Mar 17, 2008 ... Non-sedating histamine H1 receptor antagonists. Clin Pharm. 1989; 8:331-344. 33 Woodward J. Pharmacology of antihistamines. J Allergy Clin ...For example, loratadine is a non-sedating second-generation antihistamine that has demonstrated effectiveness in managing AR in children.29,33 In a 3-week, double-blind, placebo-controlled, randomized trial involving children aged 3–12 years with AR, loratadine significantly reduced sneezing, rhinorrhea and nasal itching.33 Loratadine …Ebastine is a once-daily, non-sedating, selective, long-acting, second-generation antihistamine. The use of ebastine is indicated in patients suffering from intermittent and persistent allergic rhinitis and chronic idiopathic urticaria. Ebastine 10 mg/day, appears as effective as other second-genera …Comparisons with other allergy medications · Allegra: This contains the active ingredient fexofenadine. Allegra is non-sedating, so drowsiness is not a common ...ฮิสตามีน (histamine) ที่หลั่งจาก mast cell มีบทบาทสำคัญที่ทำให้เกิดการแพ้แบบ type I hypersensitivity ดังนั้นยาต้านฮิสตามีน (antihistamine) จึงเป็นยาตัวเลือกอันดับหนึ่งสำหรับ ...Side effects of antihistamines that make you drowsy can include: sleepiness (drowsiness) and reduced co-ordination, reaction speed and judgement – do not drive or use machinery after taking these antihistamines. dry mouth. blurred vision. difficulty peeing. Side effects of non-drowsy antihistamines can include: headache. Antihistamines are currently one of the most commonly administered drugs in children. They are used to treat symptoms that depend on histamine release, namely allergic diseases, such as rhinitis, asthma, urticaria, and anaphylaxis. It is possible to distinguish first- and second-generation antihistamines. Pharmacological effects and therapeutic ...Acute urticaria can be effectively treated with a non-sedating antihistamine; Background. Urticaria is a common skin condition characterised by recurrent, transient, raised pruritic lesions (wheals), more commonly known as “hives”Side-effects, further information. Non-sedating antihistamines such as loratadine cause less sedation and psychomotor impairment than the older antihistamines, but can still occur; sedation is generally minimal. This is because non-sedating antihistamines penetrate the blood brain barrier to a much lesser extent.Antihistamines are classified in two distinct groups: First generation (or sedating antihistamines) Second generation (or non-sedating antihistamines) First generation drugs offer sedative which result in their use for the alleviation of discomfort and disturbed patterns of behaviour, such as being unable to sleep through excessive itching ...– Second and third-generation, or non-sedating antihistamines, are a more recent development and are used much more frequently as they usually, they don’t cause drowsiness and can be …For people with mild urticaria with an identifiable and avoidable cause/trigger, advise that urticaria is likely to be self-limiting without treatment. For people with symptoms requiring treatment: Offer a non-sedating antihistamine (for example cetirizine, fexofenadine, or loratadine) for up to 6 weeks (use clinical judgement to determine the ...A second-generation non-sedating antihistamine used to treat symptoms of allergic rhinoconjunctivitis and urticaria. GSK-1004723: Gsk1004723 has been investigated for the treatment of Allergic Rhinitis and Rhinitis, Allergic, Seasonal. Oxatomide: An antihistamine indicated in the treatment and prevention of allergic symptoms. DexchlorpheniramineNon-sedating antihistamines should be preferentially used whenever possible as most antihistamines are equally efficacious, while adverse effects of sedating antihistamines can be serious. This review summarizes the pharmacological properties of clinically useful non-sedating antihistamines from the perspective of histamine function in the CNS. Desloratadine is a relatively new, second-generation, tricyclic antihistamine which came into medical use in 2001. This study aimed to review the available evidence in the literature around the clinical efficacy of desloratadine on a range of allergic conditions.Side-effects, further information. Non-sedating antihistamines such as loratadine cause less sedation and psychomotor impairment than the older antihistamines, but can still occur; sedation is generally minimal. This is because non-sedating antihistamines penetrate the blood brain barrier to a much lesser extent.Side effects of antihistamines that make you drowsy can include: sleepiness (drowsiness) and reduced co-ordination, reaction speed and judgement – do not drive or use machinery after taking these antihistamines. dry mouth. blurred vision. difficulty peeing. Side effects of non-drowsy antihistamines can include: headache. Oct 1, 2017 · First- and second-generation antihistamines are generally classified into sedating and non-sedating compounds based on the presence/absence of sedation. Sedating action is usually evaluated on the basis of subjective drowsiness and impaired performance, as measured by a cognitive function test. We have devised a method to non-invasively ... Apr 29, 2000 · Introduction. Antihistamines are often used to treat the symptoms of allergies such as seasonal and perennial allergic rhinitis and urticaria. The first generation antihistamines have been associated with side effects, particularly sedation.1 Second generation antihistamines are therefore favoured over the first generation drugs, not because of greatly improved efficacy but because they have ... ): a new non-sedating antihistamine in seasonal allergic rhinitis. Ann Allergy. 1987;58(6):407-411. 57. Ucb. A study evaluating the efficacy and safety of 5 ...For people with mild urticaria with an identifiable and avoidable cause/trigger, advise that urticaria is likely to be self-limiting without treatment. For people with symptoms requiring treatment: Offer a non-sedating antihistamine (for example cetirizine, fexofenadine, or loratadine) for up to 6 weeks (use clinical judgement to determine the ...Our preferred antihistamines for various age groups (not in order of preference) · 6 months to 2 years: cetirizine, levocetirizine, desloratadine, fexofenadine ...Non-sedating antihistamines should be preferentially used whenever possible as most antihistamines are equally efficacious, while adverse effects of sedating antihistamines can be serious. This review summarizes the pharmacological properties of clinically useful non-sedating antihistamines from the perspective of histamine function in the CNS. Therefore, non-sedating antihistamine-containing eye or nasal drops should be used as first choice treatments. We propose a method to assess sedating action by measuring H 1 receptor occupancy after single-dose administration. The weakness of this method is that the measurement is not made in allergy patients after multiple dosing.Sep 21, 2023 · However, if you are taking an antihistamine to treat motion sickness, relieve anxiety or use as a sleep aid, a first-generation antihistamine may be recommended due to the sedating effects. There are many brands of antihistamines that are available over the counter (OTC), and finding the appropriate one for your needs can be confusing. May 4, 2018 · Second-generation antihistamines include: Claritin/Alavert (loratadine) Allegra (fexofenadine) Zyrtec (cetirizine) Clarinex (desloratadine) Third -generation antihistamines include: Xyzal (levocetirizine) Of the above medications, all are non-drowsy except Zyrtec and Xyzal. However, those two are not nearly as sedating as first-generation ... Antihistamines are classified into non-sedating (<20%), less-sedating (20⁻50%), and sedating (≥50%) groups based on H₁RO. Among the non-sedating group, fexofenadine and bilastine are classified into "non-brain-penetrating antihistamines" based on the H₁RO. These two drugs have many common chemical properties. However, …non-drowsy antihistamines (also known as non-sedating antihistamines) – these are less likely to enter your brain and tend to cause less sleepiness as a result. Some people do sometimes feel drowsy even with these …Side-effects, further information. Non-sedating antihistamines such as fexofenadine cause less sedation and psychomotor impairment than the older antihistamines, but can still occur; sedation is generally minimal. This is because non-sedating antihistamines penetrate the blood brain barrier to a much lesser extent. H 1- antihistamines, the mainstay of treatment for urticaria, were developed from anticholinergic drugs more than 70 years ago. They act as inverse agonists rather than antagonists of histamine H 1 -receptors which are members of the G-protein family. The older first generation H 1- antihistamines penetrate readily into the brain to cause ... Non-sedating antihistamines are less toxic in overdose but may cause tachycardia, drowsiness, gastrointestinal disturbances and headache. Arrhythmias have been reported with non-sedating antihistamine overdose but this appears to be rare. Treatment of antihistamine overdose includes activated charcoal (when indicated) and …Antihistamines are not recommended as part of the initial emergency treatment of anaphylaxis. Following stabilisation of the patient, a non-sedating oral antihistamine such as cetirizine hydrochloride (in preference to chlorphenamine maleate) may be considered, especially in patients with persistent cutaneous symptoms (urticaria and/or angioedema). There is now little role for sedating antihistamines in allergic conditions. Less sedating antihistamines are equally efficacious. The less sedating ...Side-effects, further information. Non-sedating antihistamines such as loratadine cause less sedation and psychomotor impairment than the older antihistamines, but can still occur; sedation is generally minimal. This is because non-sedating antihistamines penetrate the blood brain barrier to a much lesser extent.The main adverse effects seen with non-sedating antihistamine tablets include: Dry mouth. Blurred vision. These side effects should be mild but if you have any concerns about these or any other side effects please contact your doctor or specialist nurse for advice. If you are affected with drowsiness when taking these tablets you should avoid ...Nov 26, 2014 ... The use of double approved doses of fexofenadine, rupatadine, or bilastine shows an objective improvement in most (>50%) of patients that ...Rupatadine is a modern non-sedating H1-antihistamine that also haswith …Cardiac side effects. Side effects with geriatric use. Contraindications to …Oct 28, 2017 · Loratadine (Claritin) - The first of the prescription second generation antihistamines to go over the counter. It is also the least expensive. This is a great choice to try first for your allergy symptoms since it is almost completely non-drowsy and works for 24 hours. Cetirizine (Zyrtec) - Cetirizine was the second of the second generation ... Best Allergy Medicine: Antihistamines. We surveyed hundreds of pharmacists to collect their expert recommendations of the best allergy medicines. Zyrtec is the No. 1 allergy medicine followed by ...The first non-sedating antihistamine was terfenadine (Seldane) and was developed in 1973. Subsequently, other non-sedating antihistamines like loratadine (Claritin), cetirizine (Zyrtec), and fexofenadine (Allegra) were developed and introduced. Non-sedating antihistamines are the preferred choice for a breastfeeding mother: Cetirizine (Zirtek®, BecoAllergy®, Piriteze®, Benadryl®) reaches low levels in breastmilk and is recommended by the British Society for Allergy and Clinical Immunology (Powell 2007) Fexofenadine (Telfast®) is a newer antihistamine with similar low levels of ...There are 2 types of antihistamines available in Australia: First-generation (sedating) antihistamines often cause sleepiness. Examples of sedating antihistamines include Phenergan® and Polaramine®. Second-generation (less sedating or non-sedating) antihistamines that usually do not cause sleepiness. Examples include Claratyne®, …Sep 21, 2023 · However, if you are taking an antihistamine to treat motion sickness, relieve anxiety or use as a sleep aid, a first-generation antihistamine may be recommended due to the sedating effects. There are many brands of antihistamines that are available over the counter (OTC), and finding the appropriate one for your needs can be confusing. Although discouraged by treatment guidelines, sedating antihistamines are frequently prescribed for nighttime use when urticaria symptoms are severe as add-on therapy to a non-sedating antihistamine. However, their pronounced effects on rapid eye movement sleep and hangover negatively impact QoL, learning and performance, and limit their use …Desloratadine is a new, selective, H1-receptor antagonist that also has anti-inflammatory activity. In vitro studies have shown that desloratadine inhibits the release or generation of multiple inflammatory mediators, including IL-4, IL-6, IL-8, IL-13, PGD2, leukotriene C4, tryptase, histamine, and the TNF-α–induced chemokine RANTES. Desloratadine also …First Generation Antihistamine have more potent Anticholinergic activity (sedation, Dry Mouth) Second Generation Antihistamines (e.g. Fexofenadine) are labeled as Non-Sedating Antihistamines; H2 Blockers (e.g. Cimetidine) are also Antihistamines. Although primarily active in suppressing acid secretion from the Stomach, H2 Blockers have some …Oral H1-antihistamines (AHs) are the most commonly used therapy to treat allergic rhinitis and chronic urticaria. Older, first-generation AHs (e.g. diphenhydramine, hydroxyzine) have significant and common side effects including sedation, impairment with decreased cognitive function, poor sleep quality, dry mouth, dizziness, and orthostatic …Astemizole. acrivastine. fexofenadine. ebastine. Cetirizine. Most of the modern non-sedating H1 receptor antagonists (antihistamines) penetrate the brain poorly, allowing the use of doses large enough to counteract allergic processes in peripheral tissues without important central effects. The antihistamines reviewed here are acrivastine ... There is now little role for sedating antihistamines in allergic conditions. Less sedating antihistamines are equally efficacious. The less sedating ...Loratadine is an antihistamine medicine that helps with the symptoms of allergies. It's used to treat: hay fever; conjunctivitis (red, itchy eyes) eczema; hives (urticaria) reactions to insect bites and stings; some food allergies; Loratadine is known as a non-drowsy antihistamine. It's much less likely to make you feel sleepy than some other ... Sedating antihistamines are no longer recommended by guidelines for routine use in urticaria. The licensed oral daily doses of chlorphenamine are [ BNF, 2022; BNF for children, 2022 ]: Age 2 years to 5 years - 1 mg every 4-6 hours; maximum of 6 mg daily. Chlorphenamine is not licensed for use in children younger than 1 year [ ABPI, 2021c ], …Apr 17, 2023 · Antihistamines are drugs that block histamine release and are used to treat allergies, cold and flu symptoms, nausea, and motion sickness. Some antihistamines are sedating (sedating antihistamines) and some are not (non-sedating antihistamines). Learn about the differences, uses, side effects, and common brands of antihistamines. There are 2 types of antihistamines available in Australia: First-generation (sedating) antihistamines often cause sleepiness. Examples of sedating antihistamines include Phenergan® and Polaramine®. Second-generation (less sedating or non-sedating) antihistamines that usually do not cause sleepiness. Examples include Claratyne®, Desonex ... Allegra (fexofenadine), Claritin (loratadine), and Zyrtec (cetirizine) are over-the-counter (OTC) antihistamines used to treat allergies. All of them are considered non-drowsy medications and one is …Oct 1, 2017 · First- and second-generation antihistamines are generally classified into sedating and non-sedating compounds based on the presence/absence of sedation. Sedating action is usually evaluated on the basis of subjective drowsiness and impaired performance, as measured by a cognitive function test. We have devised a method to non-invasively ... Non-sedating antihistamines should be preferentially used whenever possible as most …using sedating antihistamines increases the risk of drowsiness and irritability. In conclusion (4): first-generation antihistamines are considered safe to use during pregnancy. There are relatively fewer data on the nonsedating second-generation antihistamines; however, published studies are reassuring.Learn about the choice, dosage, and safety of non-sedating antihistamines for the …Side-effects, further information. Non-sedating antihistamines such as cetirizine hydrochloride cause less sedation and psychomotor impairment than the older antihistamines, but can still occur; sedation is generally minimal. This is because non-sedating antihistamines penetrate the blood brain barrier to a much lesser extent.Conclusions These findings suggest that the mechanism of action of the rare proarrhythmic effects of the nonsedating antihistamines appears to be secondary to ...Antihistamines are classified into non-sedating (<20%), less-sedating (20–50%), and sedating (≥50%) groups based on H 1 RO. Among the non-sedating group, fexofenadine and bilastine are classified into “non-brain-penetrating antihistamines” based on the H 1 RO. These two drugs have many common chemical properties.In most instances this nonsedating antihistamine was terfenadine (44.2%), followed by cetirizine (23.3%) and loratadine (16.3%). Table 1 Number of adverse drug reactions reported to LAREB until July 1999 categorized according to WHO-ART as system and organ class 1030 ‘heart rate and rhythm disorders’ sorted by type of arrhythmia.Rupatadine is a modern non-sedating H1-antihistamine that also haswith additional antagonist effects on platelet-activating factor (PAF). Under the tradenames Rupafin® and Urtimed®, Rrupatadine is approvedregistered in Germany for the treatment of allergic rhinitis and urticaria infor adults and children aged over 12 years.Clinical experiences with the non-sedating antihistamine terfenadine identified a significant risk for death due to induced disturbances in the electrical conduction of the heart (prolonged QT interval). Terfenadine was withdrawn back in the 1990s. Since then, a lot of attention has been paid to the risk when new antihistamines are developed.First-generation OTC oral antihistamines, including diphenhydramine and chlorpheniramine, are the oldest group. They are sedating, which means they're ...All second-generation antihistamines have been shown to be non-sedative; however, of these, bilastine, the newest-marketed non-sedating antihistamine, has been shown to have one of the lowest cerebral histamine H1 receptor occupancies compared with other modern second-generation antihistamines [24, 25].Antihistamines are drugs that reduce symptoms of nasal and eye allergies, urticaria, and …Antihistamines are classified into two groups – the first-generation (“sedating”) …Sep 28, 2023 · Loratadine (brand example: Claritin), an over-the-counter (OTC) non-sedating antihistamine, does not usually increase blood pressure when used alone as a single ingredient. Some OTC combination products do contain loratadine plus the decongestant pseudoephedrine (brand example: Claritin-D), which can raise your blood pressure. Second-generation antihistamines include: Claritin/Alavert (loratadine) Allegra (fexofenadine) Zyrtec (cetirizine) Clarinex (desloratadine) Third -generation antihistamines include: Xyzal (levocetirizine) Of the above medications, all are non-drowsy except Zyrtec and Xyzal. However, those two are not nearly as sedating as first-generation ...Loratadine is known as a non-drowsy antihistamine. It's less likely to make you feel sleepy than other, so-called, sedating antihistamines such as Piriton ( ...Antihistamines are not recommended as part of the initial emergency treatment of anaphylaxis. Following stabilisation of the patient, a non-sedating oral antihistamine such as cetirizine hydrochloride (in preference to chlorphenamine maleate) may be considered, especially in patients with persistent cutaneous symptoms (urticaria and/or angioedema). Antihistamines suppress the histamine-induced wheal response (swelling) and flare …The non‐sedating antihistamines studied were cetirizine, loratadine, terfenadine and astemizole. The latter two are no longer available due to the risk of serious cardiac side effects. The design of the studies varied between experimental infection of participants versus naturally acquired colds. Comparison of such studies in a meta ...Oct 12, 2022 ... These medicines may be used for their sedative effects should your sleep be disturbed by itching. Non-sedating or second-generation ...Nov 15, 2019 · Antihistamines may be classified as sedating (first-generation antihistamines), and non-sedating (second-generation antihistamines). Both act on the H1 receptor, but the first-generation drugs act ... There are 2 types of antihistamines available in Australia: First-generation (sedating) antihistamines often cause sleepiness. Examples of sedating antihistamines include Phenergan® and Polaramine®. Second-generation (less sedating or non-sedating) antihistamines that usually do not cause sleepiness. Examples include Claratyne®, Desonex ... Non-sedating antihistamines are less toxic in overdose but may cause tachycardia, drowsiness, gastrointestinal disturbances and headache. Arrhythmias have occasionally been reported with sedating and non-sedating antihistamine overdose. Treatment of antihistamine overdose includes activated charcoal (when indicated) and …WO2011003074 - NON-SEDATING ANTIHISTAMINE INJECTION FORMULATIONS AND METHODS OF USE THEREOF. Publication Number WO/2011/003074. Publication Date 06.01.2011. International Application No. PCT/US2010/040925. International Filing …Recent EAACI guidelines for management of CSU recommend second-generation non-sedating H1 antihistamines (sgAH 1 s) as initial treatment in children (weight-adjusted) as in adults, followed by increased doses (up to 4 times) if the standard dose is not effective. The efficacy and tolerability of fourfold updosing in adults are known, but there ...H. 1. antagonist. H1 antagonists, also called H1 blockers, are a class of medications that block the action of histamine at the H 1 receptor, helping to relieve allergic reactions. Agents where the main therapeutic effect is mediated by negative modulation of histamine receptors are termed antihistamines; other agents may have antihistaminergic ...Astemizole. acrivastine. fexofenadine. ebastine. Cetirizine. Most of the modern non-sedating H1 receptor antagonists (antihistamines) penetrate the brain poorly, allowing the use of doses large enough to counteract allergic processes in peripheral tissues without important central effects. The antihistamines reviewed here are acrivastine ... Jun 14, 2022 · Allergists recommend long-acting, non-sedating antihistamines — ones that won’t make you sleepy — for everyday use. Though you may know them by their brand names, the generic versions tackle the same problems: Cetirizine (Zyrtec®, Aller-Tec®, Wall-Zyr®). Fexofenadine (Allegra®, Aller-ease®, Aller-Fex®, Wal-Fex®). Therefore, non-sedating antihistamine-containing eye or nasal drops should be used as first choice treatments. We propose a method to assess sedating action by measuring H 1 receptor occupancy after single-dose administration. The weakness of this method is that the measurement is not made in allergy patients after multiple dosing.Loratadine is a new non-sedating antihistamine. The present studies compared loratadine and terfenadine, another non-sedating antihistamine, for their ability to inhibit the bronchial response to histamine and other autacoids which have been implicated as contributing to the symptoms of an allergic reaction. Sedating antihistamines have the ability to cross the blood-brain barrier, the ability to bind to non-histamine receptors and have less selectivity for peripheral or central H1-receptors 2. Therefore, sedating antihistamines tend to cause more adverse reactions than 'second generation' or 'non-sedating' antihistamines 2 .
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How They Work: Antihistamines used to treat allergy symptoms fall into two broad categories: sedating and non-sedating. The first category includes the older antihistamines.These allergy drugs relieve allergy symptoms but cause drowsiness and other side effects, including dry mouth.Newer antihistamines are said to be non …These antihistamines start to take effect in about 30 to 60 minutes and last for four to six hours. The most popular first-generation antihistamine is chlorpheniramine, especially for emergency use. The affinity of an H 1-antihistamine for H 1-receptors is determined in vitro in preclinical studies. Comparing the three most recently developed drugs, desloratadine is the most potent antihistamine (Ki: 0.4 nM) followed by levocetirizine (Ki: 3 nM) and fexofenadine (Ki: 10 nM) (the lower the concentration, the higher the potency).Combined central antiserotonin-antihistamine effects are poorly known, but they can cause variations in sedation among non-sedating antihistamine. Ritan ...An antihistamine agent used for the symptomatic relief of seasonal allergic rhinitis such as sneezing, rhinorrhea, pruritus, lacrimation, and nasal congestion. Mizolastine: A second-generation non-sedating antihistamine used to treat symptoms of allergic rhinoconjunctivitis and urticaria. Bilastine Dependent on indication. Consider non-sedating antihistamine (e.g. loratadine). Refer to [AMH-Antihistamine]. In some instances (e.g. chronic urticaria), non-sedating antihistamine can be titrated up to four fold higher than the standard dose without compromising safety.6 Topical treatments include moisturisers, anti-inflammatoriesNon-sedating antihistamines are the preferred choice for a breastfeeding mother: Cetirizine (Zirtek®, BecoAllergy®, Piriteze®, Benadryl®) reaches low levels in breastmilk and is recommended by the British Society for Allergy and Clinical Immunology (Powell 2007) Fexofenadine (Telfast®) is a newer antihistamine with similar low levels of ...Acrivastine is a non-sedating antihistamine, which works by blocking histamine H1 receptors, which cause allergic symptoms. It doesn't prevent the release of ...Summary Many people use antihistamines to treat allergy symptoms. Zyrtec (cetirizine) and Claritin (loratadine) are two popular brands. They contain different compounds but appear to be equally...For people with mild urticaria with an identifiable and avoidable cause/trigger, advise that urticaria is likely to be self-limiting without treatment. For people with symptoms requiring treatment: Offer a non-sedating antihistamine (for example cetirizine, fexofenadine, or loratadine) for up to 6 weeks (use clinical judgement to determine the ...First Generation Antihistamine have more potent Anticholinergic activity (sedation, Dry Mouth) Second Generation Antihistamines (e.g. Fexofenadine) are labeled as Non-Sedating Antihistamines; H2 Blockers (e.g. Cimetidine) are also Antihistamines. Although primarily active in suppressing acid secretion from the Stomach, H2 Blockers have some …Desloratadine is a relatively new, second-generation, tricyclic antihistamine which came into medical use in 2001. This study aimed to review the available evidence in the literature around the clinical efficacy of desloratadine on a range of allergic conditions.Dec 20, 2013 · Antihistamines are classified in two distinct groups: First generation (or sedating antihistamines) Second generation (or non-sedating antihistamines) First generation drugs offer sedative which result in their use for the alleviation of discomfort and disturbed patterns of behaviour, such as being unable to sleep through excessive itching ... This article evaluates second-generation antihistamines, including acrivastine, astemizole, azelastine, cetirizine, ebastine, fexofenadine, ketotifen, loratadine, mizolastine and terfenadine, for significant features that affect choice. In addition to their primary mechanism of antagonising histamine at the H1 receptor, these agents may act on ...Loratadine is a long-acting, second-generation, non-sedating tricyclic antihistamine (piperidine derivative) with selective antagonistic properties to peripheral histamine H1-receptors. Loratadine selectively inhibits H1-receptors primarily located on respiratory smooth muscle cells, vascular endothelial cells, the gastrointestinal tract, and ….