Anticholinergic Effects of Antihistamine Drugs Used in the Clinic

Wolff, S. C.; Brubaker, K.; Navrátil, Tomáš; Fulcher, E; Lankford, J.R.; Boyer, José L.

doi:10.1016/j.jaci.2006.11.535

Cited by 5 publications

(4 citation statements)

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“…In addition, some drugs have been approved for intranasal administration for topical treatment and adjuvant therapy not targeting the brain nervous system. Patanase® (FDA 2009 ), Optivar® (Wolff et al 2007 ), and Nasonex® (Berkowitz et al 1999 ) are formulations prescribed to treat inflammatory and allergic symptoms in the nasal passages. Narcan® has been approved by the FDA for the acute treatment of symptoms of opioid poisoning (FDA 2015 ).…”

Section: Clinical Application Cases and Research Statusmentioning

confidence: 99%

Drug delivery to the brain via the nasal route of administration: exploration of key targets and major consideration factors

Jeong

Jang

Lee

2022

J. Pharm. Investig.

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Background Cranial nerve-related diseases such as brain tumors, Alzheimer’s disease, and epilepsy are serious diseases that continue to threaten human. Brain-related diseases are increasing worldwide, including in the United States and Korea, and these increases are closely related to the exposure to harmful substances and excessive stress caused by rapid industrialization and environmental pollution. Drug delivery to the brain is very important for the effective prevention and treatment of brain-related diseases. However, due to the presence of the blood–brain barrier and the extensive first-pass metabolism effect, the general routes of administration such as oral and intravenous routes have limitations in drug delivery to the brain. Therefore, as an alternative, the nasal-brain drug delivery route is attracting attention as a route for effective drug delivery to the brain. Areas covered This review includes physiological factors, advantages, limitations, current application status, especially in clinical applications, and the necessary factors for consideration in formulation development related to nasal-brain drug delivery. Expert opinion The nasal-brain drug delivery route has the advantage of enhancing drug delivery to the brain locally, mainly through the olfactory route rather than the systemic circulation. The nasal-brain lymphatic system has recently attracted attention, and it has been implied that the delivery of anticancer drugs to the brain nervous system is possible effectively. However, there are limitations such as low drug permeability, as well as nasal mucosa and the mucociliary system, as obstacles in nasal-brain drug delivery. Therefore, to overcome the limitations of nasal-brain drug delivery, the use of nanocarriers and mucoadhesive agents is being attempted. However, very few drugs have been officially approved for clinical application via the nasal-brain drug delivery route. This is probably because the understanding of and related studies on nasal-brain drug delivery are limited. In this review, we tried to explore the major considerations and target factors in drug delivery through the nasal-brain route based on physiological knowledge and formulation research information. This will help to provide a mechanistic understanding of drug delivery through the nasal-brain route and bring us one step closer to developing effective formulations and drugs in consideration of the key factors for nasal-brain drug delivery.

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Section: Clinical Application Cases and Research Statusmentioning

confidence: 99%

Drug delivery to the brain via the nasal route of administration: exploration of key targets and major consideration factors

Jeong

Jang

Lee

2022

J. Pharm. Investig.

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“…The H 2 -antihistamines (ranitidine, famotidine) are used to block gastric hypersecretion [117]. However, histamine-1 receptor antagonists also have anticholinergic effects [222], and excessive doses may be associated with urinary retention [223] and negatively affect mental status [224,225].…”

Section: Antihistaminesmentioning

confidence: 99%

Recent advances in our understanding of mast cell activation – or should it be mast cell mediator disorders?

Theoharides

Tsilioni

Ren

2019

Expert Review of Clinical Immunology

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Introduction: An increasing number of patients present with multiple symptoms affecting many organs including the brain due to multiple mediators released by mast cells. These unique tissue immune cells are critical for allergic reactions triggered by immunoglobulin E (IgE), but are also stimulated (not activated) by immune, drug, environmental, food, infectious, and stress triggers, leading to secretion of multiple mediators often without histamine and tryptase. The presentation, diagnosis, and management of the spectrum of mast cell disorders are very confusing. As a result, specialists have recently excluded neuropsychiatric symptoms, and made the diagnostic criteria stricter, at the expense of excluding most patients.

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“…Moreover, H1 antihistamines are known to cause rapid tolerance of their sedative effects within a few days of administration, which limits their potential use as sedatives [170]. In addition, antihistamines have potent anticholinergic effects that can cause delirium in elderly hospitalized patients [171]. Therefore, it is recommended to avoid prescribing antihistamines for sleep or circadian disturbance, which is also suggested by the AASM guideline [134].…”

Section: Pharmacological Approachmentioning

confidence: 99%

Disturbance of Sleep and Circadian Rhythm in Hospitalized Patients

Park

Kyong

2023

Chronobiol Med

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Sleep and circadian disturbance are common in hospitalized patients. Problems related to sleep induction, frequent awakening, poor sleep quality, and disturbed circadian rhythm including daytime somnolence and nighttime arousal are frequently observed in the hospital. Disturbance of sleep and circadian rhythm could interfere recovery of the patients, prolong the length of stay, and contribute to patient dissatisfaction. Various factors affect sleep and circadian rhythm disturbance in the hospital. Intrinsic factors are related to patients, including medical and psychiatric conditions, uncontrolled pain, prescribed medications, and physical inactivity. External factors related to the hospital environment such as noisy environment, excessive exposure to artificial light, inappropriate humidity, and temperature are also known interrupters for sleep. Medical care provided by professionals, including nighttime vital sign monitoring, phlebotomy, and medication administration, can also contribute to sleep and circadian rhythm disturbances. This review aims to systematically address sleep and circadian rhythm disturbances in hospitalized patients, discuss factors that affect sleep in the hospital, and suggest non-pharmacological and pharmacological treatment options.

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Anticholinergic Effects of Antihistamine Drugs Used in the Clinic

Cited by 5 publications

References 0 publications

Drug delivery to the brain via the nasal route of administration: exploration of key targets and major consideration factors

Drug delivery to the brain via the nasal route of administration: exploration of key targets and major consideration factors

Recent advances in our understanding of mast cell activation – or should it be mast cell mediator disorders?

Disturbance of Sleep and Circadian Rhythm in Hospitalized Patients

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