This study was designed to evaluate the therapeutic effect of H2 and H2 antihistaminics on dermographism. Twenty four patients with dermographism were allocated on a random to one of the following 3 treatment regimens. A) chlorphenirarnine and cimetidine (H1+H1) B) chlorpheniramine alone (H>) C) cimetidine alone (H) The patients cutaneous response to the dermographometer was assessed at weekly intervals for four weeks. The results were as follows: 1. The combinded treatment with chlorpheniramine and cimetidine was significantly more effective in inhibiting wheal and flare than the cimetidine alone (wheal p<0.01, flare p<0.02). 2. Following comparisions were not statistically significant: chlorpheniramine+ cimetidine vs chlorpheniramine (p>0. 05), chlorpbeniramine alone vs cimetidine alone(p>0.05). 3. Main side effects were drowsiness (3 cases) and mild gastric disturbance (2 cases) on hlorpheniramine alone.
Chlorpheniramine ; Cimetidine ; Histamine H2 Antagonists* ; Humans ; Sleep Stages

Ranitidine is a widely used histamine-2-receptor antagonist and it is usually well tolerated by patients with an excellent safety record. Anaphylactic reaction to ranitidine is rare event. We report here on 2 cases with anaphylactic reaction after the intravenous administration of ranitidine in an emergency medical center. Awareness of this rare, but life threatening adverse reaction to a commonly used ranitidine can help physicians avoid being caught unaware when they experience this medical situation. Although the incidences of anaphylactic reactions induced by these drugs are low, clinicians should be aware of this possibility of life threatening risk of anaphylactic reaction when administering ranitidine. Furthermore, the possibility of cross reactivity between drugs in the same antihistamine group should be considered. (ED note: please check the part in the yellow.)
Administration, Intravenous ; Anaphylaxis ; Emergencies ; Histamine H2 Antagonists ; Humans ; Incidence ; Ranitidine

The present study was carried out to determine the role of histamine H(1) and H(2) receptors in the generation of basic respiratory rhythm. Neonatal (aged 0-3 d) Sprague-Dawley rats of either sex were used. The medulla oblongata slice containing the medial region of the nucleus retrofacialis (mNRF) and the hypoglossal nerve rootlets was prepared and the surgical procedure was performed in the modified Kreb's solution (MKS) with continuous carbogen (95% O(2) and 5% CO(2)), and ended in 3 min. Respiratory rhythmical discharge activity (RRDA) of the rootlets of hypoglossal nerve was recorded by suction electrode. Thirty medulla oblongata slice preparations were divided into 5 groups. In groups I, II and III, histamine (5 μmol/L), H(1) receptor specific antagonist pyrilamine (10 μmol/L) and H(2) receptor specific antagonist cimetidine (5 μmol/L) was added into the perfusion solution for 15 min separately. In group IV, after application of histamine for 15 min, additional pyrilamine was added into the perfusion for another 15 min. In group V, after application of histamine for 15 min, additional cimetidine was added into the perfusion for another 15 min. The discharges of the roots of hypoglossal nerve were recorded. Signals were amplified and band-pass filtered (100-3.3 kHz). Data were sampled (1-10 kHz) and stored in the computer via BL-420 biological signal processing system. Our results showed that histamine significantly decreased the respiratory cycle (RC) and expiratory time (TE), but changes of integral amplitude (IA) and inspiratory time (TI) were not statistically significant. Pyrilamine induced significant increases in RC and TE, but changes of TI and IA were not statistically significant. Cimetidine had no effects on RC, TE, TI and IA of RRDA. The effect of histamine on the respiratory rhythm was reversed by additional application of pyrilamine but not cimetidine. Taken together, with the results mentioned above, histamine H(1) receptors but not H(2) receptors may play an important role in the modulation of RRDA in the medulla oblongata slice preparation of neonatal rats.
Animals ; Animals, Newborn ; Cimetidine ; pharmacology ; Female ; Histamine ; pharmacology ; Histamine H1 Antagonists ; pharmacology ; Histamine H2 Antagonists ; pharmacology ; Hypoglossal Nerve ; physiology ; In Vitro Techniques ; Male ; Medulla Oblongata ; physiology ; Pyrilamine ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Receptors, Histamine H1 ; physiology ; Receptors, Histamine H2 ; physiology ; Respiration

BACKGROUND/AIMS: Anxiety and depression are associated with reflux symptoms in patients with gastroesophageal reflux disease (GERD). The purpose of this study is to investigate whether the anxiety and depression in patients with GERD will improve with anti-secretory treatment. MATERIALS AND METHODS: Participants who had taken upper endoscopic evaluation and who had symptoms of heartburn or acid regurgitation more than once a week were included through questionnaires. The hospital anxiety and depression scale was used to compare the scores before and after anti-secretory drug (proton pump inhibitor [PPI] or histamine-2 receptor blocker [H2 blocker]) treatment for four weeks. RESULTS: Eighty-four out of a total 94 patients were randomly assigned to a four week treatment, in which, 46 and 38 patients were each assigned to PPI and H2 blocker, respectively. Regardless of the type of treatment, anxiety scores decreased significantly from 5.8+/-3.8 to 5.2+/-3.9 after treatment (P=0.033). Depression scores of 6.3+/-3.4 before treatment reduced to 5.5+/-3.4 after treatment (P=0.011). Anxiety scores and depression scores decreased significantly after treatment in the H2 blocker group. In the response group, anxiety and depression showed significant improvement (P=0.008, P=0.011). CONCLUSIONS: Regardless of the type of drugs, anti-secretory therapy is helpful in treating symptomatic GERD patients, not only in relieving symptoms, but also in relieving anxiety and depression accompanied with GERD.
Anxiety ; Depression ; Gastroesophageal Reflux ; Heartburn ; Histamine H2 Antagonists ; Humans ; Proton Pump Inhibitors ; Surveys and Questionnaires

BACKGROUND/AIMS: Anxiety and depression are associated with reflux symptoms in patients with gastroesophageal reflux disease (GERD). The purpose of this study is to investigate whether the anxiety and depression in patients with GERD will improve with anti-secretory treatment. MATERIALS AND METHODS: Participants who had taken upper endoscopic evaluation and who had symptoms of heartburn or acid regurgitation more than once a week were included through questionnaires. The hospital anxiety and depression scale was used to compare the scores before and after anti-secretory drug (proton pump inhibitor [PPI] or histamine-2 receptor blocker [H2 blocker]) treatment for four weeks. RESULTS: Eighty-four out of a total 94 patients were randomly assigned to a four week treatment, in which, 46 and 38 patients were each assigned to PPI and H2 blocker, respectively. Regardless of the type of treatment, anxiety scores decreased significantly from 5.8+/-3.8 to 5.2+/-3.9 after treatment (P=0.033). Depression scores of 6.3+/-3.4 before treatment reduced to 5.5+/-3.4 after treatment (P=0.011). Anxiety scores and depression scores decreased significantly after treatment in the H2 blocker group. In the response group, anxiety and depression showed significant improvement (P=0.008, P=0.011). CONCLUSIONS: Regardless of the type of drugs, anti-secretory therapy is helpful in treating symptomatic GERD patients, not only in relieving symptoms, but also in relieving anxiety and depression accompanied with GERD.
Anxiety ; Depression ; Gastroesophageal Reflux ; Heartburn ; Histamine H2 Antagonists ; Humans ; Proton Pump Inhibitors ; Surveys and Questionnaires

Child ; Famotidine ; adverse effects ; therapeutic use ; Gastrointestinal Hemorrhage ; drug therapy ; Histamine H2 Antagonists ; adverse effects ; therapeutic use ; Humans

BACKGROUND AND OBJECTIVES: Reflux laryngitis gives rise to inflammatory change in the pharyngolaryngeal tissue with various otolaryngologic and respiratory symptoms. Histamine H2 receptor antagonists and H(+)-K(+)-Exchanging ATPase are currently used as therapeutic medications. However, the efficacy of those two drugs on reflux laryngitis has never been proven yet. Therefore, we intended to analyze and compare the efficacy of the two drugs on reflux laryngitis. MATERIALS AND METHOD: Among the patients who had visited the Department of Otolaryngology, those with the total score of greater than 6 and having more than 2 symptoms that score greater than 2, had undergone laryngoscopy. Of these, the patients who had shown greater than 7 on the Belafsky's Reflux Finding Score (RFS) were studied. The RAN (Ranitidine) group (59 subjects) with Ranitidine administered and RAB (Rabeprazole)group (66 subjects) with Rabeprazole were followed up for 12 weeks, and then the efficacy of each drug was evaluated at 2nd, 4th, and 12th week. Then, the Symptom Score Improvement (SSI) and RFS were compared and analyzed. RESULTS: In comparison the RAN group that had Histamine H2 receptor antagonists and prokinetic agents administered to the RAB group that had H(+)-K(+)-Exchanging ATPase and prokinetic agents administered for the improvement of symptoms caused by reflux laryngitis, no difference was observed till after the first 2 weeks. On the evaluation at 4th and 12th week, statistically higher therapeutic efficacy was shown to a great extent in the RAB group. The findings of laryngoscopy at the 12th week also showed higher therapeutic efficacy in the RAB group. In comparison of symptoms between the groups, there were significant differences in pharyngolaryngeal foreign body sense and chronic throat clearing, and laryngeal edema and injection as well. CONCLUSION: For therapy of reflux laryngitis patients with moderately severe symtpoms, the use of H(+)-K(+)-Exchanging ATPase and prokinetic agents were superior in improving symptoms and clinicopathologic findings of larynx than Histamine H2 receptor antagonists and prokinetic agents.
Foreign Bodies ; H(+)-K(+)-Exchanging ATPase ; Histamine H2 Antagonists ; Humans ; Laryngeal Edema ; Laryngitis* ; Laryngoscopy ; Larynx ; Otolaryngology ; Pharynx ; Rabeprazole* ; Ranitidine*

Serotonin syndrome is an unexpected fatal adverse event related to serotonergic medication. This case report is the first report describing the possible treatment effect of famotidine on serotonin syndrome. Furthermore, this is the first case report of serotonin syndrome induced by meperidine alone in a patient with no previous history suggesting a susceptibility to serotonin syndrome. A 70-year-old male with no recent history of serotonergic drug use presented with severe serotonin syndrome following ureteroscopy, possibly due to postoperative meperidine administration. The patient's symptoms included hypertension, tachycardia, tachypnea, hyperthermia, myoclonus, diaphoresis, retching, nausea, agitation, and semicoma mentality with no pupillary light reflex. Symptoms began to subside immediately after the administration of intravenous famotidine for prevention of aspiration pneumonia, with mental and neurological symptoms showing improvement initially, followed by autonomic symptoms. This case report suggests that the histamine type 2 receptor antagonist famotidine may be an effective emergency treatment for serotonin syndrome.
Aged ; Dihydroergotamine ; Emergency Treatment ; Famotidine ; Fever ; Histamine ; Histamine H2 Antagonists ; Humans ; Hypertension ; Male ; Meperidine ; Myoclonus ; Nausea ; Pneumonia, Aspiration ; Reflex ; Serotonin Syndrome* ; Serotonin* ; Tachycardia ; Tachypnea ; Ureteroscopy

Serotonin syndrome is an unexpected fatal adverse event related to serotonergic medication. This case report is the first report describing the possible treatment effect of famotidine on serotonin syndrome. Furthermore, this is the first case report of serotonin syndrome induced by meperidine alone in a patient with no previous history suggesting a susceptibility to serotonin syndrome. A 70-year-old male with no recent history of serotonergic drug use presented with severe serotonin syndrome following ureteroscopy, possibly due to postoperative meperidine administration. The patient's symptoms included hypertension, tachycardia, tachypnea, hyperthermia, myoclonus, diaphoresis, retching, nausea, agitation, and semicoma mentality with no pupillary light reflex. Symptoms began to subside immediately after the administration of intravenous famotidine for prevention of aspiration pneumonia, with mental and neurological symptoms showing improvement initially, followed by autonomic symptoms. This case report suggests that the histamine type 2 receptor antagonist famotidine may be an effective emergency treatment for serotonin syndrome.
Aged ; Dihydroergotamine ; Emergency Treatment ; Famotidine ; Fever ; Histamine ; Histamine H2 Antagonists ; Humans ; Hypertension ; Male ; Meperidine ; Myoclonus ; Nausea ; Pneumonia, Aspiration ; Reflex ; Serotonin Syndrome* ; Serotonin* ; Tachycardia ; Tachypnea ; Ureteroscopy

OBJECTIVETo investigate histamine-induced changes of the intracortical vessels in the cortical slice of rat brain.

METHODSImmunohistochemistry was employed to detect the expression of H1 and H2 receptors in the intracortical blood vessels of rats. Histamine-induced constriction of the intracortical blood vessels of the brain slices was observed with differential interference contrast microscope. Measurements of the luminal diameter were made on-line during the course of the experiment and confirmed off-line from the stored images. In order to observe whether histamine H1 and H2 receptors affected histamine-induced constriction, the intracortical blood vessels in the brain slices were pre-treated with H1 receptor antagonist diphenhydramine and H2 receptor antagonist cimetidine.

RESULTSExpression of H1 and H2 receptors was detected in the intracortical blood vessels of the rat brain. Histamine (1-100 micromol/L) induced a concentration-dependent constriction from (1.48-/+0.67)% to (32.91-/+7.91)%. The reactions to each histamine concentration were significantly (P<0.01) different from each other, with the exception of the highest histamine concentrations (30 and 100 micromol/L) when maximal constriction due to histamine were observed (P>0.05). With pre-treatment of the slice with 10 micromol/L diphenhydramine, application of histamine did not elicit constriction. Pre-treatment of the slice with 10 micromol/L cimetidine did not completely inhibit but somehow significantly weakened vascular constriction in response to histamine treatment at 10 and 30 micromol/L (P<0.05).

CONCLUSIONHistamine can induce constriction of the intracortical blood vessels, which is mediated by H1 receptor.

Animals ; Blood Vessels ; drug effects ; metabolism ; physiology ; Cerebral Cortex ; blood supply ; Cimetidine ; pharmacology ; Diphenhydramine ; pharmacology ; Histamine ; pharmacology ; Histamine H1 Antagonists ; pharmacology ; Histamine H2 Antagonists ; pharmacology ; In Vitro Techniques ; Male ; Rats ; Rats, Sprague-Dawley ; Receptors, Histamine H1 ; metabolism ; physiology ; Receptors, Histamine H2 ; metabolism ; physiology ; Vasoconstriction ; drug effects