Antihistamines prostatic hypertrophy

The antihistamines are used cautiously in patients with bronchial asthma, cardiovascular disease, narrow-angle glaucoma, symptomatic prostatic hypertrophy, hypertension, impaired kidney function, peptic ulcer, urinary... 

Significant side effects have been estimated to occur in about 5% of patients on TCAs, most of these effects being attributed to their antimuscarinic properties, for example, blurred vision, dry mouth, tachycardia and disturbed gastrointestinal and urinary tract function. Orthostatic hypotension due to the block of alphai adrenoceptors and sedation resulting from antihistaminic activity frequently occur at therapeutic doses, particularly in the elderly. Excessive sweating is also a fairly common phenomenon, but its precise mechanism is uncertain. In the elderly patient, the precipitation of prostatic hypertrophy and glaucoma by the TCAs is also a frequent cause of concern. 

Q82 A patient with prostatic hypertrophy who has a chesty cough could be advised to use carbocisteine syrup. Carbocisteine syrup does not contain antihistamine drugs. 

Carbocisteine is a mucolytic agent that may be used in chesty cough. Antihistamines tend to have antimuscarinic properties, resulting in urinary retention and are therefore contraindicated in prostatic hypertrophy. 

First-generation antihistamines Flypersensitivity to specific or structurally related antihistamines newborns or premature infants nursing mothers monoamine oxidase (MAO) therapy pregnancy (hydroxyzine) angle-closure glaucoma, stenosing peptic ulcer, symptomatic prostatic hypertrophy, bladder neck obstruction, pyloroduodenal obstruction, elderly, debilitated patients (cyproheptadine). 

Antihistamines that produce sedation should not be used with alcohol or any other sedating drug, such as opioid analgesics. Antihistamines with strong anticholinergic effects should be avoided in patients with peptic ulcer disease, prostatic hypertrophy, or bladder or pyloro-duodenal obstruction and in patients who have the potential for acute angle-closure glaucoma. 

Both hyoscine and antihistamines should be avoided in patients suffering from glaucoma or prostatic hypertrophy, are not recommended for use by pregnant or breastfeeding women, and should be used with caution in the elderly and patients with epilepsy or cardiac or cardiovascular disease. 

Like other antihistamines, promethazine has signih-cant anticholinergic effects it should be used with caution in patients with narrow-angle glaucoma, peptic ulcer, or pyloroduodenal obstruction or urinary bladder obstruction from prostatic hypertrophy or narrowing of the bladder neck. It also should be used with caution in patients with CVD or hypertension because of the risk of palpitations with acute or chronic respiratory dysfunction (especially children) as promazine may depress the cough reflex. 

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