Farmacologia clinica
Gli antistaminici in Dermatologia pediatrica
ANTIHISTAMINES IN PAEDIATRIC DERMATOLOGY
ERNESTO BONIFAZI
Dermatologia Pediatrica, Bari
Novembre 2001 - pagg. 604 -608
Abstract
The Author offers an overview of the pharmacological properties of first, second, and third
generation antihistamines and discusses their indications in paediatric dermatology (urticaria,
insect bites, atopic dermatitis and mastocytosis). Loratadine (or cetirizine in the first 2
years of age) is indicated for acute urticaria. Severe and acute cases should be treated
with parenteral clorpheniramine and prednisone. Acrivastine can be used for prevention of
urticaria when exposure to the trigger is inevitable. When insect bites are recent and particularly
numerous a second generation antihistamine should be used. The same class of
drugs is indicated in mastocytosis. Atopic dermatitis does not respond well to antihistamines
and the use should be confined to treating severe pruritus, particularly at night time.
Antihistamines should not be used to treat pruritus in herpetic dermatitis, scabies or lice,
where etiologic treatment must be prioritised.
Classificazione MeSH
Bibliografia
1. Krause L, Shuster S. Mechanism of action
of antipruritic drugs. Br Med J 1983;287:1199-
200.
2. Curtis AC, Owens BB. B-dimethylaminoethyl benzhydyl ether hydrochloride (benadryl) in the treatment of acute and chronic urticaria. Univ Hosp Bull Ann Arbor 1945;11:25.
3. Black JW, Duncan WAM, Durant CJ, et al. Definition and antagonism of histamine H2- receptors. Nature 1972;236:385-90.
4. Arrang JM, Garbarg M, Schwartz JC. Autoinhibition of brain histamine release mediated by a novel class (H3) of histamine receptor. Nature1983;302:832-7.
5. Babe KS Jr, Serafin WE. Istamina, bradichinina e loro antagonisti. In: Goodman & Gilman. Le basi farmacologiche della terapia. Hardman JG, Limbird LE, Molinoff PB, Ruddon W, Goodman Gilman A (eds). Nona edizione. Milano: McGraw-Hill Libri Italia srl, 1997:577-94.
6. Brandes LJ, LaBella FS, Glavin GB, et al. Histamine as an intracellular messenger. Biochem Pharmacol 1993;40:1677-81.
7. Hollande F, Bali JP, Magous R. Autoregulation of histamine synthesis through H3 receptors in isolated fundic mucosal cells. Am J Physiol 1993;265:G1039-G1044.
8. Monti JE. Involvement of histamine in the control of the waking state. Life Sci 1993; 53:1331-8.
9. Greaves MW. Antihistamines. Dermatol Clin 2001;19:53-62.
10. Rimmer SJ, Church MK. The pharmacology and mechanism of action of histamine H1 antagonists. Clin Exp Allergy 1990;20 (suppl. 2):3-17.
11. Simons FE, Simons KJ. The pharmacology and use of H1 receptor antagonist drugs. N Engl J Med 1994;330:1663.
12. Walsh GM. The anti-inflammatory effects of cetirizine. Clin Exp Allergy 1994;24:81.
13. Leprevost C, Capron M, De Vos C, et al. Inhibition of eosinophil chemotaxis by a new anti allergic compound (cetirizine). Int Arch Allergy Appl Immunol 1988;87:9-13.
14. 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.
15. Redier H, Chanez P, De Vos C, et al. Inhibitory effect of cetirizine on the bronchial eosinophil recruitment induced by allergen inhalation challenge in allergic patients with asthma. J Allergy Clin Immunol 1992;90:215.
16. Simons FER. Recent advances in H1 antagonist treatment. J Allergy Clin Immunol 1990;86995-9.
17. Brandes LJ, Warrington RC, Arron RJ, et al. Enhanced cancer growth in mice administered daily human-equivalent doses of some H1-antihistamines: predictive in vitro correlates. J Natl Cancer Inst 1994;86:770-5.
18. Long WF, Taylor RJ, Wagner CJ, et al. Skin test suppression by antihistamines and the development of subsensitivity. J Allergy Clin Immunol 1985;76:113-7.
19. Monash S. Development of retractory condition of skin towards antihistamine drugs after antihistamine therapy as determined by histamine iontopheresis. J Invest Dermatol 1950;15:1.
20. Rantuccio F, Meneghini CL, Bonifazi E. Rilievi sui test epicutanei con serie fisse di allergeni in soggetti eczematosi. Folia Allergol 1967;14:46-55.
21. Carruthers SG, Shoeman DW, Hignite CE, Azarnoff DL. Correlation between plasma diphenhydramine level and sedative and antihistamine effects. Clin Pharmacol Ther 1978;23:375-82.
22. Sorkin EM, Heel RC. Terfenadine: a review of its pharmacodynamic properties and therapeutic efficacy. Drugs 1985;29:34-56.
23. MacConnell TJ, Stanners AI. Torsades de pointes complicating treatment with tertenadine. Br Med J 1991;302:1469.
24. Rao KA, Adlakha A, Verman-Ansil B, et al. Torsades de pointes ventricular tachycardia associated with overdose of astemizole. Mayo Clin Proc 1994;69:589-93.
25. Woosley RL, Chen Y, Freiman JP, Gillis RA. Mechanism of the cardiotoxic actions of terfenadine. JAMA 1993;269:1532-6.
26. Woosley R, Darrow WR. Analysis of potential adverse drug reactions - a case of mistaken identity. Am J Cardiol 1994;74:208-9.
27. Handley DA, Magnetti A, Higgins AJ. Therapeutic advantages of third generation antihistamines. Exp Opin Invest Drugs 1998;7:104.
28. Hill G. Carcinoid tumours: Pharmacological therapy. Oncology 1971;25:329.
29. Weiler JM, Bloomfield JR, Woodworth GG, et al. Effects of fexofenadine, diphenhydramine and alcohol on driving performance: a randomized, placebo-controlled trial in the Iowa driving simulator. Ann Intern Med 2000;132:354.
30. Thomas SE, Bleeken SS, Greaves MW, et al. Cimetidine and chlorpheniramine in the treatment of chronic idiopathic urticaria: A multicentre randomised double-blind study. Br J Dermatol 1987;117:81.
31. Timmerman H. Histamine H3 ligands: just pharmacological tools or potential therapeutic agents? J Med Chem 1990;33:4-11.
2. Curtis AC, Owens BB. B-dimethylaminoethyl benzhydyl ether hydrochloride (benadryl) in the treatment of acute and chronic urticaria. Univ Hosp Bull Ann Arbor 1945;11:25.
3. Black JW, Duncan WAM, Durant CJ, et al. Definition and antagonism of histamine H2- receptors. Nature 1972;236:385-90.
4. Arrang JM, Garbarg M, Schwartz JC. Autoinhibition of brain histamine release mediated by a novel class (H3) of histamine receptor. Nature1983;302:832-7.
5. Babe KS Jr, Serafin WE. Istamina, bradichinina e loro antagonisti. In: Goodman & Gilman. Le basi farmacologiche della terapia. Hardman JG, Limbird LE, Molinoff PB, Ruddon W, Goodman Gilman A (eds). Nona edizione. Milano: McGraw-Hill Libri Italia srl, 1997:577-94.
6. Brandes LJ, LaBella FS, Glavin GB, et al. Histamine as an intracellular messenger. Biochem Pharmacol 1993;40:1677-81.
7. Hollande F, Bali JP, Magous R. Autoregulation of histamine synthesis through H3 receptors in isolated fundic mucosal cells. Am J Physiol 1993;265:G1039-G1044.
8. Monti JE. Involvement of histamine in the control of the waking state. Life Sci 1993; 53:1331-8.
9. Greaves MW. Antihistamines. Dermatol Clin 2001;19:53-62.
10. Rimmer SJ, Church MK. The pharmacology and mechanism of action of histamine H1 antagonists. Clin Exp Allergy 1990;20 (suppl. 2):3-17.
11. Simons FE, Simons KJ. The pharmacology and use of H1 receptor antagonist drugs. N Engl J Med 1994;330:1663.
12. Walsh GM. The anti-inflammatory effects of cetirizine. Clin Exp Allergy 1994;24:81.
13. Leprevost C, Capron M, De Vos C, et al. Inhibition of eosinophil chemotaxis by a new anti allergic compound (cetirizine). Int Arch Allergy Appl Immunol 1988;87:9-13.
14. 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.
15. Redier H, Chanez P, De Vos C, et al. Inhibitory effect of cetirizine on the bronchial eosinophil recruitment induced by allergen inhalation challenge in allergic patients with asthma. J Allergy Clin Immunol 1992;90:215.
16. Simons FER. Recent advances in H1 antagonist treatment. J Allergy Clin Immunol 1990;86995-9.
17. Brandes LJ, Warrington RC, Arron RJ, et al. Enhanced cancer growth in mice administered daily human-equivalent doses of some H1-antihistamines: predictive in vitro correlates. J Natl Cancer Inst 1994;86:770-5.
18. Long WF, Taylor RJ, Wagner CJ, et al. Skin test suppression by antihistamines and the development of subsensitivity. J Allergy Clin Immunol 1985;76:113-7.
19. Monash S. Development of retractory condition of skin towards antihistamine drugs after antihistamine therapy as determined by histamine iontopheresis. J Invest Dermatol 1950;15:1.
20. Rantuccio F, Meneghini CL, Bonifazi E. Rilievi sui test epicutanei con serie fisse di allergeni in soggetti eczematosi. Folia Allergol 1967;14:46-55.
21. Carruthers SG, Shoeman DW, Hignite CE, Azarnoff DL. Correlation between plasma diphenhydramine level and sedative and antihistamine effects. Clin Pharmacol Ther 1978;23:375-82.
22. Sorkin EM, Heel RC. Terfenadine: a review of its pharmacodynamic properties and therapeutic efficacy. Drugs 1985;29:34-56.
23. MacConnell TJ, Stanners AI. Torsades de pointes complicating treatment with tertenadine. Br Med J 1991;302:1469.
24. Rao KA, Adlakha A, Verman-Ansil B, et al. Torsades de pointes ventricular tachycardia associated with overdose of astemizole. Mayo Clin Proc 1994;69:589-93.
25. Woosley RL, Chen Y, Freiman JP, Gillis RA. Mechanism of the cardiotoxic actions of terfenadine. JAMA 1993;269:1532-6.
26. Woosley R, Darrow WR. Analysis of potential adverse drug reactions - a case of mistaken identity. Am J Cardiol 1994;74:208-9.
27. Handley DA, Magnetti A, Higgins AJ. Therapeutic advantages of third generation antihistamines. Exp Opin Invest Drugs 1998;7:104.
28. Hill G. Carcinoid tumours: Pharmacological therapy. Oncology 1971;25:329.
29. Weiler JM, Bloomfield JR, Woodworth GG, et al. Effects of fexofenadine, diphenhydramine and alcohol on driving performance: a randomized, placebo-controlled trial in the Iowa driving simulator. Ann Intern Med 2000;132:354.
30. Thomas SE, Bleeken SS, Greaves MW, et al. Cimetidine and chlorpheniramine in the treatment of chronic idiopathic urticaria: A multicentre randomised double-blind study. Br J Dermatol 1987;117:81.
31. Timmerman H. Histamine H3 ligands: just pharmacological tools or potential therapeutic agents? J Med Chem 1990;33:4-11.