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Anti-histamines and Clinical Aspects of Non-Sedating Antihistamines

Doctor's details
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General Questions

  1. What percentage of the patients in your practice suffer from Allergic Rhinitis? *

  2. Amongst the patients visiting your clinic for Allergic Rhinitis, what percentage do you prescribe oral anti histamine? *

  3. Are you observing an increase in the prevalence of Allergic Rhinitis in the patients in your clinical practice? *

  4. Which generation of oral anti histamine (OAH) do you prefer while managing allergic rhinitis? *

  5. According to your experience, which generation OAH have more sedation property? *

  6. According to your experience, which all 2nd generation OAHs are truly non sedative? *
  7. Do you consider sedation caused by oral anti histamine as an important factor while choosing anti histamine? *

  8. Do you agree that some OAHs are associated with side effects such as somnolence and impaired learning/ memory? *

  9. Do you agree that sedation from OAH affects the quality of life of patients? *

  10. Which class of patients in your clinical practice are likely to complain more on sedation affecting their quality of life? *

  11. Which age group of patients in your clinical practice are likely to complain more on sedation affecting their quality of life? *

  12. Have you observed any gender predisposition amongst patients complaining of sedation due to OAH? *

  13. Do you feel that understanding daily routine of an individual plays a critical role in the choice of oral anti histamines? *

  14. Do you consider the professional requirements of an individual before choosing an oral anti histamine? *

  15. In your practice, how will you rate the sedation property of Levocetirizine? *

  16. In your practice, how will you rate the sedation property of Fexofenadine?*

  17. In your practice, how will you rate the sedation property of Bilastine? *

  18. In your practice, how will you rate the sedation property of Ebastine? *

  19. Do you select OAH based on histamine H1 receptor occupancy (H1RO) rate? *

  20. Do you agree that Bilastine & Fexofenadine are non-brain-penetrating antihistamines? *

  21. Do you agree that shortening of the sleep time, drowsiness and impaired performance are seen the next day with sedating oral anti histamines? *

  22. In your practice, do you prefer Bilastine & Fexofenadine or any second-generation oral anti histamine? *

  23. What all factors do you consider while choosing an oral anti histamine? *
  24. What are the common complaints you get from your patients who are on oral anti histamines which cause sedation?*
  25. What do you ask to a patient before making your choice of oral anti histamines? *
  26. How do you evaluate the CNS safety of an oral anti histamines? *
  27. Which oral anti histamines will you prefer when your patients complaining about sedation? *

    28. Pls click on the article & go through the below mentioned article & revert with your opinion

    https://www.mdpi.com/1422-0067/20/1/213
  28. Do you feel both the below mentioned parameters are equally important to understand the sedation property of an anti-histamine? *

    29. • Objective parameter: OAH’s H1 receptor occupancy in brain assessed on a PET scan

    • Subjective parameter: sleepiness assessed on a scale

  29. Increase in hydrophilicity of OAH’s reduces the brain penetration & thus sedation property? Do you observe the same in your practice? *

  30. As per the article, a new classification of antihistamines based on brain histamine H1 receptor occupancy has being devised. Are your experiences in clinical practice with the OHAs aligned with the sedative property ascribed to it in this new classification? *

  31. What is your opinion on the newer classification of OAH, based on brain histamine H1 receptor occupancy? *
  32. The article states that, “The half-life of H1 antihistamines in the brain can be longer than that in the plasma; therefore, caution is necessary”. *
    33. a. Have you observed sedation action lasting longer than anti-allergic action (symptom free duration)?

    b. Do you feel, patients should be made aware on the fact about this longer action of sedation and their effects?
  33. The article states that, “Sedating antihistamines affect the circadian sleep/wake cycle, delaying the occurrence of REM sleep or shortening the sleeping time.” *

    34. Did your patients on sedating anti histamines have complained the same?

  34. The article states that, “Bilastine has been shown not to affect psychomotor performance and driving performance even at the dose of 40 mg, which is twice the usual dose, by well-controlled studies using objective indices, and thus is considered to be a useful drug for allergic rhinitis. *
    35. a. Have you observed the same in your clinical practice, especially in patients associated with driving/machine operations?

    b. Do you feel, patients should be made aware of sedation properties if they are prescribed oral anti histamine?
  35. The article states that, “As for antihistamines used for the treatment of allergic rhinitis, drugs not only of “the second generation” but those that have been confirmed to be non-sedating should be recommended.” What is your opinion on the above statement? *
  36. The article states that, “Judging from efficacy results from clinical studies, pharmacological findings regarding non-sedating properties, and clinical study results, Bilastine may be one of the best options for H1 antihistamines for allergic rhinitis.” What is your opinion on these properties of Bilastine? *
  37. The article states that, “Communication between physicians and patients is important for the treatment of allergic rhinitis. Understanding of not only the symptoms but also the life pattern and degree of treatment satisfaction of the patients and their desire regarding economy/cost may also be necessary. When prescribing H1 antihistamines, physicians should confirm concomitantly used drugs if any, select non-sedating antihistamines with as few drug–drug interactions as possible, and explain the benefits and risks of the selected drug to the patients.” *
    38. a. Do you feel that detail discussion with patients suffering from allergic rhinitis on above mentioned points will help in better patient management?

    b. How can we further improve the degree of satisfaction of patients suffering from Allergic Rhinitis?