Seasonal allergic rhinitis and antihistamine effects on children's learning

Vuurman, E.F.P.M.; Veggel, L. Van; Uiterwijk, M. M. C.; Leutner, D; O’Hanlon, John

doi:10.1016/0924-977x(92)90101-d

Cited by 145 publications

(190 citation statements)

References 3 publications

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“…However, their use is markedly limited by these anticholinergic effects that can cause dry mouth, tachycardia, and urinary retention, and by their affinity for H 1 receptors in the central nervous system (CNS) which results in marked sedation, daytime somnolence, decreased reaction time, and impaired performance. 46,[49][50][51][52] The significant sedation associated with first-generation and certain secondgeneration antihistamines is attributed to their high liposolubility and low molecular weight -which allows penetration into the CNS -and their high affinity for CNS histamine H 1 receptors. 42,[49][50][51][52][53] Most newer second-generation antihistamines have minimal or no sedating properties (due to minimal CNS penetration and a low affinity for central H 1 receptors) and less anticholinergic effects and are therefore preferable to first-generation antihistamines in most cases.…”

Section: 24mentioning

confidence: 99%

Allergic rhinitis-induced nasal congestion: its impact on sleep quality

Storms¹

2008

Primary Care Respiratory Journal

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Allergic rhinitis (AR) is an extremely common health problem affecting 20 to 40 million Americans and between 10-25% of the world's population. Patients with AR suffer from both nasal symptoms (congestion, rhinorrhea, itching, and sneezing) and ocular symptoms (itching, redness, and tearing). The negative impact on sleep quality and quantity, and consequently on various aspects of the patient's life, is an under-recognised and under-treated component of AR morbidity. Nasal congestion, which is one of the most bothersome and prevalent symptoms of AR, is thought to be the leading symptom responsible for rhinitis-related sleep problems.In addition to reducing clinical symptoms, pharmacologic therapies for AR that specifically reduce inflammatory cells and mediators -and therefore nasal congestion and other symptoms -should also improve sleep quality and overall quality of life (QOL). Intranasal corticosteroids (INS) are the current mainstay of therapy for AR. Results of a number of clinical trials demonstrate that INS effectively reduce nasal congestion and ocular symptoms, improve sleep quality, and decrease daytime somnolence. Intranasal corticosteroids have also proved to be effective in reducing symptoms of acute rhinosinusitis and nasal polyposis, both of which also negatively impact on sleep quality. Intranasal corticosteroids are considered safe due to their low systemic bioavailability.

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Section: 24mentioning

confidence: 99%

Allergic rhinitis-induced nasal congestion: its impact on sleep quality

Storms¹

2008

Primary Care Respiratory Journal

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“…4 In addition, children with untreated allergy symptoms exhibit lower learning ability at school compared with nonallergic children. 5 Furthermore, if left untreated, allergic rhinitis can potentially exacerbate and contribute to asthma 6 as well as other comorbidities such as conjunctivitis, otitis, dental malocclusions, sinusitis, respiratory infections, and learning problems. [7][8][9][10][11][12] Antihistamines have been a valuable allergic rhinitis treatment for decades, and data from studies in adult populations have been widely reported.…”

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confidence: 99%

Fexofenadine is efficacious and safe in children (aged 6-11 years) with seasonal allergic rhinitis

Wahn¹,

Meltzer²,

Finn³

et al. 2003

Journal of Allergy and Clinical Immunology

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Background: This is the first prospective, randomized, doubleblind, placebo-controlled study showing statistical improvement of an H 1 -antihistamine in children with seasonal allergic rhinitis in all symptoms throughout the entire treatment period. Objective: This randomized, placebo-controlled, parallelgroup, double-blind study was performed to assess the efficacy and safety of fexofenadine in children with seasonal allergic rhinitis. Methods: This study was conducted at 148 centers in 15 countries. Nine hundred thirty-five children (aged 6-11 years) were randomized and treated with either fexofenadine HCl 30 mg (n = 464) or placebo (n = 471) tablets twice a day for 14 days. Individual symptoms (sneezing; rhinorrhea; itchy nose, mouth, throat, and/or ears; itchy, watery, and/or red eyes; and nasal congestion) were assessed at baseline and then daily at 7:00 AM and 7:00 PM (±1 hour) during the double-blind treatment period. Each total symptom score was the sum of all symptoms, excluding nasal congestion. The primary efficacy variable was the change from baseline in the average of the daily 12-hour evening reflective total symptom scores throughout the double-blind treatment. Safety was evaluated from adverse-event reporting, vital signs, physical examinations, and clinical laboratory data at screening and study end point.Results: Fexofenadine was significantly superior to placebo in the primary efficacy analysis (P ≤ .0001). Individual symptom scores showed statistically significant superiority compared with placebo (P < .05), including nasal congestion in the evening reflective assessment (P < .05). There was no significant difference in adverse events between fexofenadine and placebo, either overall or by causality.

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“…Desloratadine, a potent metabolite of loratadine, is a nonsedating, histamine H 1 -receptor antagonist. The pathophysiology of allergic rhinitis and chronic idiopathic urticaria is thought to be similar in adults and children [4]. In addition, the response to antihistamine treatment is similar in adults and children [5], suggesting a similar concentration-response relationship.…”

Section: Introductionmentioning

confidence: 64%

Desloratadine dose selection in children aged 6 months to 2 years: comparison of population pharmacokinetics between children and adults

Gupta¹,

Kantesaria²,

Banfield³

et al. 2007

Brit J Clinical Pharma

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What is already known about this subject • According to recent literature, the pathophysiologies of allergic rhinitis and chronic idiopathic urticaria are thought to be similar in adults and children. In addition, the response to antihistamine treatment is similar in adults and children, suggesting a similar concentration-response relationship.• However, an appropriate dose selection and the pharmacokinetics of desloratadine in children of Ն6 months-Յ2 years old have never been addressed in the literature. What this study adds• This study demonstrated that desloratadine syrup offers a safe treatment option for allergic conditions in young children.• A suitable dose for children aged Ն6 months-<1 year is 1.0 mg, while the corresponding predicted dose for children aged Ն1 year-Յ2 years is 1.25 mg. These paediatric doses yielded similar systemic desloratadine exposures (AUC) to those seen with a typical adult dose of 5.0 mg. AimsThe aim of this study was to identify the dose of desloratadine in children aged Ն6 months-Յ2 years that would yield a single-dose target exposure (AUC) comparable with that in adults taking 5 mg desloratadine as syrup. MethodsIn a phase 1, single-dose, open-label, pharmacokinetic study in 58 children aged Ն6 months-<1 year and Ն1 year-Յ2 years were randomly assigned to desloratadine syrup 0.625 mg (1.25 ml) and 1.25 mg (2.5 ml), respectively. Because the volume of blood that could be collected from individual subjects was limited, a population pharmacokinetic approach was used to estimate the pharmacokinetics of desloratadine. Safety was assessed based on results of screening and postdose physical examinations, laboratory safety tests, vital signs, and adverse events. ResultsThe apparent clearance (CL/F) of desloratadine, population estimate (%CV), in children aged Ն6 months-<1 year was 27.8 l h -1 (35) and corresponding values in children Ն1 year-Յ2 years was 35.5 l h -1 (51), compared with 137 l h -1 (58) for adults. The CL/F ratios (children to adults) indicated that doses of 1 mg for Ն6 months-<1 year and 1.25 mg for Ն1 year-Յ2 years would result in similar systemic exposure to that observed in adults receiving the recommended 5 mg dose. Desloratadine was well tolerated with no safety issues. ConclusionsDoses of 1.0 and 1.25 mg in children aged Ն6 months-Յ2 years should result in an exposure to desloratadine similar to that of adults receiving doses of 5 mg.

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Seasonal allergic rhinitis and antihistamine effects on children's learning

Cited by 145 publications

References 3 publications

Allergic rhinitis-induced nasal congestion: its impact on sleep quality

Allergic rhinitis-induced nasal congestion: its impact on sleep quality

Fexofenadine is efficacious and safe in children (aged 6-11 years) with seasonal allergic rhinitis

Desloratadine dose selection in children aged 6 months to 2 years: comparison of population pharmacokinetics between children and adults

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