ANTIHISTAMIN

Oleh Wiwik Kusumawati

Objectives
1. 2.

3.

4.

Describe localized generalized allergic responses Discuss the role of histamine in allergic responses Describe the common side effect of antihistamines, including the anti cholinergic effect Develop a nursing care plan for a patient taking an antihistamine

Introduction
Histamine the amino acid histidine Mast cell Basophil cell Allergic reactions Lung, skin, brain

GIT

Introduction
Antigen antibody (Ig E) Mast cell (granule) degranulation Release histamine (heparin, leukotrien, etc) Allergic reaction (capillary permeability) Dilatasi arteriol Peningkatan permeabilitas kapiler (ekstravasasi cairan dan protein)

Allergic reactions
Urticaria Rhinitis Purpura Eczema Asthma Angioedema Anaphylaxis

Antihistamin

Mekanisme kerja

Memblok reseptor histamin (antagonis histamin) Reseptor H1

Reseptor H2 (GIT)

Antihistamin
Efek 10 30 menit Durasi 4 6 jam Metabolisme di liver dan ginjal

Antihistamin
Chlorpheniramine maleat Hay fever, hives (paling efektif) Tidak untuk mencegah atau mengobati influenza dan juga asma Anaphylaxis (emergency) epinephrine/adrenaline Non sedating antihistamines (astemizole, cetirizine, fexofenadine, loratadine) Sedative (pyrilamine, doxylamine succinate, diphenhydramine, hydroxyzine) Antiemetic Antiparkinson

Antihistamin

Efek samping

Antikolinegik atropine like action Hambatan sekresi kelenjar, mata kabur, retensi urin, konstipasi, takikardi, dll Insomnia, gelisah, iritabilitas (anak)

Kontra indikasi
Ibu menyusui

Antihistamin

Toksisitas

Depresi SSP Stimulasi SSP (anak) Antikolinegik atropine like action Midriasis, demam tinggi, dll Tx : Induksi muntah, bilas lambung (vomiting, kecuali derivat fenothiazin aspirasi)

Interaksi

Obat-obat sedative Glaukoma, hipertiroid, hipertensi, dll