期刊
ALLERGY
卷 65, 期 4, 页码 459-466出版社
WILEY
DOI: 10.1111/j.1398-9995.2009.02325.x
关键词
adverse event; allergic rhinitis; cognitive function; sedation
资金
- MRC [G0800766, G19/34] Funding Source: UKRI
- Medical Research Council [G19/34, G0800766] Funding Source: researchfish
- Medical Research Council [G0800766, G19/34] Funding Source: Medline
P>Background: First-generation H-1-antihistamines obtained without prescription are the most frequent form of self-medication for allergic diseases, coughs and colds and insomnia even though they have potentially dangerous unwanted effects which are not recognized by the general public. Aims: To increase consumer protection by bringing to the attention of regulatory authorities, physicians and the general public the potential dangers of the indiscriminate use first-generation H-1-antihistamines purchased over-the counter in the absence of appropriate medical supervision. Methods: A GA2LEN (Global Allergy and Asthma European Network) task force assessed the unwanted side-effects and potential dangers of first-generation H1-antihistamines by reviewing the literature (Medline and Embase) and performing a media audit of US coverage from 1996 to 2008 of accidents and fatal adverse events in which these drugs were implicated. Results: First-generation H-1-antihistamines, all of which are sedating, are generally regarded as safe by laypersons and healthcare professionals because of their long-standing use. However, they reduce rapid eye movement (REM)-sleep, impair learning and reduce work efficiency. They are implicated in civil aviation, motor vehicle and boating accidents, deaths as a result of accidental or intentional overdosing in infants and young children and suicide in teenagers and adults. Some exhibit cardiotoxicity in overdose. Conclusions: This review raises the issue of better consumer protection by recommending that older first-generation H-1-antihistamines should no longer be available over-the-counter as prescription- free drugs for self-medication of allergic and other diseases now that newer second- generation nonsedating H-1-antihistamines with superior risk/benefit ratios are widely available at competitive prices.
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