In addition to causing significant patient harm, the use of anticholinergic medications in older nursing home patients negatively impacts Centers for Medicare & Medicaid Services quality measures, such as the use of high-risk antipsychotic medications, the percentage of patients with a decline in their ability to perform activities of daily living, the percentage of patients with falls and serious injury, and urinary tract infection rates.Regardless of practice setting, healthcare professionals should take steps to increase the awareness of side effects associated with first-generation antihistamines.Therefore, it is recommended that bilastine is taken at least one hour before and no sooner than two hours after a meal.
The term “antihistamine” generally is used to describe those medications that antagonize histamine activity at H1 receptors.
Currently the only FDA-approved histamine antagonist medications block the effects of histamine at H1 or H2 receptor sites.
Educating older patients and their caregivers is especially important because of the widespread OTC availability of these antihistamines.
Patients with Alzheimer’s disease are at particular risk as caregivers may purchase these medications without understanding the associated risk of exacerbating the disease.
First-generation antihistamines are widely available without a prescription and commonly used to treat allergic symptoms, including rhinitis, conjunctivitis, pruritus, eczema, urticaria, and anaphylactic reactions.