The role of the 3 generations of antihistamines in treating allergies

Abstract

Introduction: Recent statistical data show a constantly increasing incidence of allergic disorders emphasizing the role of the development of new anti-allergic medication in the treatment of different allergies. HI-antihistamines (H1A) represent the class of anti-allergies most used by physicians in handling the immediate-type of hypersensitivity reactions. Currently, there are 3 generations of HI-antihistamines, classified according to their selectivity and sedative properties. Purpose and Objectives: The study was designed to find the prevalence of HI-antihistamines among other administered anti-allergic drugs and to determine the particularities of their use. Materials and Methods: We collected data from 53 medical records inscribed in the department of Allergology from Republican Clinical Hospital of Republic of Moldova, in November - December, 2013.There were patients diagnosed with various immediate-type allergic reactions, such as : Quincke’s edema, allergic dermatitis, acute and chronic urticaria, drug allergy and Stevens-Johnson syndrome. The information about the antihistamine drugs prescribed, length and route of administration in stationary versus further ambulatory periods was analyzed. Results: We found that 28 patients out of 53 (52,83%) were prescribed antihistamines stationary and 20 out of 53(37,73%) - ambulatory. The drugs used stationary were: chloropyramine and promethazine - both first (classical) generation HI A, administered in all patients(100%), intravenous, for an average of 7-8 days. The drugs used ambulatory were as following : clemastine (first generation HI A) - in 1 patient (1,88 %), intravenous for 5 days; bilastine (second generation HI A) - in 8 patients (15,1 %), orally for 1 month; levocetirizine and desloratadine (third generation HI A) - in 11 patients (20,75 %), orally for 1-2 months. Conclusion: The role of classical HI-antihistamines in clinical practice remains still high. Second and third generations of HI A are more preferred in further ambulatory anti-allergic treatment, partly due to the absence of the sedative effect of the classical HI A, important for people who need increased attention in practicing their professions, and partly due to their prolonged time of action.