PROCESS OF RATIONAL THERAPY OF ALLERGY

Rita Grace Alvero, MD

July 24, 2014; 1:00 2:30 PM
Clinical Pharmacology
BASIC PHARMACOLOGY REVIEW

4. Differentiate the effective group of drugs as to:

duration of action, onset of action, blood-brain barrier
(BBB) penetration.
First Generation Second Generation
Onset
Short
Long
Duration
Fast
Slow
BBB penetration
Yes
No

H1-ANTIHISTAMINES
The term antihistamine, without a modifying adjective, refers to
the classic H1-receptor blockers.
These compounds do not influence the formation or release of
histamine; rather, they block the receptor-mediated response of
a target tissue.
The H1-receptor blockers can be divided into first- and secondgeneration drugs.

5.

First-Generation Antihistamines
The older first-generation drugs are still widely used because they
are effective and inexpensive.
However, most of these drugs penetrate the CNS and cause
sedation.
Furthermore, they tend to interact with other receptors,
producing a variety of unwanted adverse effects.

6. Choose the drug of choice by assessing the following

as to their efficacy, safety, suitability and cost.
Drug
Efficacy Safety Suitability Cost
Diphenhydramine
+
+/++
Loratadine
+
+/+
+
Clorpheniramine
+
+/++
Cetirizine
+
+/+
+/-

Second-Generation Antihistamines
By contrast, the second-generation agents are specific for H1
receptors, and because they do not penetrate the blood-brain
barrier, they show less CNS toxicity than the first-generation
drugs.

Case: Mang Jose, a 35 year old machine operator

complains of rashes after taking Ibuprofen for muscle
pain. Maculopapular rashes are noted in his arms. No
other significant PE findings noted.
1.

2.

3.

Which specific drug group will you choose for this

patient?
2nd generation H1 receptor antagonist because it is
non-sedating and the patient is also a machine
worker.
If for example, your patient is a housewife or elderly, a
1st generation antihistamine could be used.

Drug of Choice: Loratidine or Cetirizine

Frequency of Administration: 10 mg/day; for 3-5 days

What is your therapeutic objective?

Relieve the rashes

Jose Reyes
Silang, Cavite

What important non-drug measure/s should be

implemented?
Discontinue intake of drug
Avoid NSAIDS
For pain, give Paracetamol
Give hypoallergenic diet

September 16, 2014

Rx
Cetirizine Tablets
10 mg/tab
Dispense No. 3
Label: Take one tablet once a day for 3 days.

brsantos

Make an inventory of effective drug groups.

H1 receptor antagonist (1st generation)
Diphenhydramine
Clorpheniramine
H1 receptor antagonist (2nd generation)
Cetirizine
Loratidine

Beth Rea-Santos, MD
License No. 14344
PTR No. 6969

-END-

BASIS
REMARKS

TRANSCRIPTION DETAILS
HB 109 Notes
RECORDINGS
NOTES
DEVIATIONS
100%
CREDITS
READ AT YOUR OWN RISK. This is based on HB 109 Tranx. No powerpoint was given. Nobody was able to take pictures of the lecture.
GOOD LUCK and GOD BLESS BATCH 2016! Congratulations Nigel, Paulo, and Evan!
-BATCH 2016 Transcribers Guild Transcriptions.-

Transcribers: Robert C. Rea

Formatting: Robert C. Rea
Editor: Robert C. Rea

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