title: Evaluation of a bedtime dose of a combination antihistamine/analgesic/decongestant product on antigen challenge the next morning.
abstract: The effects of CAAD (diphenhydramine hydrochloride, 50 mg; pseudoephedrine hydrochloride, 60 mg; acetaminophen, 1 g in 10% ethanol) were evaluated in a double-blind, three-way, placebo-controlled, cross-over study on 18 volunteers with allergic rhinitis. The number of sneezes following nasal challenge with antigen was significantly reduced after a bed-time dose of CAAD (P less than .005) and a single dose of diphenhydramine (P less than .001) given 2 hours before the challenge. The levels of N-alpha-tosyl-L-arginine methyl ester (TAME) activity decreased after diphenhydramine treatment, while histamine levels following challenge were not different. The drowsiness reported after CAAD was equal to placebo, but significantly less than diphenhydramine (P less than .002 for both). The active treatments reduced the actions of histamine without suppressing its release from mast cells. The effect of CAAD persists 10 hours after administration without inducing drowsiness.
authors.affiliation: Department of Medicine (Division of Clinical Immunology), Johns Hopkins University School of Medicine, Baltimore, Md.
authors.forename: A M
authors.initials: AM
authors.lastname: Majchel
authors.forename: D
authors.initials: D
authors.lastname: Proud
authors.forename: A
authors.initials: A
authors.lastname: Kagey-Sobotka
authors.forename: T J
authors.initials: TJ
authors.lastname: Witek
authors.forename: L M
authors.initials: LM
authors.lastname: Lichtenstein
authors.forename: R M
authors.initials: RM
authors.lastname: Naclerio
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage* / Q000627:therapeutic use; D000328:Adult; D000941:Antigens / Q000009:adverse effects; D004155:Diphenhydramine / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004809:Ephedrine / Q000008:administration & dosage* / Q000627:therapeutic use; D006632:Histamine / Q000032:analysis; D006801:Humans; D010328:Patch Tests; D010447:Peptide Hydrolases / Q000378:metabolism; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy* / Q000201:enzymology / Q000276:immunology; D012894:Sleep Stages / Q000187:drug effects; D012912:Sneezing / Q000187:drug effects; D013997:Time Factors
chemical_list: D000941:Antigens; D000082:Acetaminophen; D006632:Histamine; D004155:Diphenhydramine; D010447:Peptide Hydrolases; C023073:tosylarginine methyl ester hydrolase; D004809:Ephedrine