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Histamine and antihistamines in anaphylaxis
Stephen L Winbery1, Philip L Lieberman
1University of Tennessee College of Medicine, Memphis, Tennessee, USA.
Clinical Allergy and Immunology
|July 13, 2002
Summary
Antihistamines are crucial for managing anaphylaxis and anaphylactoid reactions, offering adjunctive treatment and prophylaxis. Newer agents show promise for broader application in acute and preventive care.
Area of Science:
- Allergy and Immunology
- Pharmacology
Background:
- Anaphylaxis and anaphylactoid reactions are potentially fatal, often iatrogenic, and increasing with medical advancements.
- Non-IgE-mediated anaphylactoid reactions are common, clinically similar to anaphylaxis, and may be missed with strict diagnostic criteria.
- Histamine is a key mediator, and its cascade can be modulated by antihistamines.
Purpose of the Study:
- To evaluate the role of antihistamines in the treatment and prevention of anaphylaxis and anaphylactoid reactions.
- To explore the potential of newer antihistamines in managing these hypersensitivity disorders.
Main Methods:
- Review of histamine's role as a mediator in anaphylaxis.
- Analysis of H1-antihistamines as adjunctive therapy and in prophylaxis.
- Consideration of H2-antagonists in combination therapy.
Main Results:
- H1-antihistamines are important adjunctive treatments and prophylactic agents for anaphylaxis and anaphylactoid reactions.
- Newer antihistamines, with fewer side effects, allow higher doses for more complete histamine receptor blockade.
- Combining H1- and H2-antagonists may offer favorable outcomes in prophylaxis.
Conclusions:
- Antihistamines are vital components in managing anaphylaxis and anaphylactoid reactions, both acutely and preventively.
- The development of newer antihistamines warrants reevaluation of their therapeutic and prophylactic utility.
- Limitations exist, particularly the lack of parenteral second-generation H1-antihistamines for acute management.