Preparation for Child Psych PRITE and Boards
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* Second-generation antihistamines do not cross the blood-brain barrier, and thus are less sedating. | * Second-generation antihistamines do not cross the blood-brain barrier, and thus are less sedating. | ||
| − | ==Diphenhydramine (Benadryl)== | + | ==Diphenhydramine (Benadryl) == |
* Benadryl is a first-generation antihistamine; in addition to blocking H-1 receptors, it is a potent anti-cholinergic drug and therefore can be used to mitigate extrapyramidal effects of antipsychotics, and has a role in treatment of Parkinson's disease. As noted above, it crosses the blood-brain barrier, and thus quite sedating | * Benadryl is a first-generation antihistamine; in addition to blocking H-1 receptors, it is a potent anti-cholinergic drug and therefore can be used to mitigate extrapyramidal effects of antipsychotics, and has a role in treatment of Parkinson's disease. As noted above, it crosses the blood-brain barrier, and thus quite sedating | ||
** Its use is generally avoided in the elderly due to significant sedation (risk of falls) and potential for '''anti-cholinergic toxicity''' (dry mouth, tachycardia, urinary retention, and delirium) | ** Its use is generally avoided in the elderly due to significant sedation (risk of falls) and potential for '''anti-cholinergic toxicity''' (dry mouth, tachycardia, urinary retention, and delirium) | ||
| − | * Benadryl is frequently used in inpatient child psychiatry as a PRN medication for it's sedating properties | + | * Benadryl is frequently used in inpatient '''child psychiatry''' as a PRN medication for it's sedating properties. |
| + | * Benadryl is generally safe in pregnancy (Category B), but is excreted in breast milk. | ||
| + | * It can prolong QTc in large doses or in combination with other QTc-prolonging medications. | ||
| + | |||
| + | ==Hydroxyzine (Vistaril, Atarax) | ||
| + | |||
| + | [[Category: Medications]] | ||
Revision as of 15:08, 25 April 2015
Introduction
All medications designated as antihistamines are strong antagonists or inverse agonist at the peripheral and central histamine receptors.
- Blockade or the inverse agonism of the peripheral H-1 receptor alleviates allergy symtpoms.
- Blockade or inverse agonism of the central H-1 receptor increases sedation.
- Second-generation antihistamines do not cross the blood-brain barrier, and thus are less sedating.
Diphenhydramine (Benadryl)
- Benadryl is a first-generation antihistamine; in addition to blocking H-1 receptors, it is a potent anti-cholinergic drug and therefore can be used to mitigate extrapyramidal effects of antipsychotics, and has a role in treatment of Parkinson's disease. As noted above, it crosses the blood-brain barrier, and thus quite sedating
- Its use is generally avoided in the elderly due to significant sedation (risk of falls) and potential for anti-cholinergic toxicity (dry mouth, tachycardia, urinary retention, and delirium)
- Benadryl is frequently used in inpatient child psychiatry as a PRN medication for it's sedating properties.
- Benadryl is generally safe in pregnancy (Category B), but is excreted in breast milk.
- It can prolong QTc in large doses or in combination with other QTc-prolonging medications.
==Hydroxyzine (Vistaril, Atarax)