1
|
Church MK, Canonica GW, Kuna P, Maurer M, Mösges R, Novak Z, Papadopoulos NG, Del Rio PR. An international Delphi study on the burden of allergic rhinoconjunctivitis and urticaria and the role of bilastine among current treatment options. Expert Rev Clin Immunol 2023:1-8. [PMID: 37191185 DOI: 10.1080/1744666x.2023.2214729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND allergic rhinoconjunctivitis and chronic urticaria are common histamine-driven diseases, exerting detrimental effects on cognitive functions, sleep, daily activities and quality of life. Non-sedating second-generation H1-antihistamines are the first line treatment of choice. Aim of the study was to define the role of bilastine among second-generation H1-antihistamines in the treatment of allergic rhinoconjunctivitis and urticaria in patients of different ages. METHODS an international Delphi study was carried out to assess consensus among experts from 17 European and extra-European countries on three main topics: 1) Burden of disease; 2) Current treatment options; 3) Specific characteristics of bilastine among second generation antihistamines. RESULTS here, we present the results obtained for a selection of 15 out of 27 consensus statements, focused on disease burden, role of second-generation antihistamines and bilastine profile. The rate of concordance was ≥ 98% for 4 statements, ≥ 96% for 6, ≥ 94% for 3, and ≥ 90% for 2. CONCLUSIONS the high degree of agreement obtained suggests a wide awareness of the burden of allergic rhinoconjunctivitis and chronic urticaria among experts from all over the world and reflect a broad consensus on the role of second generation antihistamines in general and of bilastine in particular for their management.
Collapse
Affiliation(s)
- M K Church
- Institute of Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - G W Canonica
- Humanitas University, Via Rita Levi Montalcini 4 Pieve Emanuele,, 20090, Milan, Italy
- Personalized Medicine Asthma & Allergy IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
| | - P Kuna
- Division of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Poland
| | - M Maurer
- Institute of Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Allergology and Immunology, Berlin, Germany
| | - R Mösges
- IMSB, Medical Faculty, University at Cologne, and ClinCompetence Cologne GmbH, Cologne, Germany
| | - Z Novak
- Pediatric Department, University of Szeged, Hungary
| | - N G Papadopoulos
- Allergy Dpt, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | - P Rodriguez Del Rio
- Hospital Universitario Infantil Niño Jesus, Allergy Department. Madrid, Spain
| |
Collapse
|
2
|
Novel Insights in the Management of Vernal Keratoconjunctivitis (VKC): European Expert Consensus Using a Modified Nominal Group Technique. Ophthalmol Ther 2023; 12:1207-1222. [PMID: 36790673 PMCID: PMC10011216 DOI: 10.1007/s40123-023-00665-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/26/2023] [Indexed: 02/16/2023] Open
Abstract
INTRODUCTION Vernal keratoconjunctivitis (VKC) is a rare, severe allergic ocular disease, typically occurring in children and adolescents, that can have a significant impact on quality of life and lead to visual impairment. Long-term treatment may be necessary to tackle chronic inflammation and topical corticosteroid dependency must be minimised due to the risk of complications. There is a need for unified clinical guidance to aid the assessment, diagnosis and management of VKC across Europe. The aim of this expert panel (the EUR-VKC Group) was to provide clear guidance for primary care physicians and general ophthalmologists involved in the diagnosis and management of VKC. METHODS An expert group of seven European ophthalmologists was convened and a modified nominal group technique used to develop key recommendations on VKC management. The recommendations were subject to up to two rounds of voting using a 5-point Likert scale to ascertain consensus and the strength of each recommendation. Consensus was set at a predetermined threshold of ≥ 75.0% of experts selecting 'Strongly agree' or 'Agree'. RESULTS A total of 47 recommendations were developed relating to the assessment of key of VKC, guidance on who and when to refer, as well as treatment-escalation pathways, long-term follow-up, and supportive care and education. All recommendations reached consensus after two rounds. The group emphasise how timely diagnosis and treatment initiation that is appropriate to disease severity are crucial to benefit patients with VKC. Patients with signs ('red flags') indicating severe VKC, or persistent mild-to-moderate VKC that is non-responsive following 2-4 weeks of treatment, should be referred to a sub-specialist. CONCLUSION The EUR-VKC Group provides recommendations on the assessment, diagnosis, management, referral and follow-up of patients with VKC. It also provides a framework to facilitate collaboration between primary care physicians, general ophthalmologists and sub-specialists to improve the outcomes for patients with VKC.
Collapse
|
3
|
Siddiqui ZA, Walker A, Pirwani MM, Tahiri M, Syed I. Allergic rhinitis: diagnosis and management. Br J Hosp Med (Lond) 2022; 83:1-9. [DOI: 10.12968/hmed.2021.0570] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Allergic rhinitis affects 20% of the population of the UK. It confers a significant health burden upon the individual as it affects the patient's quality of life and is associated with serious comorbidities including asthma, sinusitis and conjunctivitis. Owing to its prevalence, it has a significant economic impact through its effects on education, productivity and use of healthcare resources. This review focuses on the management of allergic rhinitis and potential future treatments, because of the lack of clear national guidelines and because this illness is often misdiagnosed and mismanaged. The article provides a comprehensive overview of allergic rhinitis and illustrates the assessment criteria for various subcategories.
Collapse
Affiliation(s)
- ZA Siddiqui
- Department of Ear, Nose and Throat Surgery, University Hospital Lewisham, London, UK
| | - A Walker
- Department of Ear, Nose and Throat Surgery, University Hospital Lewisham, London, UK
| | - MM Pirwani
- Department of Life Sciences and Medicine, King's College London, London, UK
| | - M Tahiri
- Department of Life Sciences and Medicine, King's College London, London, UK
| | - I Syed
- Department of Ear, Nose and Throat Surgery, University Hospital Lewisham, London, UK
| |
Collapse
|
4
|
De Nardi L, Lanzetta MA, Ghirigato E, Barbi E, Gortani G. Approach to the child with fatigue: A focus for the general pediatrician. Front Pediatr 2022; 10:1044170. [PMID: 36533226 PMCID: PMC9755349 DOI: 10.3389/fped.2022.1044170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/16/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Fatigue is a common, nonspecific complaint commonly used to describe various conditions, ranging from a vague, subjective sense of weariness to muscular weakness, fatigability, exercise intolerance or excessive daytime somnolence. Despite its high frequency in the general population, literature addressing the approach to the child with fatigue from a general pediatrician perspective is poor. We herein propose a review of the available evidence on the topic, providing a practical framework to assist physicians in dealing with the issue. METHODS Data were identified by searches of MEDLINE, UpToDate, Google Scholar and references from relevant articles. Articles published between 1990 and 2021 were considered, prioritizing systematic reviews and meta-analyses. Then, an empirically-based model of approaching the tired child was proposed according to our center experience. RESULTS To correctly characterize the meaning of fatigue reporting, specific clues from history and physical examination should be emphasized. Duration, severity, and the age at onset are to be considered. Then, specific queries about everyday activities, sleep hygiene and social domain could be useful in reaching a specific diagnosis and offering an appropriate treatment. CONCLUSIONS We suggest a pragmatic approach to fatigue in children based on age assessment, targeted questions, physical examination clues, and some laboratory first-level tests. This could provide pediatricians with a useful tool to discriminate the broad etiology of such a complaint, disentangling between psychological and organic causes. Further studies are needed to investigate the predictive value, specificity and sensitivity of this diagnostic workflow in managing the child with fatigue.
Collapse
Affiliation(s)
- Laura De Nardi
- University of Trieste, Clinical Department of Medical Surgical and Health Science, Trieste, Italy
| | - Maria Andrea Lanzetta
- University of Trieste, Clinical Department of Medical Surgical and Health Science, Trieste, Italy.,Department of Pediatrics, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Elena Ghirigato
- University of Trieste, Clinical Department of Medical Surgical and Health Science, Trieste, Italy
| | - Egidio Barbi
- University of Trieste, Clinical Department of Medical Surgical and Health Science, Trieste, Italy.,Department of Pediatrics, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Giulia Gortani
- Department of Pediatrics, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| |
Collapse
|
5
|
Kavya R, Christopher J, Panda S, Lazarus YB. Machine Learning and XAI approaches for Allergy Diagnosis. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102681] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
6
|
Kua CH, Lee SRE, Cheng SST, Lin JFY, Wang H, Lee GWF. Evaluating the optimization of the use of sedating antihistamines in a community pharmacy: a retrospective quality improvement study in Singapore. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2021; 29:451-457. [PMID: 34244771 DOI: 10.1093/ijpp/riab035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 05/31/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVES This study aimed to retrospectively assess whether community pharmacy customers accepted the pharmacist's recommendations for the selection of an antihistamine based on medicine optimization guidelines. METHODS A retrospective study was conducted on the implementation of an antihistamine use optimization guide for patients who were seeking first-generation antihistamines between July and December 2019 across forty-five community pharmacies in Singapore. The primary outcome measure was the acceptance rate of ceasing or substituting first-generation antihistamine with a second-generation antihistamine. Secondary measures included the reduction in types of first-generation antihistamines used, adverse drug-related events reported, intended use of antihistamines and the types of recommendations. KEY FINDINGS During the study period, 2328 patients fulfilled the inclusion criteria, out of which 523 patients agreed to optimize their use of sedating first-generation antihistamines. Chlorpheniramine (95.2%) was the most widely accepted first-generation antihistamine for optimization, with 59.6% of the users experiencing adverse events, the most common being drowsiness (53.2%). The main indication of use was allergic conditions (allergic rhinitis or atopic dermatitis) (70.3%). After implementation of the guide, most interventions were direct substitution (72.8%) with a less-sedating antihistamine, followed by gradual tapering (22.6%). Loratadine, a second-generation antihistamine, was most frequently (51.4%) used to substitute first-generation antihistamines. The optimization guide can potentially reduce adverse effects in 59.6% (297 patients) of chlorpheniramine users, which were mainly drowsiness (265 patients; 53.2%) and dry mouth (14 patients; 2.8%). CONCLUSIONS This study highlighted the importance of assessing and reducing potentially inappropriate first-generation antihistamine self-use and that a guided approach and substitution with less-sedating antihistamines can be employed in the community pharmacy setting.
Collapse
Affiliation(s)
- Chong-Han Kua
- School of Applied Science, Republic Polytechnic, Singapore, Singapore
| | - Shawn Rong En Lee
- Pharmacy Practice Department, Guardian Health and Beauty, Singapore, Singapore
| | | | - Joanne Fang Yun Lin
- Pharmacy Practice Department, Guardian Health and Beauty, Singapore, Singapore
| | - Hui Wang
- Pharmacy Practice Department, Guardian Health and Beauty, Singapore, Singapore
| | - Grace Wai Fong Lee
- Pharmacy Practice Department, Guardian Health and Beauty, Singapore, Singapore
| |
Collapse
|
7
|
Grinnell M, Price KN, Shah A, Butler DC. Antihistamine safety in older adult dermatologic patients. J Am Acad Dermatol 2021; 87:381-386. [PMID: 33465430 DOI: 10.1016/j.jaad.2021.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 01/05/2021] [Accepted: 01/07/2021] [Indexed: 10/22/2022]
Abstract
Twenty percent of Americans will be older than 65 years by 2030, and without a dedicated geriatrics curriculum in many residency trainings programs, dermatologists may be less familiar with age-associated adverse effects of common dermatologic medications. Herein, we provide a practical guide and clinical safety pearls for the use of antihistamines in older adults. This Review aims to address the risks of antihistamines, anticholinergic burden and polypharmacy, pertinent preexisting medical conditions, and safe alternatives for aging adult patients.
Collapse
Affiliation(s)
| | - Kyla N Price
- University of Illinois Chicago College of Medicine, Chicago, Illinois
| | - Amit Shah
- Department of Internal Medicine, Mayo Clinic, Scottsdale, Arizona
| | - Daniel C Butler
- Department of Dermatology, University of California-San Francisco, San Francisco, California.
| |
Collapse
|
8
|
Kassem MA, Ghalwash MM, Abdou EM. Development of nanoemulsion gel drug delivery systems of cetirizine; factorial optimisation of composition, in vitro evaluation and clinical study. J Microencapsul 2020; 37:413-430. [PMID: 32421463 DOI: 10.1080/02652048.2020.1771446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Aim: This work aimed to develop topical nanoemulsion gels of cetirizine, a second-generation antihistamine, to avoid its oral intake drawbacks and enhance skin permeation.Methods: Cetirizine nanoemulsions were formulated and characterised for their particle size, polydispersity index, zeta potential, drug release and drug permeation through rat skin. The optimised formulation, obtained using 23 full factorial design, was incorporated in carbopol and chitosan gels and evaluated clinically for urticaria treatment.Results: The optimised formulation had particle size of 32.015 ± 1.87 nm, polydispersity index of 0.29 ± 0.04, zeta potential of -19.31 ± 0.43 mV, cetirizine percent released of 98.50 ± 1.23% and permeability coefficient of 7.65 cm.h-1. Cetirizine nanoemulsion gels were more effective than their control gels in urticaria treatment with significant decrease in the degree of wheals and itching and higher recovery percent.Conclusion: Cetirizine nanoemulsion topical gels are expected to be a rational and effective tool for avoiding cetirizine oral side effects and targeting the affected skin.
Collapse
Affiliation(s)
- Mohammed A Kassem
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Maha M Ghalwash
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Modern University for Technology and Information (MTI), Cairo, Egypt
| | - Ebtsam M Abdou
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Modern University for Technology and Information (MTI), Cairo, Egypt.,National Organization of Drug Control and Research (NODCAR), Giza, Egypt
| |
Collapse
|
9
|
Baharudin A, Abdul Latiff AH, Woo K, Yap FBB, Tang IP, Leong KF, Chin WS, Wang DY. Using Patient Profiles To Guide The Choice Of Antihistamines In The Primary Care Setting In Malaysia: Expert Consensus And Recommendations. Ther Clin Risk Manag 2019; 15:1267-1275. [PMID: 31802877 PMCID: PMC6828722 DOI: 10.2147/tcrm.s221059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 09/14/2019] [Indexed: 01/05/2023] Open
Abstract
H1-antihistamines are recognized to be effective for conditions such as allergic rhinitis and chronic spontaneous urticaria. However, management of such conditions in the real-world primary care setting may be challenging due to diverse patient-specific considerations, the wide range of antihistamines available, choice of other treatment modalities, and the complexity of interpreting specialist treatment algorithms. Despite regular updates to international guidelines, regional/national surveys of healthcare professionals show a clear gap between guidelines and real-world practice, particularly at the primary care level. This article thus presents the consensus opinion of experts from relevant specialties in Malaysia - allergology, pediatrics, otorhinolaryngology, and dermtology - on harmonizing the use and choice of antihistamines in primary care. Patient profiling is recommended as a tool to guide primary care practitioners in prescribing the appropriate antihistamine for each patient. Patient profiling is a three-step approach that involves 1) identifying the individual's needs; 2) reviewing patient-specific considerations; and 3) monitoring treatment response and referral to specialists in more severe or difficult-to-treat cases. Concurrently, guidelct 3ines should be reviewed and updated periodically to include recommendations that are easily actionable for primary care practitioners.
Collapse
Affiliation(s)
- Abdullah Baharudin
- Department of Otorhinolaryngology - Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | | | - Kent Woo
- Allergy and Immunology Clinic, Gleneagles Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Felix Boon-Bin Yap
- Department of Dermatology, Sunway Medical Centre, Bandar Sunway, Selangor, Malaysia
| | - Ing Ping Tang
- Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine & Health Sciences, University Malaysia Sarawak, Kuching, Sarawak, Malaysia
| | - Kin Fon Leong
- Department of Dermatology, Pediatric Institute, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
| | - Wai Seong Chin
- Pediatric Clinic, Dr Chin's Child Specialist Clinic, Kuala Lumpur, Malaysia
| | - De Yun Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| |
Collapse
|
10
|
Arsoy G, Varış A, Saloumi LM, Abdi A, Başgut B. Insights on Allergic Rhinitis Management from a Northern Cyprus Perspective and Evaluation of the Impact of Pharmacist-Led Educational Intervention on Patients' Outcomes. MEDICINA (KAUNAS, LITHUANIA) 2018; 54:E83. [PMID: 30405059 PMCID: PMC6262628 DOI: 10.3390/medicina54050083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 11/02/2018] [Accepted: 11/02/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND OBJECTIVE the global prevalence of allergic rhinitis (AR) is rising and yet there is scarce information concerning the diagnosis, management and treatment patterns of AR in Northern Cyprus (NC). This study aims to provide a unique perspective on AR management as well as assessing the effectiveness of the pharmacist-led educational intervention for improving care of AR patients. METHODS across-sectional survey was carried out with community pharmacists (n = 70), patients (n = 138) and ear, nose and throat (ENT) specialists (n = 12) in NC. For a controlled interventional trial, trained pharmacists provided a brief education on management of AR and nasal spray technique for patients while other pharmacists provided the usual care. Quality of life (QoL) and other outcome measures on the perceived symptom severity of the two groups were compared after a 6-week period. RESULTS only 33.3% of the ear, nose and throat (ENT) specialists and 15.7% of the community pharmacists are aware of the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines. The majority of patients (63%) self-managed with over-the-counter medications. Nasal congestion (96.4%) is the most bothersome symptom and oral antihistamines are the most commonly purchased medications (51.4%), indicating a pattern of suboptimal management. The pharmacists-led educational intervention has resulted in statistically more significant improvement in regards to nasal congestion and QoL for the intervention group patients (p < 0.05). CONCLUSION the current management of AR has not been in accordance with the ARIA guidelines in NC. An educational intervention of the pharmacists can enhance the symptom management and improve the QoL in patients with AR.
Collapse
Affiliation(s)
- Günay Arsoy
- Department of Clinical Pharmacy, Faculty of Pharmacy, Near East University, Nicosia, Northern Cyprus, Mersin 10, Turkey.
| | - Ahmet Varış
- Department of Otolaryngology, Burhan Nalbantoglu State Hospital, Nicosia, Northern Cyprus, Mersin 10, Turkey.
| | - Louai M Saloumi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Near East University, Nicosia, Northern Cyprus, Mersin 10, Turkey.
| | - Abdikarim Abdi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Near East University, Nicosia, Northern Cyprus, Mersin 10, Turkey.
| | - Bilgen Başgut
- Department of Clinical Pharmacy, Faculty of Pharmacy, Near East University, Nicosia, Northern Cyprus, Mersin 10, Turkey.
| |
Collapse
|
11
|
Reményi Á, Grósz A, Szabó SA, Tótka Z, Molnár D, Helfferich F. Comparative study of the effect of bilastine and cetirizine on cognitive functions at ground level and at an altitude of 4,000 m simulated in hypobaric chamber: a randomized, double-blind, placebo-controlled, cross-over study. Expert Opin Drug Saf 2018; 17:859-868. [PMID: 30032673 DOI: 10.1080/14740338.2018.1502268] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Antihistamines are easily accessible and cover the vast majority of the medical therapy of allergic rhinitis. However, their systemic administration may more frequently associate with their well-known side-effect, sedation, which is a serious problem in persons in safety-critical jobs such as aviation. We have a poor understanding whether a non-sedative antihistamine has an impact on vigilance when hypobaric hypoxia occurs during flight. METHODS In this randomized, placebo-controlled, double-blind, cross-over study the effect of 20 mg bilastine was compared to 10 mg cetirizine and to placebo (20 mg pyridoxine) in 33 individuals at ground level and at 4,000 m altitude simulated in hypobaric chamber. Levels of vigilance, ultrashort memory, combined distributive attention, monotony tolerance and peripheral blood oxygen saturation (SpO2) were assessed. RESULTS Bilastine did not impair the tested abilities in comparison with the control groups either at ground level or hypobaric hypoxia. Administration of cetirizine increased the number of errors at ground level. At the simulated altitude, already impaired results were additionally demonstrated with regards to the distributive attention test. CONCLUSIONS From the two examined antihistamines, bilastine should be the preferred medication for by individuals who require constant attention and are exposed to hypobaric hypoxia.
Collapse
Affiliation(s)
- Ákos Reményi
- a Department of Otorhinolaryngology , Head and Neck Surgery, Military Hospital, Medical Centre, Hungarian Defence Forces , Budapest , Hungary
| | - Andor Grósz
- b Department of Aviation and Space Medicine, Faculty of Medicine , University of Szeged , Kecskemét , Hungary
| | - Sándor András Szabó
- b Department of Aviation and Space Medicine, Faculty of Medicine , University of Szeged , Kecskemét , Hungary.,c Aeromedical,Military Screening and Healthcare Institute, Medical Centre, Hungarian Defence Forces , Kecskemét , Hungary
| | - Zsolt Tótka
- b Department of Aviation and Space Medicine, Faculty of Medicine , University of Szeged , Kecskemét , Hungary
| | - Dávid Molnár
- a Department of Otorhinolaryngology , Head and Neck Surgery, Military Hospital, Medical Centre, Hungarian Defence Forces , Budapest , Hungary
| | - Frigyes Helfferich
- a Department of Otorhinolaryngology , Head and Neck Surgery, Military Hospital, Medical Centre, Hungarian Defence Forces , Budapest , Hungary
| |
Collapse
|