Which medications in the drug class Antihistamines, 2nd Generation are used in the treatment of Pediatric Allergic Rhinitis?

Answer

Antihistamines, 2nd Generation

Antihistamines are classified in several ways, including sedating and nonsedating, newer and older, and first- and second-generation antihistamines (most widely accepted classification). First-generation antihistamines are primarily over-the-counter OTC) and are included in many combination products for cough, colds, and allergies. These include brompheniramine, chlorpheniramine (Chlor-Trimeton), and diphenhydramine (Benadryl). Some 2nd generation antihistamines, such as fexofenadine (Allegra), loratadine (Claritin), and cetirizine (Zyrtec) are now available OTC without a prescription. Second-generation antihistamines include desloratadine (Clarinex), and levocetirizine dihydrochloride (XYZAL), are also available without a prescription.

Cetirizine (Zyrtec, Zyrtec Allergy, Children's Zyrtec Allergy)

Low-sedating second-generation medication with fewer adverse effects than first-generation medications. Selectively inhibits peripheral histamine H1 receptors. Available as syr (5 mg/5 mL) and 5- or 10-mg tab.

Levocetirizine (Xyzal)

Histamine H1-receptor antagonist. Active enantiomer of cetirizine. Peak plasma levels are reached within 1 h, and half-life is about 8 h. Available as a 5-mg breakable (scored) tab. Indicated for seasonal and perennial AR

Loratadine (Claritin)

Nonsedating second-generation antihistamine. Fewer adverse effects than with first-generation medications. Selectively inhibits peripheral histamine H1 receptors. Available as tab, disintegrating tab (Reditab), syr (5 mg/5 mL), or combined with pseudoephedrine in 12- or 24-h preparations.

Desloratadine (Clarinex, Clarinex RediTabs)

Nonsedating second-generation antihistamine. Fewer adverse effects than with first-generation antihistamines. Selectively inhibits peripheral histamine H1 receptors. Relieves nasal congestion and systemic effects of seasonal allergies. Long-acting tricyclic histamine antagonist selective for H1-receptor. Major metabolite of loratadine, which, after ingestion, is extensively metabolized to active metabolite 3-hydroxydesloratadine. Available as tabs, syr (0.5 mg/mL), or PO disintegrating Reditabs (2.5 and 5 mg).

Fexofenadine (Allegra, Allegra Allergy 12 Hour, Allegra Allergy 24 Hour, Children's Allegra Allergy)

Nonsedating second-generation medication with fewer adverse effects than first-generation medications. Competes with histamine for H1 receptors in GI tract, blood vessels, and respiratory tract, reducing hypersensitivity reactions. Available OTC in qd and bid preparations. Also OTC available combined with pseudoephedrine.

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Meltzer EO. Productivity costs of antihistamines in the workplace. Occup Health Saf. 1996 Aug. 65(8):46-50. [Medline].
[Guideline] World Health Organization (WHO). Allergic rhinitis and its impact on asthma. 2008. [Full Text].
Crystal-Peters J, Neslusan C, Crown WH, Torres A. Treating allergic rhinitis in patients with comorbid asthma: the risk of asthma-related hospitalizations and emergency department visits. J Allergy Clin Immunol. 2002 Jan. 109(1):57-62. [Medline].
Gendo K, Larson EB. Evidence-based diagnostic strategies for evaluating suspected allergic rhinitis. Ann Intern Med. 2004 Feb 17. 140(4):278-89. [Medline].
Malone DC, Lawson KA, Smith DH, Arrighi HM, Battista C. A cost of illness study of allergic rhinitis in the United States. J Allergy Clin Immunol. 1997 Jan. 99(1 Pt 1):22-7. [Medline].
Herr M, Clarisse B, Nikasinovic L, et al. Does allergic rhinitis exist in infancy? Findings from the PARIS birth cohort. Allergy. 2011 Feb. 66(2):214-21. [Medline].
Hatzler L, Panetta V, Lau S, Wagner P, Bergmann RL, Illi S, et al. Molecular spreading and predictive value of preclinical IgE response to Phleum pratense in children with hay fever. J Allergy Clin Immunol. 2012 Jul 25. [Medline].
Söderström L, Lilja G, Borres MP, Nilsson C. An explorative study of low levels of allergen-specific IgE and clinical allergy symptoms during early childhood. Allergy. 2011 Aug. 66(8):1058-64. [Medline].
Cox LS, Larenas Linnemann D, Nolte H, Weldon D, Finegold I, Nelson HS. Sublingual immunotherapy: a comprehensive review. J Allergy Clin Immunol. 2006 May. 117(5):1021-35. [Medline].
Compalati E, Penagos M, Tarantini F, Passalacqua G, Canonica GW. Specific immunotherapy for respiratory allergy: state of the art according to current meta-analyses. Ann Allergy Asthma Immunol. 2009 Jan. 102(1):22-8. [Medline].
FDA OKs Oralair, First US Sublingual Allergy Immunotherapy. Medscape. Available at https://www.medscape.com/viewarticle/822975. Accessed: April 4, 2014.
Grastek [package insert]. Whitehouse Station, NJ: Merck & Co, Inc. April 2014. Available at [Full Text].
Maloney J, Bernstein DI, Nelson H, Creticos P, Hébert J, Noonan M, et al. Efficacy and safety of grass sublingual immunotherapy tablet, MK-7243: a large randomized controlled trial. Ann Allergy Asthma Immunol. 2014 Feb. 112(2):146-153.e2. [Medline].
Hand L. First-year allergen exposures may reduce later risks. Medscape Medical News. June 11, 2014. [Full Text].
Lynch SV, Wood RA, Boushey H, Bacharier LB, Bloomberg GR, Kattan M, et al. Effects of early-life exposure to allergens and bacteria on recurrent wheeze and atopy in urban children. J Allergy Clin Immunol. 2014 May 28. [Medline].
Dykewicz MS, Wallace DV, Baroody F, Bernstein J, Craig T, et al. Treatment of seasonal allergic rhinitis: An evidence-based focused 2017 guideline update. Ann Allergy Asthma Immunol. 2017 Nov 2. [Medline].
Seidman MD, Gurgel RK, Lin SY, Schwartz SR, Baroody FM, et al. Clinical practice guideline: Allergic rhinitis. Otolaryngol Head Neck Surg. 2015 Feb. 152 (1 Suppl):S1-43. [Medline].
Aaronson DW. Side effects of rhinitis medications. J Allergy Clin Immunol. 1998 Feb. 101(2 Pt 2):S379-82. [Medline].
Allergies in America. Allergies in America Executive Summary. myallergiesinamerica. Available at https://www.myallergiesinamerica.com/pdfs/myaia.pdf. Accessed: June 2007.
Brooks M. FDA OKs carbinoxamine ER for allergic rhinitis in children. Medscape Medical News. April 3, 2013. Available at https://www.medscape.com/viewarticle/781921. Accessed: April 8, 2013.
Busse W. Allergic rhinitis: charting a course for the 21st century. J Respir Dis. 1998. 19:S1-64.
Day J. Pros and cons of the use of antihistamines in managing allergic rhinitis. J Allergy Clin Immunol. 1999 Mar. 103(3 Pt 2):S395-9. [Medline].
Day JH, Briscoe M, Widlitz MD. Cetirizine, loratadine, or placebo in subjects with seasonal allergic rhinitis: effects after controlled ragweed pollen challenge in an environmental exposure unit. J Allergy Clin Immunol. 1998 May. 101(5):638-45. [Medline].
Delafuente JC, Davis TA, Davis JA. Pharmacotherapy of allergic rhinitis. Clin Pharm. 1989 Jul. 8(7):474-85. [Medline].
FDA approves Tris Pharma’s new drug application for Karbinal ER (carbinoxamine maleate) extended-release oral suspension [press release]. April 3, 2013. Available at https://www.trispharma.com/news_karbinal_apr2013.php. Accessed: April 8, 2013.
Hemp P. Presenteeism: at work--but out of it. Harv Bus Rev. 2004 Oct. 82(10):49-58, 155. [Medline].
Hussain I, Kline JN. DNA, the immune system, and atopic disease. J Investig Dermatol Symp Proc. 2004 Jan. 9(1):23-8. [Medline].
LaForce C. Use of nasal steroids in managing allergic rhinitis. J Allergy Clin Immunol. 1999 Mar. 103(3 Pt 2):S388-94. [Medline].
Lange B, Lukat KF, Rettig K, Holtappels G, Bachert C. Efficacy, cost-effectiveness, and tolerability of mometasone furoate, levocabastine, and disodium cromoglycate nasal sprays in the treatment of seasonal allergic rhinitis. Ann Allergy Asthma Immunol. 2005 Sep. 95(3):272-82. [Medline].
Ledford DK, Lockey RF. Allergic rhinitis: understanding the process. J Respir Dis. 1998. 19(7):576-84.
Middleton E, Reed C, Ellis E. Allergic and non-allergic rhinitis. Allergy: Principles and Practice. 5th ed. Mosby-Year Book; 1998. Vol 2: Chapter 70.
Naclerio R, Solomon W. Rhinitis and inhalant allergens. JAMA. 1997 Dec 10. 278(22):1842-8. [Medline].
Plevkova J, Brozmanova M, Pecova R, Tatar M. Effects of intranasal histamine on the cough reflex in subjects with allergic rhinitis. J Physiol Pharmacol. 2005 Sep. 56 Suppl 4:185-95. [Medline].
Settipane RJ, Hagy GW, Settipane GA. Long-term risk factors for developing asthma and allergic rhinitis: a 23-year follow-up study of college students. Allergy Proc. 1994 Jan-Feb. 15(1):21-5. [Medline].
Spector S. Pathophysiology and pharmacotherapy of allergic rhinitis. Foreword. J Allergy Clin Immunol. 1999 Mar. 103(3 Pt 2):S377. [Medline].
Sublett JL. The environment and risk factors for atopy. Curr Allergy Asthma Rep. 2005 Nov. 5(6):445-50. [Medline].
Wahn U, Klimek L, Ploszczuk A, Adelt T, Sandner B, Trebas-Pietras E, et al. High-dose sublingual immunotherapy with single-dose aqueous grass pollen extract in children is effective and safe: A double-blind, placebo-controlled study. J Allergy Clin Immunol. 2012 Aug 29. [Medline].
Wahn U, Tabar A, Kuna P, et al. Efficacy and safety of 5-grass-pollen sublingual immunotherapy tablets in pediatric allergic rhinoconjunctivitis. J Allergy Clin Immunol. 2009 Jan. 123(1):160-166.e3. [Medline].
Wheeler PW, Wheeler SF. Vasomotor rhinitis. Am Fam Physician. 2005 Sep 15. 72(6):1057-62. [Medline].

Media Gallery

Photo demonstrates the allergic salute, which is the action performed when a patient rubs the nose using a motion across the nose.
Photo demonstrates allergic shiners. Note the periorbital edema and bluish discoloration seen in allergic rhinitis and sinusitis.
Impact of nasal allergies.
How patient feel when they have allergy symptoms.
Nasal symptoms and affect on work performance.

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Which medications in the drug class Antihistamines, 2nd Generation are used in the treatment of Pediatric Allergic Rhinitis?

Antihistamines, 2nd Generation

Cetirizine (Zyrtec, Zyrtec Allergy, Children's Zyrtec Allergy)

Levocetirizine (Xyzal)

Loratadine (Claritin)

Desloratadine (Clarinex, Clarinex RediTabs)

Fexofenadine (Allegra, Allegra Allergy 12 Hour, Allegra Allergy 24 Hour, Children's Allegra Allergy)

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