Krausen A S
Ann Otol Rhinol Laryngol. 1976 Sep-Oct;85(5 Pt.1):686-91. doi: 10.1177/000348947608500520.
Antihistamines may be used to maximum benefit for the allergic patient if the physician adheres to four guidelines. These guidelines are based upon 1) an appreciation of certain structural and pharmacologic differences among antihistamines, and 2) an understanding of their mechanism of action. Around the clock administration is advisable, the dosage should be titrated for the individual patient, substitutions to another antihistamine should be to a different class of antihistamine, and the efficacy of any single antihistamine usually will diminish with prolonged use, either on the basis of true tolerance or because of psychic factors. There is good theoretical evidence when alpha-adrenergic sympathomimetics, employed as decongestants in combination with antihistamines, should not be given to allergic patients. Two newer drugs, disodium cromoglycate and beclomethasone, may provide symptomatic relief for allergic rhinitis patients. They may benefit the patient who does not obtain full symptomatic relief from antihistamines.
如果医生遵循四条指导原则，抗组胺药可为过敏患者带来最大益处。这些指导原则基于：1）了解抗组胺药之间某些结构和药理差异；2）理解其作用机制。建议持续给药，应根据个体患者调整剂量，换用另一种抗组胺药时应换用不同类别的抗组胺药，并且任何一种抗组胺药的疗效通常会因长期使用而降低，这要么是基于真正的耐受性，要么是由于心理因素。有充分的理论证据表明，作为减充血剂与抗组胺药联合使用的α-肾上腺素能拟交感神经药不应给予过敏患者。两种新药，色甘酸钠和倍氯米松，可能为过敏性鼻炎患者提供症状缓解。它们可能使那些使用抗组胺药后未获得完全症状缓解的患者受益。
