Roma J, et al. Treatment of perennial allergic rhinitis with cetirizine. Allergol Immunopathol Madr 1992; 20: 139–43PubMedGoogle Scholar
  172. 172.
    Simons FER, Simons KJ. H1 receptor antagonist treatment of chronic rhinitis. J Allergy Clin Immunol 1988; 81: 975–80CrossRefPubMedGoogle Scholar
  173. 173.
    Lebaton P, Moreno F, Coulie P. Comparison of cetirizine with astemizole in the treatment of perennial allergic rhinitis and study of the concomitant effect on histamine and allergen-induced wheal responses. Ann Allergy 1990; 65: 401–5Google Scholar
  174. 174.
    Renton R, Fidler C, Rosenberg R. Multicenter, crossover study of the efficacy and tolerability of terfenadine, 120mg, versus cetirizine, 10mg, in perennial allergic rhinitis. Ann Allergy 1991; 67: 416–20PubMedGoogle Scholar
  175. 175.
    Margari P, Sichletidis L, Pechlivanidis T, et al. Comparative efficacy of cetirizine 2HCl and ketotifen in chronic allergic rhinitis [abstract]. Allergy 1992; 47 Suppl.: 92CrossRefGoogle Scholar
  176. 176.
    Carlsen KH, Kramer J, Fagertun HE, et al. Loratadine and terfenadine in perennial allergic rhinitis: treatment of nonresponders to the one drug with the other drug. Allergy 1993; 48: 431–6CrossRefPubMedGoogle Scholar
  177. 177.
    Chaweean B, Jareonchai P, Dhorranitra B. A clinical comparison of cetirizine versus astemizole in perennial allergic rhinitis. Drug Invest 1993; 5: 222–8CrossRefGoogle Scholar
  178. 178.
    Rosario NA. Comparison of terfenadine once daily with terfenadine twice daily for the treatment of perennial allergic rhinitis. J Int Med Res 1991; 19: 112–20PubMedGoogle Scholar
  179. 179.
    Gastpar H, Dorow P, Aurich R, et al. Investigation of long-term efficacy and tolerability of azelastine nasal spray in the treatment of perennial allergic rhinitis. Arzeimittelforsehung 1993; 43: 7771–6Google Scholar
  180. 180.
    Dorow P, Aurich R, Petzold U. Efficacy and tolerability of azelastine nasal spray in patients with allergic rhinitis compared to placebo and butesonide. Arzneimittelforschung 1993; 43: 909–12PubMedGoogle Scholar
  181. 181.
    Dechant KL, Goa KL. Levocabastine: a review of its pharmacological properties and therapeutic potential as a topical antihistamine in allergic rhinitis and conjunctivitis. Drugs 1991: 41: 202–24CrossRefPubMedGoogle Scholar
  182. 182.
    Sohoel P, Freng BA, Kramer J, et al. Topical levocabastine compared with orally administered terfenadine for the prophylaxis and treatment of seasonal rhinoconjunctivitis. J Allergy Clin Immunol 1993; 92: 73–81CrossRefPubMedGoogle Scholar
  183. 183.
    Palma-Carlos AG, Chieira C, Conde TA, et al. Double-blind comparison of levocabastine nasal spray with sodium cromoglycate nasal spray in the treatment of seasonal allergic rhinitis. Ann Allergy 1991; 67: 394–8PubMedGoogle Scholar
  184. 184.
    Schata M, Jorde W, Richarz-Barthauer U. Levocabastine nasal spray better than sodium cromoglycate and placebo in the topical treatment of seasonal allergic rhinitis. J Allergy Clin Immunol 1991; 87: 873–8CrossRefPubMedGoogle Scholar
  185. 185.
    Gastpar H, Nolte D, Aurich R, et al. Comparative efficacy of azelastine nasal spray and terfenadine in seasonal and perennial rhinitis. Allergy 1994; 49: 152–8CrossRefPubMedGoogle Scholar
  186. 186.
    Secher C, Kirkergaard J, Borum P. et al. Significance of H1 and H2 receptors in the human nose. Rationale for combined antihistamine preparations. J Allergy Clin Immunol 1982: 70: 211–8CrossRefPubMedGoogle Scholar
  187. 187.
    Brooks CD, Butler D, Metzier C. Effect of H2 blockade in the challenged allergic nose. J Allergy Clin Immunol 1982; 70: 373–6CrossRefPubMedGoogle Scholar
  188. 188.
    Holberg K, Pipkorn U, Bake B, et al. Effects of topical treatment with H1 and H2 antagonists on clinical symptoms and nasal vascular reactions in patients with allergic rhinitis. Allergy 1989; 44: 281–7CrossRefGoogle Scholar
  189. 189.
    Nuutinen J, Holopainen E, Malberg H, et al. Terfenadine with or without phenylpropolamine in the treatment of seasonal allergic rhinitis. Clin Exp Allergy 1989; 19: 603–8CrossRefPubMedGoogle Scholar
  190. 190.
    Grossman J, Bronsky EA, Lanier BQ, et al. Loratadine pseudoephedrine combination versus placebo in patients with seasonal allergic rhinitis. Ann Allergy 1989; 63: 317–21PubMedGoogle Scholar
  191. 191.
    Storms WW, Bodman SF, Nathan RA, et al. SCH 434, a new antihistamine/decongestant for seasonal allergic rhinitis. J Allergy Clin Immunol 1989; 83: 1083–90CrossRefPubMedGoogle Scholar
  192. 192.
    Backhouse CI, Rosenberg RM, Filder C. Treatment of seasonal allergic rhinitis: a comparison of a combination tablet of terfenadine and pseudoephedrine with the individual ingredients. Br J Clin Pract 1990; 44: 274–9PubMedGoogle Scholar
  193. 193.
    Meran A, Morse J, Gibbs TG. A cross-over comparison of acrivastine, pseudoephedrine and their combination in seasonal allergic rhinitis. Rhinology 1990; 28: 33–40PubMedGoogle Scholar
  194. 194.
    Henauer S, Seppey M, Huguenot C, et al. Effects of terfenadine and pseudoephedrine, alone and in combination in a nasal provocation test and in perennial rhinitis. Eur J Clin Pharmacol 1991; 41: 321–4CrossRefPubMedGoogle Scholar
  195. 195.
    Drouin M, Knight A, Dolovitch J, et al. Astemizole/pseudoephedrine combination in the treatment of seasonal allergic rhinitis [abstract]. J Allergy Clin Immunol 1993; 91: 131Google Scholar
  196. 196.
    Segal AT, Falliers CJ, Podleski WK, et al. Safety and efficacy of terfenadine/pseudoephedrine versus clemastine/pseudoephedrine in the treatment of seasonal allergic rhinitis. Ann Allergy 1993; 70: 389–94PubMedGoogle Scholar
  197. 197.
    Howarth PH, Holgate ST. Basic aspects of allergic reactions. In: Naspitz CK, Tinkelman D, editors. Childhood rhinitis and sinusitis: pathophysiology and treatment. New York: Dekker, 1990: 2–35Google Scholar
  198. 198.
    Guill MF, Buckley RH, Rocha Jr W, et al. Multicenter, double-blind, placebo-controlled trial of terfenadine suspension in the treatment of fall-allergic rhinitis in children. J Allergy Clin Immunol 1986; 78: 4–9CrossRefPubMedGoogle Scholar
  199. 199.
    Boner AL, Miglioranzi P, Richelli C, et al. Efficacy and safety of loratadine suspension in the treatment of children with rhinitis. Allergy 1989; 44: 437–41CrossRefPubMedGoogle Scholar
  200. 200.
    Watson WTA, Simons KJ, Chen XY, et al. Cetirizine: a pharmacokinetic and pharmacodynamic evaluation in children with seasonal allergic rhinitis. J Allergy Clin Immunol 1989; 84: 457–64CrossRefPubMedGoogle Scholar
  201. 201.
    Baedle Y, Dupont P. Cetirizine in children with chronic allergic rhinitis: a multicenter double-blind study of two doses of cetirizine and placebo. Drug Invest 1992; 4: 466–72CrossRefGoogle Scholar
  202. 202.
    Wood SF. Experience with non-sedating antihistamines in paediatric allergic rhinitis. Rhinology 1992; 13 Suppl.: 27–37Google Scholar
  203. 203.
    Masi M, Candiani R, Van de Venne H. A placebo controlled trial of cetirizine in seasonal allergic rhinoconjunctivitis in children aged 6 to 12 years. Pediatr Allergy Immunol 1993; 4 Suppl.: 47–52CrossRefPubMedGoogle Scholar
  204. 204.
    Feldman W, Shanon A, Leiken L, et al. Central nervous system side-effects of antihistamines in schoolchildren. Rhinology 1993; 30 Suppl.: 13–9Google Scholar
  205. 205.
    Vuurman EF, Van Veggel LM, Uiterwijk L, et al. Seasonal allergic rhinitis and antihistamine effects on children’s learning. Ann Allergy 1993; 71: 121–6PubMedGoogle Scholar
  206. 206.
    Simons KJ, Watson WTA, Martin TJ, et al. The pharmacokinetics and pharmacodynamics of terfenadine and chlorpheniramine in the elderly [abstract]. J Allergy Clin Immunol 1989; 83: 276Google Scholar
  207. 207.
    Matzke GR, Yeh J, Awni WA, et al. Pharmacokinetics of cetirizine in the elderly and patients with renal insufficiency. Ann Allergy 1987; 59: 25–30PubMedGoogle Scholar
  208. 208.
    Awni WM, Yeh J, Halstenson CE, et al. Effect of hemodialysis on the pharmacokinetics of cetirizine. Eur J Pharmacol 1990; 38: 67–9CrossRefGoogle Scholar
  209. 209.
    Incaudo GA. Diagnosis and treatment and treatment of rhinitis during pregnancy and lactation. Clin Rev Allergy 1987; 5: 525–37Google Scholar
  210. 210.
    Schatz M, Zeiger RS. Diagnosis and management of rhinitis during pregnancy. Allergy Proc 1988; 9: 545–8CrossRefPubMedGoogle Scholar
  211. 211.
    National Heart, Lung and Blood Institute; National Institutes of Health. Management of asthma during pregnancy. Bethesda, MD: US Department of Health and Human Services, 1993. NIH Publication No. 93-3279AGoogle Scholar
  212. 212.
    Schatz M, Hoffman CP, Zeiger RS, et al. The course and management of asthma and allergic diseases during pregnancy. In: Middleton Jr E, Reed CE, Ellis EF, editors. Allergy principles and practice. St Louis: Mosby, 1993: 1301–42Google Scholar
  213. 213.
    Greenberger PA, Patterson R. Beclomethasone diproprionate for severe asthma during pregnancy. Ann Intern Med 1983; 98: 478–80PubMedGoogle Scholar
  214. 214.
    Greenberg PA, Patterson R. Management of asthma during pregnancy. N Engl J Med 1987; 312: 897–902CrossRefGoogle Scholar
  215. 215.
    Prenner PM. Neonatal withdrawal syndrome associated with hydroxyzine hydrochloride. Am J Dis Child 1977; 131: 529–30PubMedGoogle Scholar
  216. 216.
    Parkin DE. Probable benadryl withdrawal manifestations in a new-born infant. J Pediatr 1974; 85: 580PubMedGoogle Scholar
  217. 217.
    Kok THHG, Taitz LS, Bennett MJ, et al. Drowsiness due to clemastine transmitted in breast milk [letter]. Lancet 1982; 1: 914CrossRefPubMedGoogle Scholar
  218. 218.
    Schuller DE. The spectrum of antihistamines adversely affecting pulmonary function in a subset of asthmatic children. Pediatr Asthma Allergy Immunol 1987; 1: 61–6CrossRefGoogle Scholar
  219. 219.
    Collins-Williams C. Antihistamines in asthma. J Asthma 1987; 24: 55–8CrossRefPubMedGoogle Scholar
  220. 220.
    Bruttmann G, Pedrali P, Arnendt C, et al. Protective effect of cetirizine in patients suffering from pollen asthma. Ann Allergy 1990; 64: 224–8PubMedGoogle Scholar
  221. 221.
    Rafferty P, Jackson L, Smith R, et al. Terfenadine, a potent histamine H1-receptor antagonist in the treatment of grass pollen sensitive asthma. Br J Clin Pharmacol 1990; 30: 229–35CrossRefPubMedGoogle Scholar
  222. 222.
    Brik A, Tashkin D, Gong H, et al. Effect of cetirizine, a new H1-antagonist on airway dynamics and responsiveness to inhaled histamine in mild asthma. J Allergy Clin Immunol 1987; 80: 51–6CrossRefPubMedGoogle Scholar
  223. 223.
    Ricci AR, Settipane RJ, Goldstein BM, et al. The effect of chlorpheniramine on asthma. Allergy Proc 1990; 11: 229–33CrossRefPubMedGoogle Scholar
  224. 224.
    Town G, Holgate S. Comparison of the effect of loratadine on the airway and skin responses to histamine, methacholine and allergen in asthmatic subjects. J Allergy Clin Immunol 1990; 86: 886–93CrossRefPubMedGoogle Scholar
  225. 225.
    Wood-Baker R, Holgate ST. The comparative actions and adverse effect profile of single doses of H1-receptor antihistamines in the airways and skin of subjects with asthma. J Allergy Clin Immunol 1993; 91: 1005–14CrossRefPubMedGoogle Scholar
  226. 226.
    Sly MR, Kemp JP, Anderson J, et al. Position Statement: The American Academy of Allergy and Immunology. The use of antihistamines in patients with asthma. J Allergy Clin Immunol 1988; 82: 481–2CrossRefGoogle Scholar

Copyright information

© Adis International Limited 1994

Authors and Affiliations

  • Kalliopi Kontou-Fili
    • 1
  1. 1.Section of Allergology and Clinical Immunology, Division of Internal MedicineLaikon General District Hospital of AthensAthensGreece

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