KEENEY E L
Calif Med. 1950 May;72(5):377-89.
The tissues affected by histamine and anaphylactic reactions are identical. Epinephrine antagonizes the action of histamine by acting on effector cells in a direction opposite to that of histamine. The so-called antihistaminic drugs block rather than antagonize the action of histamine. The injection into the human body of epinephrine or certain antihistaminic substances provokes the release of histamine and thereby produces a rise in the histamine blood level. There is a remarkable conformity of potency of antihistaminics as determined by Dale experiments and by histamine intoxication experiments in the intact guinea pig. Neoantergan, Pyribenzamine and Histadyl are usually superior to other compounds when potency is assayed by these methods. All antihistaminics provide similar protection again animal anaphylaxis. Larger doses are necessary to protect against anaphylaxis than against histamine intoxication. The differences in potency as determined by Dale experiments and histamine experiments in animals are not found in clinical use. One compound is not generally superior to all others in the treatment of any one or several allergic disorders. The antihistaminic drugs are beneficial in the symptomatic treatment of allergic rhinitis, acute urticaria and angioneurotic edema, and mild non-infective bronchial asthma. Their effectiveness in the management of moderately severe and severe non-infective bronchial bronchial asthma; infective bronchial asthma; migraine; atopic dermatitis (disseminated neurodermatitis), and pruritus of skin disorders other than acute urticaria and angioneurotic edema, is not worthy of particular commendation. The size of the dose of any antihistaminic substance influences the incidence of but not the type of side-effect that may accompany its usage. The quality of side effects varies according to the drug, although there is an individuality of response for each patient which must be reckoned with. In selecting an antihistaminic compound it is necessary to consider the percentage of cases in which side effects occur, as well as the percentage of good results. Optimal results are obtained by employing combinations of compounds and changing from one to the other as the case demands.
受组胺和过敏反应影响的组织是相同的。肾上腺素通过以与组胺相反的方向作用于效应细胞来拮抗组胺的作用。所谓的抗组胺药是阻断而非拮抗组胺的作用。向人体注射肾上腺素或某些抗组胺物质会引发组胺的释放，从而导致血液中组胺水平升高。通过戴尔实验和完整豚鼠组胺中毒实验测定的抗组胺药效力具有显著的一致性。当通过这些方法测定效力时，新安替根、吡苄明和氯苯那敏通常优于其他化合物。所有抗组胺药对动物过敏反应都提供相似的保护作用。预防过敏反应所需的剂量比对抗组胺中毒所需的剂量更大。在动物身上通过戴尔实验和组胺实验确定的效力差异在临床应用中并未发现。在治疗任何一种或几种过敏性疾病时，一种化合物通常并不普遍优于所有其他化合物。抗组胺药在过敏性鼻炎、急性荨麻疹、血管神经性水肿以及轻度非感染性支气管哮喘的对症治疗中有益。它们在治疗中度严重和严重非感染性支气管哮喘、感染性支气管哮喘、偏头痛、特应性皮炎（播散性神经性皮炎）以及除急性荨麻疹和血管神经性水肿之外的其他皮肤疾病瘙痒方面的有效性并不值得特别称赞。任何抗组胺物质的剂量大小会影响其使用时可能伴随的副作用发生率，但不影响副作用的类型。副作用的性质因药物而异，尽管每个患者的反应存在个体差异，必须予以考虑。在选择抗组胺化合物时，有必要考虑出现副作用的病例百分比以及良好效果的百分比。通过联合使用化合物并根据情况需要从一种换成另一种可获得最佳效果。
