Discussion Response

Discussion Response

Hello colleague. Thanks for the insightful discussion on Fexofenadine. Indeed, anti-allergic agents are not sedative because of their inability to cross the blood barrier. However, fexofenadine is an antihistamine that blocks the histamine receptor and the allergic response (Meltzer et al., 2021). The allergic responses are mediated by the IgE and mast cells among others in the body system. Therefore, depending on the type of hypersensitivity, the patients are likely to have increased IgE in their blood systems. The allergic reactions are characterized by redness, swelling, and fever. Therefore, the administration of the medication addresses the symptoms. On the other hand, the patients must be monitored closely for possible dysrhythmias. Also, the medication may induce headache, vomiting, and diarrhea as side effects. The antihistamines reduce the permeability of the blood vessels to the white blood cells and also trigger their narrowing (Meltzer et al., 2021). The narrowing could increase the peripheral resistance that results in high blood pressure. Patients with cardiovascular diseases should be monitored closely for effective therapeutic outcomes.

Understanding the drug interaction helps the therapist make an appropriate decision on when and how to administer the medication. Fexofenadine interacts with ketoconazole which is an antifungal medication and erythromycin (an antibiotic) (Meltzer et al., 2021). In most cases, patients may need medications from different classes including antihistamines and antibiotics. Knowledge of the drug interactions is necessary for selecting the best medication combination. Fexofenadine is not recommended for pregnant women. People with renal impairments should be given lower doses because of the reduced pharmacodynamics (Meltzer et al., 2021). Reduced elimination of the drug from the system means that it will stay in the blood system for a long time. Therefore, giving a high dose could imply that the dose concentration will be high and this could be harmful to the patient.

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Reference

Meltzer, E. O., Rosario, N. A., Van Bever, H., & Lucio, L. (2021). Fexofenadine: Review of safety, efficacy, and unmet needs in children with allergic rhinitis. Allergy, Asthma & Clinical Immunology, 17(1). https://doi.org/10.1186/s13223-021-00614-6

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Fexofenadine (Allegra)

An antiallergic agent which is classified second-generation (nonsedating) agents is Fexofenadine also known as Allegra. The reason why this medication is considered less sedating is due to the medication not able to cross the blood brain barrier so easily. The mechanism of action is when histamine is released from enterochromaffin-like cells (ECL) it then bonds to H2 receptors, cyclic adenosine monophosphate and protein kinase. The h2 receptor blocks the histamine receptors and process of allergic symptoms is decreased. Monitoring for the medication is making sure the patient is getting relief form meditation and that the patient does not have a severe allergic reaction to medication. Monitoring also includes an EKG and monitoring heart rhythm due to possibility of QTc interference (Rosenthal & Burchum, 2021). Side effects can include vomiting, or less common, diarrhea, headache, back pain, chills, body aches.

Some medications to avoid are ketoconazole and erythromycin due to making symptoms of drowsiness worst. Avoiding drinking fruit juice is also recommended due to lowering the efficacy of the medication and reduce doses in individuals with renal impairments (Rosenthal & Burchum, 2021). The use of the medication is not recommended due to limited information known about interactions of pregnant women when drinking fexofenadine (Allegra, n.d.). Fexofenadine is ultimately safe for individuals who are not pregnant and in smaller doses it is safe for children too.

 

Dosing includes: Fexofenadine (Allegra, Allegra ODT) route of: PO and dosage: 180 mg every 24 h, Children 6–11 years: 30 mg every 12 h, Children 6 months−2 years: 15 mg every 12 h.