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At least 109 records · Page 6Linked to original sources

Coma and apnea in a dog with hydroxyzine toxicosis.

Hydroxyzine is a commonly prescribed H1-receptor antagonist in small animal practice. The most common adverse effect reported after therapeutic dosing is mild sedation; severe reactions resulting in coma have occasionally been reported in children. We present a case of large po hydroxyzine exposure causing in coma and apnea in a dog. Exposure was confirmed with gas chromatography/mass spectrometry analysis of urine. Extensive therapeutic measures to enhance drug elimination and assist ventilation were required for 11 d. The positive outcome justifies critical care of similarly exposed animals. Veterinarians should be aware of the potential for coma and apnea secondary to hydroxyzine exposure.

Animals↗

[Effects of hydroxyzine on attention and memory in elderly subjects].

A single intake of hydroxyzine 25 mg was compared to placebo, and lorazepam 1 mg as a verum, in a double-blind, triple-crossover trial. Each of the 12 elderly volunteers was tested on three different days, once under each condition. At 2.5 hours after drug intake they were assessed or reassessed for attention, immediate and delayed (30') memory, cognitive ability and feelings of anxiety and fatigue. Some subjects mentioned a minimal sedation under hydroxyzine 25 mg and under lorazepam 1 mg, but only hydroxyzine preserved memory and attention, while lorazepam caused clear deficiencies in memory recall.

Aged↗

Relative efficacy and safety of loratadine, hydroxyzine, and placebo in chronic idiopathic urticaria.

The efficacy and safety of a new non-sedating antihistamine, loratadine (Clarityn, CAS 79794-75-5) 10 mg q.d., was compared to the classical antihistamine, hydroxyzine 25 mg t.i.d. and placebo in a 4-week (optional 12 week) randomized, double-blind, multi-center study in 203 patients with chronic idiopathic urticaria. Efficacy evaluations included weekly physician and patient assessments of pruritus, overall disease condition, and therapeutic response to treatment. Loratadine and hydroxyzine were significantly more effective than placebo and clinically comparable to each other as measured by all efficacy evaluations at each visit. Loratadine was safe and well tolerated with sedation and dry mouth similar to placebo and significantly less than hydroxyzine.

Adolescent↗

Comparison of oral midazolam with and without hydroxyzine in the sedation of pediatric dental patients.

PURPOSE: The purpose of this study was to compare the effectiveness of midazolam (MDZ) alone to a combination of MDZ and hydroxyzine (MDZH) when sedating young children for dental treatment. METHODS: This was a prospective, double-blinded, crossover clinical study of young uncooperative children in need of at least 2 restorative visits. Twenty-eight children, ages 21 to 56 months, with a mean age of 36.6 months, participated in this study. The subjects were assigned randomly to receive either 0.5 mg/kg of oral MDZ 20 minutes prior to the beginning of dental treatment or the combination of 0.3 mg/kg oral MDZ with 3.7 mg/kg of hydroxyzine 30 minutes before treatment. The alternative drug regimen was administered at the second appointment. All subjects also received 50% nitrous oxide and were restrained with a papoose board. The child's behavior (quiet or crying, relaxed or moving) was evaluated every 5 minutes by an experienced pediatric dentist who was unaware of the drug given to the child. At the conclusion of treatment, each session was evaluated for overall effectiveness. RESULTS: Regardless of the type of premedication, more patients exhibited quiet behavior at the beginning of treatment, with an increase in crying and movement toward the end of treatment. Regarding movement, a significant difference was observed during the first 20 minutes between the 2 regimens. MDZ showed more children exhibiting movement. During the first 30 minutes of treatment, more children cried in the MDZ group, while MDZH presented more children asleep or quiet. No significant differences were found in behavior as a function of the order the sedative regimens were given. No significant differences between the 2 regimens regarding overall behavior and success (t=0.655 at 27 degrees of freedom; P=.518) were found. CONCLUSIONS: The combination of hydroxyzine (3.7 mg/kg) with MDZ (0.3 mg/kg) administered 30 minutes before treatment resulted in safe and effective sedation for the dental treatment of young children. This combination's use might be more advantageous when compared to MDZ alone, resulting in less crying and movement during the first 30 and 20 minutes, respectively.

Administration, Oral↗

Epidural morphine pruritus reduction with hydroxyzine in parturients.

A majority of patients experience pruritus, nausea and/or emesis following epidural morphine administration post-cesarean section. Naloxone or diphenhydramine are commonly used to treat these side effects. Prevention or reduction in the incidence of side effects of epidural morphine is a clinical goal. The purpose of the study was to observe the efficacy of prophylactic administration of hydroxyzine on the incidence and severity of pruritus following the epidural administration of morphine in 40 patients who requested epidural morphine for postoperative pain relief. Group I (n = 20) received saline, while Group II (n = 20) received 50 mg of hydroxyzine ten minutes after the administration of 5 mg epidural morphine. Both solutions were administered by deep intramuscular injection in the thigh area. The results of this investigation demonstrated that hydroxyzine was efficacious in attenuating the incidence of severe pruritus.

Adult↗

A comparison of acrivastine versus hydroxyzine and placebo in the treatment of chronic idiopathic urticaria.

A total of 21 patients with a diagnosis of chronic idiopathic urticaria were assessed in a fully randomized, double-blind, crossover study to investigate the efficacy of 8 mg acrivastine versus 20 mg hydroxyzine and placebo administered three times daily. Both acrivastine and hydroxyzine were found to be effective, and significantly better than placebo, in controlling signs and symptoms of urticaria. No significant differences were found between the active preparations. Hydroxyzine was associated with significantly more reports of drowsiness than was placebo.

Adult↗

Absence of amnesia induction in mice with hydroxyzine in comparison with three other minor tranquillizers.

Hydroxyzine (Atarax) was compared with three traditional anxiolytics (diazepam, meprobamate, triazolam) for potential amnesic activity in a step-through passive avoidance task in the mouse. The doses investigated were: hydroxyzine (4, 8 and 16 mg/kg); diazepam (0.25, 0.5 and 1 mg/kg); meprobamate (8, 16 and 32 mg/kg); triazolam (0.0015, 0.003 and 0.006 mg/kg). The doses investigated were chosen on the basis of prior experiments for not having sedative effects as measured in a photo-cell activity meter. All drugs were administered i.p. 30 min before the first trial of the passive avoidance task. The compounds were also investigated for eventual analgesic activity using the hot plate test. The results indicated that hydroxyzine up to sedative doses was devoid of amnesic activity, whereas clear signs of amnesia were induced by diazepam, meprobamate and triazolam at doses at least 8 times lower than those which reduced spontaneous motor activity. None of the compounds showed analgesic activity in the hot plate test suggesting that the signs of amnesia observed in the passive avoidance test were not due to reduced sensitivity to aversive stimulation.

Amnesia↗

The efficacy of oral theophylline and the combination of theophylline + hydroxyzine in chronic bronchial asthma.

The efficacy of 265 mg theophylline (150 mg of the theophylline being slow-release) and the combination of 265 mg theophylline + 7.5 mg hydroxyzine hydrochloride were compared in a double-blind cross-over placebo-controlled study in 12 patients with chronic reversible bronchial asthma. The patients took their drugs at 7.00 a.m., 1.00 p.m. and 7.00 p.m. During the trial the patients measured their peak expiratory flow (PEF) every day at 7.00 a.m., 10.00 a.m. and 9.30 p.m. The frequency and severity of symptoms and side-effects as well as the auxiliary use of isoprenaline inhalations were also recorded. The trial involved three three-day periods. Both oral theophylline and the combination of theophylline + hydroxyzine caused significant improvements in PEF in all measurement times. The PEF-level was higher when the combination was used than with plain theophylline, though the difference was not significant. Only the combination of theophylline + hydroxyzine had a significant effect on the symptoms, and the use of additional isoprenaline inhalations was also reduced during the combination period. Side-effects were minimal. Circadian variation of bronchial obstruction was seen in all these patients.

Administration, Oral↗

Hydroxyzine intoxication in a 13-month-old child.

A case of hydroxyzine toxicity following accidental ingestion in a 13-month old female infant has been presented. A plasma hydroxyzine concentration 8.5 hours after the acute ingestion was 102.7 micrograms/ml and toxicity was manifested primarily by generalized seizures and sinus tachycardia. General supportive care and seizure control with physostigmine resulted in complete recovery within 72 hours. This case represents the first documented report of hydroxyzine toxicity following acute ingestion in a child.

Diazepam↗

Massive tissue necrosis after hydroxyzine injection.

A 47-year-old man hospitalized for disk surgery received a preoperative injection of hydroxyzine hydrochloride in the upper outer quadrant of the gluteal region. The immediate pain decreased after 3 days but later became incapacitating. Substantial tissue necrosis in the region of the injection was confirmed 4 weeks after the injection, and 100 g of necrotic tissue was excised, leaving the patient with lost muscle mass and a definite limp 2 years later. During the injection of hydroxyzine, the needle penetrated through the gluteal muscle and entered the gluteal artery, causing thrombosis of the artery and necrosis of the gluteus maximus muscle. This case and other reported cases indicate that the use of intramuscular hydroxyzine is contraindicated.

Antiemetics↗

The effects of nitrous oxide on behavior and physiological parameters during conscious sedation with a moderate dose of chloral hydrate and hydroxyzine.

The purpose of this study was to determine differences in heart rate (HR), blood pressure (BP), peripheral oxygen saturation (pO2), expired CO2 (CO2), and behavior (using two scales) comparing nitrous oxide/oxygen (N2O) with oxygen (O2) alone in 20 children (mean age 45 +/- 5.1 months) sedated with chloral hydrate (CH) and hydroxyzine in a double-blind crossover design. Administration of CH (40 mg/kg) and hydroxyzine (2 mg/kg) was held constant for each patient visit; however, N2O (50%) was administered during one visit and O2 (100%) at the other in a randomly determined manner. Physiologic and behavioral parameters were collected during eight specific procedural events (e.g., administration of local anesthesia). Data were analyzed with a repeated-measures ANOVA, one-way ANOVA, t-test, Kruskal Wallis ANOVA, and descriptive statistics. There was no statistically significant difference in any physiologic or behavioral parameter as a function of inhalation agent. However, significant differences were found for certain physiological parameters (i.e., HR [F = 5.41, P < 0.001], pO2 [F = 6.04, P < 0.001], and CO2 [F = 2.33, P < 0.027]) and all behavioral measures (% crying [F = 2.82, P < 0.008], % quiet [F = 5.38, P < 0.001], % movement [F = 3.88, P < 0.001], and % struggle [F = 2.83, P < 0.007]) of one scale (Ohio State University Behavioral Rating Scale [OSUBRS]) as a function of procedural events. Although no statistically significant differences were attributable to inhalation agent, evidence suggests that N2O resulted in less crying and struggling and more quiet behaviors than O2. Significant correlations existed between sub-categories of the two behavioral rating scales, suggesting some association between the scales. One may conclude from the results of this study that moderate doses of CH and hydroxyzine in combination with nitrous oxide are not associated with any significant potentiation effects on physiologic parameters compared with the same oral agents with oxygen alone. Certain procedural events (e.g., administration of local anesthesia) do result in patient responses that affect specific behaviors and physiology. Although the effects of N2O may not be statistically significant, generally it produces an attenuation in physiological and behavioral responses as measured under the conditions of this study.

Analysis of Variance↗

The effectiveness of midazolam and hydroxyzine as sedative agents for young pediatric dental patients.

The purpose of the study was to compare hydroxyzine (HYD) and 0.2mg/Kg midazolam (MDZ) as sedative agents for young pediatric dental patients. Twenty-nine healthy two-to-four-year-old children participated in the study. Hydroxyzine was dripped nasally 10 minutes before treatment. The patient's crying, alertness, movement and general behavior were blindly assessed and statistically analyzed. No differences were found between the mean general behavior scores nor between the first and second visits in both groups. A significant difference (p < 0.02) was found in the acceptance of the face and nasal masks by children of the midazolam group between the first and second appointments. None of the children of this group cried nor moved at the first visit. The results of the study indicate that midazolam is somewhat more effective than hydroxyzine as a sedative agent for short procedures in young pediatric dental patients.

Administration, Intranasal↗

Systemic contact dermatitis to hydroxyzine.

Systemic contact dermatitis is an underreported type of delayed hypersensitivity caused by a systemically administered substance. When interpreting patch test reactions, it is important to obtain a history of all current related oral medications. Many oral medications can cross-react with structurally similar topical antigens and induce systemic contact dermatitis. Identification and elimination of the inciting agent can lead to resolution of otherwise chronic, unresponsive eczema. We report a case of systemic contact dermatitis to hydroxyzine in a patient who was patch tested positive to ethylenediamine. Repeated oral provocation with hydroxyzine reproduced her eczema on several occasions. We conclude that systemic contact dermatitis to hydroxyzine, a common medication used to treat pruritus, must be considered as a potential cause for unresponsive eczema.

Antipruritics↗

[Thin-layer chromatographic technic for the semiquantitative determination of hydroxyzine residues in animal material].

The solution behaviour of hydroxyzine in water and chloroform (in the strongly alkaline and the strongly acidic range) is utilized to extract it from animal material and to purify the extract. A concentration of 0.01 p.p.m. is detectable in liver, kidneys and muscular substance. 0.05 p.p.m. may be determined semiquantitatively by visual spot comparison. In milk, the detectable amount is 0.1 p.p.m. and 0.5 p.p.m. can be determined semiquantitatively. The recoveries of low concentrations of hydroxyzine are likely to be lower in milk samples than in organ samples.

Animals↗

Evaluation of the cognitive, psychomotor and pharmacokinetic profiles of rupatadine, hydroxyzine and cetirizine, in combination with alcohol, in healthy volunteers.

INTRODUCTION: The Central Nervous System (CNS) impairment induced by moderate alcohol (ALC) ingestion may be enhanced if other drugs are taken simultaneously. Rupatadine (RUP) is a new H(1)-antihistamine which also inhibits platelet activating factor (PAF) release in inflammatory reactions. OBJECTIVE: The main aim of the study was to assess the effects of ALC 0.8 g/Kg on RUP (10 mg and 20 mg) CNS effects. An evaluation of alcohol and RUP pharmacokinetics was also attained. METHODS: Eighteen healthy young volunteers of both sexes participated in a phase I, randomised, crossover, double-blind, placebo-controlled study. At 2-week intervals they received six treatments: (a) placebo (PLA), (b) ALC alone and ALC in combination with: (c) hydroxyzine 25 mg (HYD), (d) cetirizine 10 mg (CET), (e) RUP 10 mg or (f) RUP 20 mg. At baseline and several times thereafter, seven psychomotor performance tests (finger tapping, fine motoric skills, nystagmus, temporal estimation, critical-flicker-fusion frequency, 'd2' cancellation, simple reaction) and eleven subjective self-reports (drunkenness, sleepiness, alertness, clumsiness, anger, inattentiveness, efficiency, happiness, hostility, interest and extraversion) were carried out. Two-way (treatment, time) ANOVAs for repeated measures to each variable together with a multivariate non-parametric approach were applied. Plasma concentrations of alcohol, and of RUP and its metabolites, were quantified by validated immunofluorescence and LC/MS/MS methods, respectively. Plasma-time curves for all compounds were analysed by means of model-independent methods. RESULTS: The combination of alcohol with HYD, CET and RUP 20 mg produced more cognitive and psychomotor impairment as compared to alcohol alone, being the combination of alcohol and HYD the one which induced the greatest deterioration. The combination of alcohol and RUP 10 mg could not be differentiated from ALC alone. Subjective self-reports reflect effects on metacognition after the combination of alcohol with HYD and CET i.e. the increased objective impairment observed was not subjectively perceived by the subjects. No significant differences were obtained when comparing alcohol plasma concentrations assessed after the treatments evaluated. RUP showed a lineal kinetic relationship after 10 and 20 mg with a higher exposition to both metabolites assayed. CONCLUSIONS: Present results showed that single oral doses of rupatadine 10 mg in combination with alcohol do not produce more cognitive and psychomotor impairment than alcohol alone. Higher doses of rupatadine, in combination with alcohol, may induce cognitive and psychomotor deterioration as hydroxyzine and cetirizine at therapeutic doses.

Analysis of Variance↗

Sensitive assay for determination of hydroxyzine in plasma and its human pharmacokinetics.

An assay suitable for hydroxyzine determination in human plasma following therapeutic doses was developed. The method involves GLC and chemical-ionization mass spectrometry of the acetate derivatives of hydroxyzine and of a pentadeuterated analog internal standard. Following administration of 100-mg single oral doses to normal male volunteers, peak plasma concentrations of approximately 80 ng/ml were observed; the half-life of drug removal was approximately 3 hr.

Half-Life↗

Simultaneous determination of hydroxyzine hydrochloride and benzyl alcohol in injection solutions by high-performance liquid chromatography.

A stability-indicating, high-performance liquid chromatographic method was developed for the simultaneous determination of hydroxyzine hydrochloride and benzyl alcohol in injection solutions. Separation was achieved using a mu Bondapak C18 column and the eluent [60% water, 25% acetonitrile, and 15% methanol containing 0.06% (v/v) sulfuric acid, 0.5% (w/v) sodium sulfate, and 0.02% (w/v) heptanesulfonic acid sodium salt] at a flow rate of 2 ml/min. Isobutyrophenone and p-nitroacetophenone were used as internal standards. The UV detector response at 257 nm was linear for hydroxyzine hydrochloride in the 3--10-mg/ml range and for benzyl alcohol in the 0.54--1.8 mg/ml range under analysis conditions. The method is accurate, simple, and precise.

Benzyl Alcohols↗

Quantitative enantiomeric analysis of chlorcyclizine, hydroxyzine, and meclizine by capillary electrophoresis.

A simple capillary zone electrophoresis method was developed for the quantitative enantiomeric analysis of piperazine antihistamines with teratogenic suspicion in animals. Enantioseparation of chlorcyclizine, hydroxyzine, and meclizine was performed in glycine buffer (0.6 mol L(-1); pH 3.00) with sulfated beta-cyclodextrin (5 mg mL(-1)) as a chiral selector; and the separated drugs were monitored by ultra-violet detector. The lower quantitation of the individual enantiomer is attainable at 10 micro mol L(-1), using an achiral piperazine drug (cyclizine) as internal standard. The method is simple and rapid with a short run time (<5 min) for the analysis of chlorcyclizine, hydroxyzine or meclizine enantiomers.

Animals↗