|
Allergic Rhinitis: Hay Fever Treatments |
|
|
|
|
Tuesday, 26 February 2008 |
|
Page 12 of 16
Medication continued... | Drug Name | Diphenhydramine (Benadryl, Benylin) | | Description | Common first-generation agent available OTC in the United States. Competes with histamine on H1-receptor sites on effector cells in blood vessels and respiratory tract. For symptomatic relief of symptoms caused by release of histamine in allergic reactions. | | Adult Dose | 25-50 mg PO q4-6h; not to exceed 400 mg/d | | Pediatric Dose | 3-12 years: 5 mg/kg/d PO divided tid/qid; not to exceed 300 mg/d
>12 years: Administer as in adults | | Contraindications | Documented hypersensitivity; MAOIs | | Interactions | Potentiates effect of CNS depressants; syrup contains alcohol; caution with concurrent use of medications with disulfiramlike reactions; caution with anticholinergic effects | | Pregnancy | C - Safety for use during pregnancy has not been established.
| | Precautions | May exacerbate angle-closure glaucoma, hyperthyroidism, peptic ulcer, urinary tract obstruction; xerostomia may occur | | Drug Name | Hydroxyzine (Atarax, Vistaril, Vistazine) | | Description | Effective first-generation agent but frequently produces sedation. Considerable sedation may occur with higher doses. Antagonizes H1 receptors in periphery. May suppress histamine activity in subcortical region of CNS. | | Adult Dose | 10-25 mg PO q6-8h | | Pediatric Dose | 0.6 mg/kg/dose PO q6h | | Contraindications | Documented hypersensitivity | | Interactions | CNS depression may increase with alcohol or other CNS depressants | | Pregnancy | C - Safety for use during pregnancy has not been established.
| | Precautions | May exacerbate porphyria (may not be safe for these patients); ECG abnormalities (alterations in T waves) may occur; may cause drowsiness; adjust dose in hepatic dysfunction | Drug Category: Decongestants Stimulate vasoconstriction by directly activating alpha-adrenergic receptors of the respiratory mucosa. Pseudoephedrine produces weak bronchial relaxation (unlike epinephrine or ephedrine) and is not effective for treating asthma. Increases heart rate and contractility by stimulating beta-adrenergic receptors. Used alone or in combination with antihistamines to treat nasal congestion. Anxiety and insomnia may occur. Expectorants may thin and loosen secretions, although experimental evidence for their efficacy is limited. Numerous preparations are available containing combinations of various decongestants, expectorants, or antihistamines. Alternatively, a separate decongestant and antihistamine can be administered to allow for individual dose titration of each drug. | Drug Name | Pseudoephedrine (Sudafed) | | Description | Stimulates vasoconstriction by directly activating alpha-adrenergic receptors of the respiratory mucosa. Available OTC in the United States. Helpful for nasal and sinus congestion. | | Adult Dose | 30-60 mg PO q4-6h; not to exceed 240 mg/d; alternatively, 120 mg SR PO q12h | | Pediatric Dose | <2 years: Not established
2-6 years: 15 mg PO q4-6h; not to exceed 4 doses/d
6-12 years: 30 mg PO q4-6h; not to exceed 4 doses/d
>12 years: Administer as in adults | | Contraindications | Documented hypersensitivity; severe anemia; postural hypotension or severe hypertension; closed-angle glaucoma; head trauma; cerebral hemorrhage; coronary artery disease; do not use within 14 d of MAOIs | | Interactions | Hypertensive crisis with MAOIs; increased pressor effects with beta-blockers; arrhythmias with epinephrine or isoproterenol; antagonizes methyldopa, reserpine, and guanethidine | | Pregnancy | C - Safety for use during pregnancy has not been established.
| | Precautions | Caution with mild-to-moderate hypertension; caution with diabetes, glaucoma, hyperthyroidism, GI obstruction, urinary obstruction, prostatic hypertrophy, epilepsy, cardiac disease, elderly patients, pregnancy and breastfeeding; adjust dose in renal dysfunction; may produce anxiety and insomnia |
|
