A 32-year-old woman has had hives (uicaria) for 8 weeks. She has not staed any new medications. Her hives are not painful and do not leave behind any pigmentation or other marks when individual resolve (within 24 hours). She has not had respiratory symptoms or lip or tongue swelling. She is frustrated with the amount of pruritis, but does not want to take any medications that make her “sleepy.” Which of the following medications would you recommend?
Correct Answer: Loratadine
Description: Loratadine - potent minimal-sedation antihistamine substantially free of anticholinergic side effects. Loratadine is not metabolized through the liver cytochrome P-450 enzyme system and is therefore believed free of cardiac arrhythmic complications. Inhibits evoked release of leukotrienes from human lung in vitro but is less active in suppressing histamine release. 2nd generation low-sedation antihistamines are probably safer in children than the older 'classic' anti- histamines.
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