Symptomatic relief of allergic symptoms caused by histamine release or symptoms associated with the common cold. Most useful in management of nasal allergies and allergic dermatoses. Available only in combination with a decongestant.
Antagonizes the effects of histamine at peripheral histamine-1 (H1) receptors, including pruritus and urticaria. Also has a drying effect on the nasal mucosa. Therapeutic Effects: Relief of symptoms associated with histamine excess usually seen in allergic conditions or with the common cold.
Adverse Reactions/Side Effects
CNS: sedation, dizziness, excitation (higher in children). EENT: blurred vision. CV: arrhythmias, hypertension, hypotension, palpitations. GI: dry mouth, constipation. GU: urinary hesitancy, urinary retention.
PHYSICAL THERAPY IMPLICATIONS
Examination and Evaluation
Assess blood pressure (BP) and compare to normal values (See Appendix F). Report changes in BP, either a sustained increase in BP (hypertension) or a problematic decrease in BP (hypotension) that results in dizziness and syncope.
Assess heart rate, ECG, and heart sounds, especially during exercise (See Appendices G, H). Report any rhythm disturbances or symptoms of increased arrhythmias, including palpitations, chest discomfort, shortness of breath, fainting, and fatigue/weakness.
Monitor symptoms of nasal allergies (sneezing, rhinitis, itching eyes, cough) or allergic skin reactions (rash, hives, itching) to help document benefits of this drug in treating these disorders.
Assess dizziness and drowsiness that might affect gait, balance, and other functional activities (See Appendix C). Report balance problems and functional limitations to the physician, and caution the patient and family/caregivers to guard against falls and trauma.
Monitor signs of increased excitation, especially in children. Severe or problematic excitation may require a change in dose or drug.
Guard against falls and trauma (hip fractures, head injury, and so forth). Implement fall- prevention strategies, especially in older adults or if balance is impaired (See Appendix E).
Because of an increased risk of arrhythmias and abnormal BP responses, use caution during aerobic exercise and other forms of therapeutic exercise. Assess exercise tolerance frequently (BP, heart rate, fatigue levels), and terminate exercise immediately if any untoward responses occur (See Appendix L).
Advise patient about the risk of daytime drowsiness and decreased attention and mental focus. These problems can be severe in certain people. Use care if driving or in other activities that require quick reactions and strong concentration.
Advise patient to avoid alcohol and other CNS depressants because of the increased risk of sedation and adverse effects.
Instruct patient to report other troublesome side effects such as severe or prolonged constipation, dry mouth, blurred vision, or problems with urination (hesitancy, retention).