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At least 73 records · Page 4Linked to original sources
PubMed1998

Effects of premedication on dose requirements for propofol: comparison of clonidine and hydroxyzine.

The influence of a single dose of clonidine (5 micrograms kg-1) or hydroxyzine (1 mg kg-1) on intraoperative propofol requirements was determined in 28 male patients (ASA I) undergoing elective orthopaedic surgery. Patients were randomly allocated to receive either clonidine or hydroxyzine orally 2 h before induction of anaesthesia. After a loading dose of propofol (2.5 mg kg-1), mivacurium (0.2 mg kg-1) and alfentanil (15 micrograms kg-1), anaesthesia was maintained with a standardized propofol infusion supplemented with nitrous oxide (66%) in oxygen. During surgery, additional propofol boluses (1 mg kg-1) were administered when heart rate or mean arterial pressure increased by more than 10% compared with preinduction values. The clonidine group demonstrated a 14.5% decrease in total propofol requirements (P < 0.05) and a 52.2% reduction in additional propofol boluses (P < 0.02) in comparison with the hydroxyzine group. intraoperative heart rate and mean arterial pressure were significantly lower in the clonidine group but no patients needed treatment with ephedrine for hypotension or bradycardia. Recovery of psychomotor function and discharge from the recovery room were not delayed in the clonidine group. This study indicates that 5 micrograms kg-1 clonidine given as premedication in ASA I patients reduces intraoperative propofol requirements in comparison with 1 mg kg-1 hydroxyzine without inducing adverse effects on recovery or haemodynamic stability.

Adolescent↗
PubMed2001

Effect of hydroxyzine on the transport of etoposide in rat small intestine.

Etoposide, an anti-neoplastic agent and a substrate of P-glycoprotein (P-gp), exhibits variable oral bioavailability. P-gp, the multidrug resistance gene (mdr1) product, has been considered as an absorption barrier against intestinal drug absorption. Terfenadine, an antihistamine, has been shown to be a P-gp inhibitor. The current study was designed to assess the effect of hydroxyzine, an antihistamine, on the transport of etoposide in the small intestine. Everted rat gut sacs were used to determine the absorption and exsorption of etoposide under different conditions, as rhodamine 123 was chosen to evaluate the role of P-gp in the drug interaction. The results showed that the transport of etoposide was significantly increased from the luminal site to the serosal site in the jejunum by 2- and 4-fold after 90 min in the presence of hydroxyzine and quinidine, respectively. A similar trend was observed in the ileal sacs. This in vitro exsorption study also demonstrated that hydroxyzine could reduce the efflux of etoposide to the luminal site in either jejunum or ileum. The effect of hydroxyzine on the pharmacokinetics of etoposide differed by the in vivo route of administration, thus assuming clinical importance for chemotherapeutic treatment.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed2003

A pilot clinical trial of oral pentosan polysulfate and oral hydroxyzine in patients with interstitial cystitis.

PURPOSE: This pilot study was designed to evaluate the feasibility of a multicenter, randomized, clinical trial in interstitial cystitis (IC). Secondary objectives were to evaluate the safety and efficacy of oral pentosan polysulfate sodium (PPS), hydroxyzine, and the combination to consider their use in a larger randomized clinical trial. MATERIALS AND METHODS: A 2 x 2 factorial study design was used to evaluate PPS and hydroxyzine. Participants met the National Institutes of Health-National Institute for Diabetes and Digestive and Kidney Diseases criteria for IC and reported at least moderate pain and frequency for a minimum of 6 months before study entry. The primary end point was a patient reported global response assessment. Secondary end points included validated symptom indexes and patient reports of pain, urgency and frequency. The target sample size was 136 participants recruited during 10 months. RESULTS: A total of 121 (89% of goal) participants were randomized over 18 months and 79% provided complete followup data. The response rate for hydroxyzine was 31% for those treated and 20% for those not treated (p = 0.26). A nonsignificant trend was seen in the PPS treatment groups (34%) as compared to no PPS (18%, p = 0.064). There were no treatment differences for any of the secondary end points. Adverse events were mostly minor and similar to those in previous reports. CONCLUSIONS: The low global response rates for PPS and hydroxyzine suggest that neither provided benefit for the majority of patients with IC. This trial demonstrated the feasibility of conducting a multicenter randomized clinical trial in IC using uniform procedures and outcomes. However, slow recruitment underscored the difficulties of evaluating commonly available IC drugs.

Adult↗
PubMed1998

Recent clinical trials of hydroxyzine in generalized anxiety disorder.

Numerous clinical trials in the 1960s and 1970s have attested to the anxiolytic efficacy of hydroxyzine and its beneficial effect on sleep, as well as in reducing stress and anxiety associated with coronary disease. Experience with hydroxyzine has also shown a lack of organ toxicity and an absence of dependency. Recent controlled clinical trials with hydroxyzine have confirmed its efficacy (at a fixed dose of 50 mg) in generalized anxiety disorder--superiority over placebo on all anxiety measures from the first week with early target symptoms which are grouped in a cognitive component of anxiety. Efficacy was maintained throughout the 4 weeks of treatment and after abrupt discontinuation. In another controlled trial vs. lorazepam, hydroxyzine demonstrated greater and more rapid cognitive improvement.

Anti-Anxiety Agents↗
PubMed1997

Skin reactions to hydroxyzine.

Sensitivity to histamine H1-antagonists has mainly been observed with phenothiazine and ethylenediamine, and is very rare with hydroxyzine. We report 3 cases of sensitization to hydroxyzine, which was prescribed to treat urticaria and atopic dermatitis. A generalized maculopapular eruption appeared shortly after taking the drug. Patch tests with Atarax tablet were positive +3, and +2 or +3 with different dilutions of hydroxyzine. Patch tests with ethylenediamine, piperazine and other antihistamines were negative; therefore, there is no cross-allergy. We believe these rapid systemic reactions to hydroxyzine after the initial dose may have been due to prior systemic sensitivity to this drug, which cannot be used topically. Allergy to antihistamines must be considered when cutaneous lesions worsen on such therapy.

Adult↗
PubMed1992

Comparative randomized double-blind study of hydroxyzine versus placebo as premedication before injection of iodinated contrast media.

The use of ionic contrast media in radiologic examinations may cause a wide variety of anaphylactoid reactions. The aim of this double-blind randomized study was to determine whether a simple and inexpensive premedication based on an antihistamine could reduce the number of idiosyncratic reactions in 400 patients (251 men and 149 women) without a clinical history of allergy who were to receive an intravenous injection of a low-osmolality iodinated contrast medium. Twelve hours before examination, a group of 200 patients was given one 100-mg tablet of hydroxyzine; another group of 200 was given a placebo tablet under the same conditions. Results in the two groups were comparable at the .05 level of significance. Twenty-five patients in the placebo group had a reaction (mainly urticaria); only two patients in the hydroxyzine group had a reaction (P less than .0001; odds ratio, 14.1). No severe reaction occurred in either group. Because hydroxyzine and placebo were allocated at random, it is concluded that hydroxyzine reduces the frequency of minor anaphylactoid reactions in patients at low risk.

Aged↗
PubMedDate not supplied

A comparison of the electroencephalographic spectral modifications induced by diazepam and by hydroxyzine.

A double-blind, randomized controlled trial using an electroencephalograph computerized analysis and cartography was carried out to investigate the spectral modifications induced by diazepam and hydroxyzine. Without monitoring response to stimulation, the spectra found for diazepam and for hydroxyzine were qualitatively very similar, showing increase of the slow waves, reduction of the alpha rhythm and accentuation of the beta 1 rhythms. These traces suggested strongly that both drugs had produced a sedative, anti-anxiety effect. The intensity of the effect produced by 50 mg of hydroxyzine appeared to be less than that produced by 10 mg diazepam. After monitoring response to stimulation, the spectra were modified and the reactivity of the two drugs differed with regard to the slow delta, theta and alpha 1 frequency bands. It was possible to distinguish between the sedative and anti-anxiety effects of both diazepam and hydroxyzine. Even if the two drugs had some similar effects, the mode of action in the central nervous system was certainly different, as can be seen from the characteristics of distribution of the slow waves, their reactivity and, with regard to frequency, the fluctuation of the dominant frequency of rapid rhythms.

Adult↗
PubMedDate not supplied

A pilot, open label, clinical trial using hydroxyzine in multiple sclerosis.

Multiple sclerosis (MS) is an autoimmune disorder of myelin destruction. Blood-brain-barrier (BBB) disruption precedes pathological or clinical findings and could involve mediators from perivascular brain mast cells, such as histamine and vascular endothelial growth factor (VEGF). Mast cells could be activated by many triggers, including acute stress that has been correlated with MS exacerbations. We considered that the histamine-1 (H1) receptor antagonist hydroxyzine, which also partially inhibits brain mast cells and has anxiolytic properties, may reduce MS symptoms. This open label, pilot, clinical trial investigated the effect on MS of an oral solution of hydroxyzine (100 mg per day), together with caffeine (200 mg per day) to reduce sedation. Twenty patients (8 males; 12 females) with relapsing-remitting or relapsing-progressive MS completed the study (12 +/- 1 months) and were evaluated using disability scales. Most patients on hydroxyzine (75%) remained stable or improved neurologically and all but one showed improved mood. Hydroxyzine could be used as an adjuvant in MS, but the small number of patients enrolled and the short duration of the study precludes any definitive conclusions. A double-blind, placebo-controlled study is warranted.

Adolescent↗
PubMed1990

Potentiation of pain relief with hydroxyzine: a therapeutic myth?

Opioid analgesics are among the oldest known medications. In spite of long usage, clinical success in controlling pain in many settings appears to be limited by a lack of understanding of the clinical pharmacology of these agents. Efforts to achieve better outcomes often focus on the use of adjunctive agents, such as hydroxyzine, in an attempt to control postoperative pain with a minimum of toxicity. Although such combined therapies are exceedingly common, clinical data supporting a hypothesis of an "opioid-sparing" effect of hydroxyzine are marked by serious methodologic flaws, including lack of placebo control, lack of statistical analyses, and use of subjective assessments, all of which compromise the validity of such conclusions. In doses that may contribute to pain relief, hydroxyzine demonstrates a significant potential for causing respiratory depression which is additive to that of opioids, but not reversible with naloxone. In total, the data do not confirm the purported clinical benefits of hydroxyzine-opioid combinations in comparison with appropriate regimens of opioids alone.

Drug Synergism↗
PubMed1997

Fixed drug eruption of the penis due to hydroxyzine hydrochloride.

OBJECTIVE: To report four cases of fixed drug eruption induced by hydroxyzine hydrochloride (Otarex, Teva, Israel). CASE SUMMARY: Four children with restlessness who were treated with hydroxyzine hydrochloride developed fixed drug eruption of the penis. Drug discontinuation was followed by complete resolution of the skin eruption. Rechallenge resulted in the same drug rash. Macrophage migration inhibiting factor (MIF) assay with hydroxyzine hydrochloride was positive. DISCUSSION: The pathogenesis of fixed drug eruption and the role of macrophage MIF assay in diagnosis is discussed. CONCLUSIONS: A fixed drug eruption induced by hydroxyzine hydrochloride is possible, but is a rare phenomenon.

Animals↗
PubMed2000

[A case of acute urticaria from hydroxyzine hydrochloride used for preanesthetic medication].

We report a case of acute urticaria probably caused by hydroxyzine hydrochloride. A 66-year-old male was scheduled for cardiac cystectomy by thoracic endoscopy. The patient was premedicated with atropine and hydroxyzine intramuscularly 30 min before arrival in the operating room. Abrupt general exanthema was observed when intravenous infusion was started. Although his general condition was stable, the operation was postponed. Three days later, the skin test was performed using several drugs. Only hydroxyzine hydrochloride gave positive result. It is assumed that hydroxyzine hydrochloride may have caused his urticaria.

Acute Disease↗
PubMed1992

Simulated assembly line performance following ingestion of cetirizine or hydroxyzine.

Twelve healthy subjects participated in three daytime work periods, in a double-blind repeated measures Latin square design. Subjects received cetirizine (10 mg), hydroxyzine (25 mg), or placebo at 0800. Performance was measured each day during eight 50-minute test periods on a simulated assembly line task between 0830 and 1700. Before entry into the study, subjects were trained to a minimum 80% correction rate on the performance task. Performance decrements were consistently associated with hydroxyzine but not with cetirizine. Subjects made fewer correct responses with hydroxyzine compared with both cetirizine and placebo. Subjectively, participants reported feeling sleepier and performing worse during the hydroxyzine condition than following placebo. Cetirizine, however, did not differ from the other two conditions on self-assessments of alertness or performance. These findings support the hypothesis that objective measures of human functioning are more specific than are subjective measures.

Adult↗
PubMedDate not supplied

Evaluation of the effect of nitrous oxide and hydroxyzine in controlling the behavior of the pediatric dental patient.

This study evaluated and compared the effect of three different sedation combinations on the young dental patient: hydroxyzine alone, hydroxyzine with nitrous oxide, and nitrous oxide alone. Nineteen uncooperative children with mean age of 37 months needing at least three restorative visits were selected for this study. Crying, alertness, and general behavior were evaluated during the dental procedure. The combination of hydroxyzine and nitrous oxide was more effective than the others for the majority of the sessions in terms of controlling crying and alertness. The results in the present study indicate that the sedative effect of hydroxyzine on children's behavior is enhanced by the addition of nitrous oxide.

Analysis of Variance↗
PubMed1980

Effect of hydroxyzine on morphine analgesia for the treatment of postoperative pain.

In a double-blind, single-dose study hydroxyzine combined with morphine was administered intramuscularly to postoperative patients to determine the efficacy of this combination in the relief of postoperative pain, and to compare its effect to that produced by morphine alone. Eighty-two patients received morphine (5 or 10 mg) with or without hydroxyzine (100 mg). Analgesia was measured by a method quantifying the subjective responses of patients when questioned about pain. Analgesia obtained when 10 mg of morphine was combined with 100 mg of hydroxyzine was significantly superior to that obtained with morphine alone. Drowsiness was significantly more frequent when 10 mg of morphine was combined with 100 mg of hydroxyzine than with morphine alone.

Adolescent↗
PubMed1981

Antiemetic effectiveness of intramuscular hydroxyzine compared with intramuscular droperidol.

In a double-blind randomized study 150 outpatients receivng the same anesthetic for first trimester therapeutic abortions were equally divided into three groups: control; droperidol, 2.5 mg IM; or hydroxyzine, 100 mg IM. The injection was given immediately after thiamylal (Surital) induction of anesthesia, and the incidence of nausea, retching, or vomiting (NRV) was recorded at 15-minute intervals for 3 hours after surgery. NRV occurred in 56% of control patients, in 44% of patients given droperidol, and in 10% of patients given hydroxyzine. The patients receiving hydroxyzine and droperidol were more sedated and experienced a delay in return of hand-eye coordination as measured by the time for the Trieger motor test to reach preoperative levels. All patients equaled their preoperative performance during the 3rd hour after surgery and were discharged 4 hours following general anesthesia. We conclude that intramuscular hydroxyzine hydrochloride, 100 mg, is a significantly better antiemetic than intramuscular droperidol, 2.5 mg.

Abortion, Induced↗
PubMedDate not supplied

Intranasal midazolam better at effecting amnesia after sedation than oral hydroxyzine: a pilot study.

Providing amnesia about a surgery is a desired side effect of a medication. This study compares anterograde amnesic effects of midazolam with hydroxyzine in children undergoing dental treatment with those drugs plus nitrous oxide, using a recall test. Thirty ASAI children 24-28 months, were shown a Standard-Binet intelligence scale-memory for objects subtest before entering treatment room. Twenty-lone randomly determined children received 3.7 mg/kg hydroxyzine 45 min before treatment or 0.2 mg/kg intranasal midazolam in two succeeding appointments, alternatively. Recall in the 30-subject treatment group was 90%. Recall in the 21-subject treatment group was 71% for hydroxyzine and 29% for midazolam. Midazolam was more effective in creating amnesia than hydroxyzine in this study.

Administration, Intranasal↗
PubMed1996

Hydroxyzine premedication--does it provide better anxiolysis than a placebo?

OBJECTIVES: To determine how effective hydroxyzine is compared with a placebo in providing pre-operative anxiolysis in our hospital population, and to assess the anxiolytic effect of our pre-operative visit. DESIGN: Double-blind, randomised, prospective, controlled trial. Anxiety levels assessed with visual analogue scales (VAS), by patient and investigator. Haemodynamic parameters measured: heart rate, blood pressure, respiratory rate. SETTING: Hillbrow Hospital, Johannesburg. PARTICIPANTS: Sixty female patients aged 20-60 years, American Society of Anesthesiologists status I-III, scheduled for elective gynaecological surgery under general anaesthesia. The overall participation rate was 100%. All cases were randomly selected. INTERVENTION: Hydroxyzine (Aterax) 1-2 mg/kg, or a placebo administered orally as anaesthetic premedication. OUTCOME MEASURES: Anxiolytic effect of agents and of pre-operative visit. Time interval between premedication and induction of anaesthesia. Blood pressure, heart rate, respiratory rate, other signs of autonomic hyperactivity (restlessness, tremors, sweating). RESULTS: A statistically significant reduction in anxiety followed the administration of hydroxyzine (P < 0.05) and the placebo (P < 0.03); however, no statistically or clinically significant difference could be demonstrated between the two agents. No significant anxiolysis occurred following the premedication visit. The average premedication-induction interval was 72 minutes. There were no significant differences in haemodynamic parameters between the two groups. CONCLUSIONS: Hydroxyzine, in the dose administered and after an appropriate premedication-induction interval, provided no better anxiolysis than a placebo in the pre-operative period. No significant anxiolytic effect was demonstrated by our routine premedication visit.

Administration, Oral↗
PubMedDate not supplied

Conscious sedation of pediatric dental patients using chloral hydrate, hydroxyzine, and nitrous oxide--a retrospective study of 382 sedations.

This retrospective study assessed the effectiveness and safety of chloral hydrate (55 mg/kg), hydroxyzine (1 mg/kg), and nitrous oxide in the sedation of 336 uncooperative pediatric dental patients over 382 sedation sessions, and identified variables associated with effectiveness including: sex, weight, age, and preoperative behavior of the patient; route and combinations of the sedative drugs; and sex of the operating and monitoring dentists. The operating and monitoring dentists rated the sedation session as either effective or ineffective and also as either heavy, moderate, light or poor. The mean age of the children was 2.6 years and mean weight was 14.1 kg. Seventy-four percent of the sedation sessions were deemed effective. Boys had more effective sessions (80.6%) than girls (65.1%) (P = 0.001). Also, the percentage of sedations rated as effective increased as the preoperative behavior was more positively rated (P = 0.001). Oral regimen of chloral hydrate alone or in combination with oral hydroxyzine was more effective (75.5%) than rectal administration of chloral hydrate alone (65.7%) (P = 0.09). There was no significant difference in effectiveness when chloral hydrate was administered orally alone or in combination with oral hydroxyzine. Sedation sessions rated effective had longer operative times, included more sextants of treatment, were more likely to include restorative treatment, and were less likely to include extractions than the ineffective sedations. Vomiting was the only complication reported, occurring in 8.1% of the sedations. Vomiting did not vary significantly with either route of administration or inclusion of hydroxyzine in the oral regimen. Pulse rates were significantly higher for children in the ineffective sedation sessions. This sedative drug regimen was deemed safe and effective for treating young and uncooperative pediatric dental patients.

Administration, Oral↗