Weiler J M, Bloomfield J R, Woodworth G G, Grant A R, Layton T A, Brown T L, McKenzie D R, Baker T W, Watson G S
Department of Internal Medicine, University of Iowa, Iowa City 52242-1081, USA.
Ann Intern Med. 2000 Mar 7;132(5):354-63. doi: 10.7326/0003-4819-132-5-200003070-00004.
Sedating antihistamines may impair driving performance as seriously as alcohol.
To compare the effects of fexofenadine, diphenhydramine, alcohol, and placebo on driving performance.
Randomized, double-blind, double-dummy, four-treatment, four-period crossover trial.
The Iowa Driving Simulator.
40 licensed drivers with seasonal allergic rhinitis who were 25 to 44 years of age.
One dose of fexofenadine (60 mg), diphenhydramine (50 mg), alcohol (approximately 0.1% blood alcohol concentration), or placebo, given at weekly intervals before participants drove for 1 hour in the Iowa Driving Simulator.
The primary end point was coherence, a continuous measure of participants' ability to match the varying speed of a vehicle that they were following. Secondary end points were drowsiness and other driving measures, including lane keeping and response to a vehicle that unexpectedly blocked the lane ahead.
Participants had significantly better coherence after taking alcohol or fexofenadine than after taking diphenhydramine. Lane keeping (steering instability and crossing the center line) was impaired after alcohol and diphenhydramine use compared with fexofenadine use. Mean response time to the blocking vehicle was slowest after alcohol use (2.21 seconds) compared with fexofenadine use (1.95 seconds). Self-reported drowsiness did not predict lack of coherence and was weakly associated with minimum following distance, steering instability, and leftlane excursion.
Participants had similar performance when treated with fexofenadine or placebo. After alcohol use, participants performed the primary task well but not the secondary tasks; as a result, overall driving performance was poorer. After participants took diphenhydramine, driving performance was poorest, indicating that diphenhydramine had a greater impact on driving than alcohol did. Drowsiness ratings were not a good predictor of impairment, suggesting that drivers cannot use drowsiness to indicate when they should not drive.
镇静性抗组胺药可能会像酒精一样严重损害驾驶能力。
比较非索非那定、苯海拉明、酒精和安慰剂对驾驶能力的影响。
随机、双盲、双模拟、四治疗、四周期交叉试验。
爱荷华州驾驶模拟器。
40名年龄在25至44岁之间患有季节性变应性鼻炎的持证驾驶员。
在参与者于爱荷华州驾驶模拟器中驾驶1小时之前，每周间隔给予一剂非索非那定（60毫克）、苯海拉明（50毫克）、酒精（血液酒精浓度约为0.1%）或安慰剂。
主要终点是连贯性，这是对参与者匹配所跟随车辆变化速度能力的连续测量。次要终点是嗜睡及其他驾驶指标，包括保持车道行驶以及对意外阻挡前方车道的车辆做出反应。
服用酒精或非索非那定后，参与者的连贯性显著优于服用苯海拉明后。与服用非索非那定相比，服用酒精和苯海拉明后保持车道行驶（转向不稳定和越过中心线）受到损害。与服用非索非那定（1.95秒）相比，服用酒精后对阻挡车辆的平均反应时间最慢（2.21秒）。自我报告的嗜睡并不能预测缺乏连贯性，且与最小跟车距离、转向不稳定和左车道偏移的关联较弱。
服用非索非那定或安慰剂时，参与者的表现相似。服用酒精后，参与者主要任务完成得较好，但次要任务完成得不好；因此，总体驾驶能力较差。服用苯海拉明后，驾驶能力最差，表明苯海拉明对驾驶的影响比酒精更大。嗜睡评分并不是驾驶能力受损的良好预测指标，这表明驾驶员不能用嗜睡来判断自己何时不应驾驶。
