Updated: 10/24/2018

H1 Blockers

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Questions
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Evidence
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Topic
Overview
  • Mechanism
    • reversible inhibition of H1 histamine receptors
1st generation
  • Drugs
    • diphenhydramine (Benadryl)
    • dimenhydrinate (Dramamine)
    • chlorpheniramine
    • hydroxyzine
    • promethazine
      • abused as a recreational drug ("purple drank" or "sizzurp")
  • Clinical uses
    • allergy
    • motion sickness 
    • sleep aid
  • Toxicity
    • antimuscarinic
    • anti-α-adrenergic
    • sedation (lipophilic and thus crosses brain barrier)
2nd generation
  • Drugs
    • loratadine (Claritin)
    • fexofenadine (Allegra)
    • cetirizine (Zyrtec)
    • desloratadine
  • Clinical uses
    • allergy
  • Toxicity
    • decreased entry into CNS (lipophobic) makes this generation far less sedating  
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(M1.PL.14.1) A 3-year-old girl swallowed a handful of pills after her grandmother dropped the bottle on the ground this afternoon. She presents to the ER in a very drowsy but agitated state. She is clutching her abdomen, as if in pain, her skin is dry and flushed, and she does not know her name or where she is. Her pupils are dilated. Her grandmother reports that she has not urinated in several hours. The grandmother's medical history is significant for allergic rhinitis and osteoarthritis, both of which are treated with over the counter medications. What is the appropriate treatment for this child? Tested Concept

QID: 105611
1

Atropine

12%

(7/58)

2

N-acetylcysteine

29%

(17/58)

3

Naloxone

7%

(4/58)

4

Physostigmine

41%

(24/58)

5

Deferoxamine

2%

(1/58)

M 3 D

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Evidence (1)
Topic COMMENTS (7)
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