{"id":215,"date":"2019-11-12T17:22:48","date_gmt":"2019-11-12T17:22:48","guid":{"rendered":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/chapter\/5-6-antihistamines\/"},"modified":"2021-12-07T11:11:08","modified_gmt":"2021-12-07T11:11:08","slug":"5-6-antihistamines","status":"publish","type":"chapter","link":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/chapter\/5-6-antihistamines\/","title":{"raw":"5.6 Antihistamines","rendered":"5.6 Antihistamines"},"content":{"raw":"Diphenhydramine is an example of a first-generation antihistamine. (See Figures 5.7[footnote]\"Benadryl Allergy USA<\/a>\" by ZenBenjamin<\/a> is licensed under CC BY-NC-SA 2.0<\/a>[\/footnote]<\/sup> and 5.8.[footnote]\"diphenhydramine (1)<\/a>\" by Intropin<\/a> is licensed under CC BY-NC 2.0[\/footnote]<\/a><\/sup>)\u00a0 Second-generation antihistamines were developed to have fewer side effects. An example of a second-generation antihistamine is cetirizine.\n\n[caption id=\"attachment_214\" align=\"aligncenter\" width=\"339\"]\"Photo Figure 5.7 Diphenhydramine is a first generation antihistamine that is available orally or as an IV medication[\/caption]\n\n[caption id=\"attachment_214\" align=\"aligncenter\" width=\"259\"]\"Photo 5.8 Diphenhydramine HCl preparation, single dose vial for IV administration[\/caption]\n\n
<\/div>\nMechanism of Action<\/strong>\n\nAntihistamines have the following mechanisms of action: blocks histamine at H1 receptors; inhibits smooth muscle constriction in blood vessels and the respiratory and GI tracts; and decreases capillary permeability, salivation, and tear formation.\n\nIndications for Use<\/strong>\n\nAntihistamines are used for relief of allergy or cold symptoms.\n\nNursing Considerations Across the Lifespan<\/strong>\n\nThis medication is not safe for children under the age of 2 years without a healthcare provider's order.\n\nAdverse\/Side Effects<\/strong>\n\nFirst-generation medications can cause anticholinergic effects (such as dry mouth, urinary retention, constipation and blurred vision). CNS depression or CNS stimulation with excessive doses can occur, especially in children. Therefore, first-generation antihistamines should be used with caution in the elderly.\n\nSecond-generation medications may cause headache, nausea, vomiting, dysmenorrhea, and fatigue.[footnote]Frandsen, G. & Pennington, S. (2018). Abrams\u2019 clinical drug: Rationales for nursing practice <\/em>(11th ed.). Wolters Kluwer.[\/footnote]<\/sup>\n\nPatient Teaching & Education<\/strong>\n\nPatients should be advised that antihistamines may cause drowsiness, and concurrent use of alcohol or other CNS depressants should be avoided.\u00a0 Patients should take only the recommended amount of medication and not to exceed dosing recommendations.\u00a0 Some patients may experience side effects such as dry mouth, and frequent oral hygiene may assist in alleviating discomfort.[footnote]uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a>[\/footnote]<\/sup>\n\nNow let's take a closer look at the medication grid for diphenhydramine and cetirizine in Table 5.6.[footnote]This work is a derivative of Pharmacology Notes: Nursing Implications for Clinical Practice<\/a> by Gloria Velarde<\/a> licensed under CC BY-NC-SA 4.0<\/a>.[\/footnote],<\/sup> [footnote]Frandsen, G. & Pennington, S. (2018). Abrams\u2019 clinical drug: Rationales for nursing practice <\/em>(11th ed.). Wolters Kluwer.[\/footnote], [footnote]This work is a derivative of Daily Med<\/a> by U.S. National Library of Medicine<\/a> in the public domain<\/a>. [\/footnote] <\/sup>Medication grids are intended to assist students to learn key points about each medication class.\u00a0 Basic information related to a common generic medication in this class is outlined, including administration considerations, therapeutic effects, and side effects\/adverse effects.\u00a0 Prototype\/generic medication listed in the medication grid is also hyperlinked to a free resource from the U.S. National Library of Medicine called Daily Med<\/a>.\u00a0 Because information about medication is constantly changing, nurses should always consult evidence-based resources to review current recommendations before administering specific medication.\n\nTable 5.6 Diphenhydramine and Cetirizine Medication Grid\n\n\n\n\n\n
\n
Class\/Subclass<\/strong><\/h5>\n<\/th>\n
\n
Prototype\/Generic<\/strong><\/h5>\n<\/th>\n
\n
Administration Considerations<\/strong><\/h5>\n<\/th>\n
\n
Therapeutic Effects<\/strong><\/h5>\n<\/th>\n
\n
Adverse\/Side Effects<\/strong><\/h5>\n<\/th>\n<\/tr>\n
First-generation antihistamine<\/th>\ndiphenhydramine<\/a><\/td>\nTake as directed\n\nAvoid allergens\n\nAvoid alcohol or CNS depressants due to sedation<\/td>\nTemporarily relieves\u00a0 symptoms due to hay fever or other upper respiratory allergies: runny nose; sneezing; itchy, watery eyes; itching of the nose or throat\n\nTemporarily relieves symptoms due to the common cold such as runny nose and sneezing<\/td>\nSedation\n\nAnticholinergic effects\n\nGastrointestinal: Nausea\/Vomiting\n\nParadoxical effect: excitation in children<\/td>\n<\/tr>\n
Second-generation antihistamine<\/th>\ncetirizine<\/a><\/td>\nTake as directed\n\nAvoid allergens\n\nAvoid alcohol or CNS depressants due to sedation<\/td>\nTemporarily relieves symptoms due to hay fever or other upper respiratory allergies: runny nose; sneezing; itchy, watery eyes; itching of the nose or throat<\/td>\nNon-sedating\n\nAnticholinergic effects\n\nGastrointestinal: Nausea\/vomitting\n\nParadoxical effect: excitation in children<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n ","rendered":"

Diphenhydramine is an example of a first-generation antihistamine. (See Figures 5.7[1]<\/sup><\/a><\/sup> and 5.8.[2]<\/sup><\/a><\/a><\/sup>)\u00a0 Second-generation antihistamines were developed to have fewer side effects. An example of a second-generation antihistamine is cetirizine.<\/p>\n

\"Photo
Figure 5.7 Diphenhydramine is a first generation antihistamine that is available orally or as an IV medication<\/figcaption><\/figure>\n
\"Photo
5.8 Diphenhydramine HCl preparation, single dose vial for IV administration<\/figcaption><\/figure>\n
<\/div>\n

Mechanism of Action<\/strong><\/p>\n

Antihistamines have the following mechanisms of action: blocks histamine at H1 receptors; inhibits smooth muscle constriction in blood vessels and the respiratory and GI tracts; and decreases capillary permeability, salivation, and tear formation.<\/p>\n

Indications for Use<\/strong><\/p>\n

Antihistamines are used for relief of allergy or cold symptoms.<\/p>\n

Nursing Considerations Across the Lifespan<\/strong><\/p>\n

This medication is not safe for children under the age of 2 years without a healthcare provider’s order.<\/p>\n

Adverse\/Side Effects<\/strong><\/p>\n

First-generation medications can cause anticholinergic effects (such as dry mouth, urinary retention, constipation and blurred vision). CNS depression or CNS stimulation with excessive doses can occur, especially in children. Therefore, first-generation antihistamines should be used with caution in the elderly.<\/p>\n

Second-generation medications may cause headache, nausea, vomiting, dysmenorrhea, and fatigue.[3]<\/sup><\/a><\/sup><\/p>\n

Patient Teaching & Education<\/strong><\/p>\n

Patients should be advised that antihistamines may cause drowsiness, and concurrent use of alcohol or other CNS depressants should be avoided.\u00a0 Patients should take only the recommended amount of medication and not to exceed dosing recommendations.\u00a0 Some patients may experience side effects such as dry mouth, and frequent oral hygiene may assist in alleviating discomfort.[4]<\/sup><\/a><\/sup><\/p>\n

Now let’s take a closer look at the medication grid for diphenhydramine and cetirizine in Table 5.6.[5]<\/sup><\/a>,<\/sup> [6]<\/sup><\/a>, [7]<\/sup><\/a> <\/sup>Medication grids are intended to assist students to learn key points about each medication class.\u00a0 Basic information related to a common generic medication in this class is outlined, including administration considerations, therapeutic effects, and side effects\/adverse effects.\u00a0 Prototype\/generic medication listed in the medication grid is also hyperlinked to a free resource from the U.S. National Library of Medicine called Daily Med<\/a>.\u00a0 Because information about medication is constantly changing, nurses should always consult evidence-based resources to review current recommendations before administering specific medication.<\/p>\n

Table 5.6 Diphenhydramine and Cetirizine Medication Grid<\/p>\n\n\n\n\n\n
\n
Class\/Subclass<\/strong><\/h5>\n<\/th>\n
\n
Prototype\/Generic<\/strong><\/h5>\n<\/th>\n
\n
Administration Considerations<\/strong><\/h5>\n<\/th>\n
\n
Therapeutic Effects<\/strong><\/h5>\n<\/th>\n
\n
Adverse\/Side Effects<\/strong><\/h5>\n<\/th>\n<\/tr>\n
First-generation antihistamine<\/th>\ndiphenhydramine<\/a><\/td>\nTake as directed<\/p>\n

Avoid allergens<\/p>\n

Avoid alcohol or CNS depressants due to sedation<\/td>\n

Temporarily relieves\u00a0 symptoms due to hay fever or other upper respiratory allergies: runny nose; sneezing; itchy, watery eyes; itching of the nose or throat<\/p>\n

Temporarily relieves symptoms due to the common cold such as runny nose and sneezing<\/td>\n

Sedation<\/p>\n

Anticholinergic effects<\/p>\n

Gastrointestinal: Nausea\/Vomiting<\/p>\n

Paradoxical effect: excitation in children<\/td>\n<\/tr>\n

Second-generation antihistamine<\/th>\ncetirizine<\/a><\/td>\nTake as directed<\/p>\n

Avoid allergens<\/p>\n

Avoid alcohol or CNS depressants due to sedation<\/td>\n

Temporarily relieves symptoms due to hay fever or other upper respiratory allergies: runny nose; sneezing; itchy, watery eyes; itching of the nose or throat<\/td>\nNon-sedating<\/p>\n

Anticholinergic effects<\/p>\n

Gastrointestinal: Nausea\/vomitting<\/p>\n

Paradoxical effect: excitation in children<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

  1. \"Benadryl Allergy USA<\/a>\" by ZenBenjamin<\/a> is licensed under CC BY-NC-SA 2.0<\/a> ↵<\/a><\/li>
  2. \"diphenhydramine (1)<\/a>\" by Intropin<\/a> is licensed under CC BY-NC 2.0 ↵<\/a><\/li>
  3. Frandsen, G. & Pennington, S. (2018). Abrams\u2019 clinical drug: Rationales for nursing practice <\/em>(11th ed.). Wolters Kluwer. ↵<\/a><\/li>
  4. uCentral from Unbound Medicine. https:\/\/www.unboundmedicine.com\/ucentral<\/a> ↵<\/a><\/li>
  5. This work is a derivative of Pharmacology Notes: Nursing Implications for Clinical Practice<\/a> by Gloria Velarde<\/a> licensed under CC BY-NC-SA 4.0<\/a>. ↵<\/a><\/li>
  6. Frandsen, G. & Pennington, S. (2018). Abrams\u2019 clinical drug: Rationales for nursing practice <\/em>(11th ed.). Wolters Kluwer. ↵<\/a><\/li>
  7. This work is a derivative of Daily Med<\/a> by U.S. National Library of Medicine<\/a> in the public domain<\/a>. ↵<\/a><\/li><\/ol><\/div>","protected":false},"author":2,"menu_order":6,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":"cc-by"},"chapter-type":[49],"contributor":[],"license":[53],"class_list":["post-215","chapter","type-chapter","status-publish","hentry","chapter-type-numberless","license-cc-by"],"part":195,"_links":{"self":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/215","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/users\/2"}],"version-history":[{"count":1,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/215\/revisions"}],"predecessor-version":[{"id":216,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/215\/revisions\/216"}],"part":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/parts\/195"}],"metadata":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/215\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/media?parent=215"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapter-type?post=215"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/contributor?post=215"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.publishdot.com\/nursingpharmacology\/wp-json\/wp\/v2\/license?post=215"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}