Pediatric Allergic Rhinitis: Antihistamine Selection Introduction
As the most common of mediated inflammation of the are not serious and do not endan-
Allergic Rhinitis and Children
19 years.5,8 As with adults, the im-pact of AR in children extends be-yond the immediate symptomsand has a profound effect on chil-dren’s QoL, the extent of which
Allergy/Asthma Associates, Mission Viejo, California.
the severity of disease.9 Trouble-some, repeated nose blowing, fa-
This paper was supported by an educational grant from Aventis Pharmaceuticals. Reprint requests and correspondence to: William E. Berger, MD, Allergy/Asthma Associates,
27800 Medical Center Road, 244 Mission Viejo, CA 92691.
2005 Westminster Publications, Inc., 708 Glen Cove Avenue, Glen Head, NY 11545, U.S.A. Older-Generation Antihistamines A n t i h i s t a m i n e s a n d A l l e r g i c R h i n i t i s
cost, availability, and advertisingplay a significant role in deter-
mining which antihistamine achild receives. MAXIMUM RECOMMENDED DAILY DOSES FOR AVAILABLE SECOND-GENERATION ANTIHISTAMINES FOR CHILDREN WITH SAR Newer-Generation Antihistamines
Loratadine rapidly disintegrating tablets
avoiding the adverse events (AEs)obser ved with older agents. Al-though these agents are credited
Cetirizine (Zyrtec®) tablets (5 mg, 10 mg)
Cetirizine (Zyrtec®) syrup (5 mL [2.5mg])
gous. Therefore, each agentshould be judged separately interms of relative efficacy and
60 mg (30 mg BID) (children 6–11 yrof age)
safety. To date, three oral newer-generation antihistamines areavailable for use in children in the
gra® [Aventis Pharm.], indicatedfor use in children aged 6 yearsand older), loratadine (Claritin®[Schering-Plough], 2 years orolder) and cetirizine (Zyrtec®
Clinical Efficacy and Safety of Newer- Generation Antihistamines in Children
rated ‘good’ or ‘excellent’ in 82%
A n t i h i s t a m i n e s a n d A l l e r g i c R h i n i t i sA n t i h i s t a m i n e s a n d A l l e r g i c R h i n i t i sConclusions
with trials of these antihistamines.
a fast onset of action is desirable.
gic rhinitis. J Allergy Clin Immunol.
rhinitis. In: ML B, ed. Epidemiology ofClinical Allergy. Monographs in Allergy.A n t i h i s t a m i n e s a n d A l l e r g i c R h i n i t i s
and its impact on asthma. J Allergy Clin
PB, et al., eds. The Pharmacological Ba-sis of Therapeutics. 9th ed. New York:
rhinitis. In: Allergy: Principles and Prac-
18. Jumbelic MI, Hanzlick R, Cohle S.
placebo-controlled study. Clin Pediatr.Pediatr Emerg Care. 2000;16:97-96.
trial) over 18 months. Pediatr Allergy
ment of rhinitis. Ann Allergy Asthma
30. Simons FE, Silas P, Portnoy JM, Port-
8. Fagin J, Friedman R, Fireman P. Aller-
Am J Emerg Med. 1990;8:321-322.
gic rhinitis. Pediatr Clin North Am.
21. Le Blaye I, Donatini B, Hall M, et al.
blind, placebo controlled study. J Al-
of present clinical experience. Druglergy Clin Immunol. 2003;111:1244-
J Allergy Clin Immunol. 2001;108(1
22. Lutsky BN, Klose P, Melon J, Krupp P.
sonal allergic rhinitis. Clin Ther.
tionnaires. J Allergy Clin Immunol.
placebo-controlled comparative study. Pediatrics. 2004;113:e116-e121.
and other side effects. Clin Exp Allergy.
learning. Ann Allergy. 1993;71:121-
years. Clin Ther. 2000;22(5):613-621.
the United States in 1990. Ann Allergy.
study. Pediatr Asthma Allergy Immunol.
gic rhinitis. J Allergy Clin Immunol.
children. In: Simons FER, ed: Hista-
25. Masi M, Candiani R, van de Venne H.
of fexofenadine in children. J Allergy
14. Settipane RA. Complications of aller-
Clin Immunol. 1996;98(6 Pt 1):1062-
gic rhinitis. Allergy Asthma Proc.
15. Casale TB, Blaiss MS, Gelfand E, et al.
tirizine for seasonal allergic rhinitis in
children aged 2–6 years. Pediatr Allergy
for seasonal allergic rhinitis. Ann Al-
lergic rhinitis. J Allergy Clin Immunol.lergy Asthma Immunol. 2001;87:22-26.
histamine for the 21st century. Clin
dence of its antiallergic activity. ClinExp Allergy. 1997;27(10):1160-1166.
jects with seasonal allergic rhinitis: ef-
pairment ratios. Hum PsychopharmacolAsthma Proc. 2003;24(2):95-105.
38. Wober W, Diez Crespo CD, Bahre M.
sure unit. J Allergy Clin Immunol.
46. Horak F, Stuber P, Zieglmayer R, Kav-
tice. BMJ. 2000;320:1184-1186.
years of age. Ar zneimittelforschung.
39. Azelastine Product Infor mation.
symptoms of seasonal allergic rhinitis.
47. Day JH, Briscoe MP, Welsh A. Onset of
40. Salib RJ, Howarth PH. Safety and tol-
erability profiles of intranasal antihist-
treatment of allergic rhinitis. J Am Os-
in the treatment of allergic rhinitis. teopath Assoc. 1999;99(7 Suppl): S7-
Drug Saf. 2003;26(12):863-893. Asthma Immunol. 1997;79:533-540.
Scott Levenson, M.D. GASTROENTEROLOGY AND HEPATOLOGY COLONOSCOPY Patient’s Procedure Location: Digestive Care Medical Center 1000A Laurel Street, San Carlos, CA (650) 596-8118 Date and Time of Procedure: Arrival Time: Purpose of Procedure: To evaluate the colon with a flexible instrument. Preparation: Obtain the prescribed 4 liter bottle
CURRICULUM VITAE Name: Sweden Educational History: Jan 1985 "On the Neuropharmacology of Conflict Behaviour - studies on noradrenergic, serotonergic and GABAergic mechanisms in experimental anxiety in the rat". Supervisor: Professor Jörgen A Engel By the Swedish government authorized to practice medicine Research Assistant at the Swedish Medical Research Council, with workin