Anti-histamines f Iraqi Dental Academy @) @iraqiDentalOverview a Histamine is found in the mast cells in the intestinal mucosa, and in the CNS = When an allergic reaction occurs, the mast cell degranulate and release histamine Release of histamine will result in: = Effects related to Hi receptors: Vasodilation, increased capillary permeability, bronchoconstriction, pain and itching = Effects related to H2 receptors: increased gastric acid secretion (§f iraqi Dental Academy i) @lraqiDentalOverview PTC ele easel 1 elem dar T meee Malet Bla te resulting in: u Decrease capillary permeability, which decrease edema = block vascular vasodilation caused by histamine = Not that effective in reversing bronchospasm, because many agents cause bronchospasm not only histamine = Reduce itching and pain Palio LUC Tce [fot c= Tad lol m aeRO Clu ee Leg severe allergic reactions or anaphylactic attack is managed dams late lalate = Other effects of antihistamines are sedation (especially Peele ee er arte) Lae xerostomia ( iraqi Dental Academy ®@ @lraqiDentalAntihistamines List First-generation antihistamines: = Diphenhydramine (Benadryl) Peace easier m Sal col ed te iti celt) | Pico diny dane =m (Pd Ly Second-generation antihistamines: u Fexofenadine (Allegra) = Loratadine (Claritin) a Desloratadine (Clarinex) = Cetirizine (Zyrtec) Poe Cie ty u Azelastine (Astelin) Nasal Spray (F iraqi Dental Academy a@ @lraqiDentalBh ate aoe =f -38 0 oe Peeters eee OOM cde Rae ACT a effect (neutilizing allergy, itching, edema), they have sedative effect ( for pain and sleep), antiemetic effect ( for nausea and vomiting), and anticholinergic effect ( for runny nose ) = Second-generation antihistamines, have mainly antihistaminic effect, with no or very little sedation, anticholinergic, antiemetic effects PSSM MC mC M ACM Lee: Teeny prefered. For sleeping and insomnia, also first generation is prefered. As antiemetic drugs, second generation has no effect on that, so first generation is the choice = In cases where only the antihistaminic effect is wanted, second generation Is the choice ( iraqi Dental Academy i) @lraqiDentalSecond Generation Antihistamines u Fexofenadine: dose is 60 mg twice daily = Loratadine: Once daily = Desloratadine: Once daily = Cetirizine: Once daily Paes a cami (a-merliNg Parle oe NC Ie le) Coie Meet Dem Von Lge) oy (& iraqi Dental Academy i @lraqiDentalUses of antihistamines = Allergic reactions: such as allergic rhinitis, and seasonal hay fever a Urticarial attacks: to relieve itching, edema and erythema = Topically, to relieve some painful oral Lesions a First generation antihistamines has anti-emetic effect, supressing nausea and vomiting. But should not be used in pregnant women for morning sickness because of adverse irae Rennes) ce) u First generation antihistamines cause relieve of pain or sedation to some degree Pooh (% iraqi Dental Academy ®@ @lraqiDentalTHANK YOU Cm {¥ Iraqi Dental Academ