Cardiotoxic potential and CNS effects of first-generation antihistamines

Trends in Pharmacological Sciences

Volumn 21, Issue 2, 2000, Pages 52-56

  Taglialatela, Maurizio ^a   Timmerman, Henk ^b   Annunziato, Lucio ^a  

^a UNIVERSITY OF NAPLES FEDERICO II   (Italy)

^b VU UNIVERSITY AMSTERDAM   (Netherlands)

Author keywords

[No Author keywords available]

Indexed keywords

ANTIHISTAMINIC AGENT; ASTEMIZOLE; CHLORPHENIRAMINE; DIPHENHYDRAMINE; FEXOFENADINE; HYDROXYZINE; NORASTEMIZOLE; ORPHENADRINE; PHENIRAMINE; POTASSIUM CHANNEL; PROMETHAZINE; TERFENADINE;

CARDIOTOXICITY; HUMAN; LONG QT SYNDROME; NEUROTOXICITY; NONHUMAN; PRIORITY JOURNAL; REVIEW; SEIZURE; STRUCTURE ACTIVITY RELATION; TORSADE DES POINTES;

EID: 0034142033     PISSN: 01656147     EISSN: None     Source Type: Journal    
DOI: 10.1016/S0165-6147(99)01437-6     Document Type: Short Survey

References (43)

1. Slater J.W.et al. Second-generation antihistamines: a comparative review. Drugs. 57:1999;31-47.
2. Woosley R.L. Cardiac actions of antihistamines. Annu. Rev. Pharmacol. Toxicol. 36:1996;233-252.
3. Taglialatela M.et al. Cardiac ion channels and antihistamines: possible mechanisms of cardiotoxicity. Clin. Exp. Allergy. 29:1999;182-189.
4. Viskin S. Long QT syndromes and torsade de pointes. Lancet. 354:1999;1625-1633.
5. Sanguinetti M.C.et al. A mechanistic link between an inherited and an acquired cardiac arrhythmia: HERG encodes the IKr potassium channel. Cell. 81:1995;299-307.
6. Roy M-L.et al. HERG, a primary human ventricular target of the nonsedating antihistamine terfenadine. Circulation. 94:1996;817-823.
7. Suessbrich H.et al. Blockade of HERG channels expressed in Xenopus oocytes by the histamine receptor antagonists terfenadine and astemizole. FEBS Lett. 385:1996;77-80.
8. Khalifa M.et al. Block of potassium currents in guinea pig ventricular myocytes and lengthening of cardiac repolarization in man by the histamine H1 receptor antagonist diphenhydramine. J. Pharmacol. Exp. Ther. 288:1999;858-865.
9. Salata J.J.et al. Cardiac electrophysiological actions of the histamine H1-receptor antagonists astemizole and terfenadine compared with chlorpheniramine and pyrilamine. Circ. Res. 76:1995;110-119.
10. Wang W.X.et al. 'Conventional' antihistamines slow cardiac repolarization in isolated perfused (Langendorff) feline hearts. J. Cardiovasc. Pharmacol. 32:1998;123-128.
11. Pratt C.M.et al. Risk of developing life-threatening ventricular arrhythmia associated with terfenadine in comparison with over-the-counter antihistamines, ibuprofen and clemastine. Am. J. Cardiol. 3:1994;346-352.
12. + channel block-related cardiotoxicity by the H1 receptor blocker cetirizine compared with other second-generation antihistamines. Mol. Pharmacol. 54:1998;113-121.
13. Wogoman H.et al. Acute intoxication with guaifenesin, diphenhydramine, and chlorpheniramine. Am. J. Forensic Med. Pathol. 20:1999;199-201.
14. Hamelin B.A.et al. In vitro characterization of cytochrome P450 2D6 inhibition by classic histamine H1 receptor antagonists. Drug Metab. Disp. 26:1998;536-539.
15. Shi W.et al. Identification of two nervous system-specific members of the erg potassium channel gene family. J. Neurosci. 17:1997;9423-9432.
16. + channel polypeptide is encoded by the seizure locus. J. Neurosci. 17:1997;875-881.
17. Stoffel M., Jan L.Y. Epilepsy genes: excitement traced to potassium channels. Nature Genetics. 18:1998;6-8.
18. Harms A.F.et al. Diphenhydramine derivatives: through manipulation toward design. Ariens E.J. Drug Design (Vol. 6). 1975;2-76 Academic Press.
19. Gjerden P.et al. Fatalities caused by anticholinergic antiparkinsonian drugs. Analysis of findings in an 11-year national material. Tidsskr. Nor. Laegenforen. 118:1998;42-44.
20. Zhang M-Q. Chemistry underlying the cardiotoxicity of antihistamines. Curr. Med. Chem. 4:1997;187-200.
21. Hollister L.E. Hydroxyzine hydrochloride: possible adverse cardiac interactions. Psychopharmacol. Comm. 1:1975;61-65.
22. Magera B.E.et al. Hydroxyzine intoxication in a 13-month-old child. Pediatrics. 67:1981;280-283.
23. Hestand H.E., Teske D.W. Diphenhydramine hydrochloride intoxication. J. Pediatr. 90:1977;1017-1018.
24. Krenzelok E.P.et al. Massive diphenhydramine overdose resulting in death. Ann. Em. Med. 11:1982;212-213.
25. Rinder C.S.et al. Survival in complicated diphenhydramine overdose. Crit. Care Med. 16:1988;1161-1162.
26. Clark R.F., Vance M.V. Massive diphenhydramine poisoning resulting in a wide-complex tachycardia: successful treatment with sodium bicarbonate. Ann. Emerg. Med. 21:1992;318-321.
27. Zareba W.et al. Electrocardiographic findings in patients with diphenhydramine overdose. Am. J. Cardiol. 80:1997;1168-1173.
28. Olson K.R.et al. Seizures associated with poisoning and drug overdose. Am. J. Emerg. Med. 11:1993;565-568.
29. Danze L.K.et al. Reversal of orphenadrine-induced ventricular tachycardia with physostigmine. J. Emerg. Med. 9:1991;453-457.
30. Malizia E.et al. Cardiotoxicity from orphenadrine intoxication in humans. Arch. Toxicol. 4:1980;425-427.
31. Sangster B.et al. Treatment of orphenadrine overdose. New Engl. J. Med. 296:1977;1006.
32. Sangster B.et al. Intoxication by orphenadrine HCL: mechanism and therapy. Acta Pharmacologic Toxicology. 41:1977;129-136.
33. Bozza-Marrubini M.et al. Two cases of severe orphenadrine poisoning with atypical features. Acta Pharmacol. Toxicol. 41:1977;137-152.
34. Kondou N.et al. A case of life-threatening ventricular arrhythmias probably due to psychotropic drugs. Kokyu To Junkan. 41:1993;1117-1120.
35. Bobik A., McLean A.J. Cardiovascular complications due to pheniramine overdosage. Aust. New Zealand J. Med. 6:1976;65-67.
36. Chouinard G.et al. Death attributed to ventricular arrhythmia induced by thioridazine in combination with a single Contac C capsule. Can. Med. Assoc. J. 119:1978;729-730.
37. Leor J.et al. Giant U waves and associated ventricular tachycardia complicating astemizole overdose: successful therapy with intravenous magnesium. Am. J. Med. 91:1991;94-97.
38. Hoppu K.et al. Accidental astemizole overdose in young children. Lancet. 338:1991;538-540.
39. Craft T.M. Torsade de pointes after astemizole overdose. Br. Med. J. 292:1986;660.
40. Vorperian V.R.et al. Torsade de pointes with an antihistamine metabolite: potassium channel blockade with desmethylastemizole. J. Am. Coll. Cardiol. 28:1996;1556-1561.
41. Monahan B.P.et al. Torsades de pointes occurring in association with terfenadine use. J.Am. Med. Assoc. 264:1990;2788-2790.
42. Davies A.J.et al. Cardiotoxic effect with convulsions in terfenadine overdose. Br. Med. J. 302:1989;1469.
43. Pinto Y.M.et al. QT lengthening and arrhythmias associated with fexofenadine. Lancet. 353:1999;980-981.