Yedi Aylık Bebekte Setirizin’in Nadir Bir Yan Etkisi: Distonik Reaksiyon
Setirizin, piperazinden türetilen seçici bir H1 histamin reseptör antagonis- tidir. Piperazin, anksiyolitikler, antidepresanlar ve antipsikotikler dahil olmak üzere birçok ilacın yapısında yer alan siklik bir moleküldür. İlaca bağlı distoni, çoğunlukla antipsikotik ve antiemetik ilaçlara bağlı olarak bildirilmektedir. Dopamin ve asetilkolin dengesinin asetilkolin lehine bozulması sonucu oluşur. Setirizin nispeten güvenli bir ilaç olmasına rağ- men, nadiren distonik reaksiyona neden olduğu bildirilmiştir. Şimdiye kadar süt çocukluğu döneminde setirizine bağlı olarak bildirilmiş bir dis- toni vakası yoktur. Burada setirizin uygulaması sonrası distonik reaksiyon gelişen 7 aylık bir hasta sunulmuştur.
A Rare Adverse Effect of Cetirizine in a 7- Month-Old Infant: Dystonic Reaction
Cetirizine is a selective H1 histamine receptor antagonist derived from piperazine. Piperazine is a cyclic moiety molecule located in the structure of many drugs, including anxiolytics, antidepressants, and antipsychotics. Drug-induced dystonia is reported mostly due to antipsychotic and antiemetic drugs. It occurs due to the disruption of dopamine and acetylcholine balance in favor of acetylcholine. Although cetirizine is a relatively safe drug, it has rarely been reported to cause a dystonic reaction. To the best of our knowledge, there is no reported case of dystonia due to cetirizine in infancy. Here, we present a 7-month-old patient who developed a dystonic reaction after cetirizine administration.
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- 1. Brito AF, Moreira LKS, Menegatti R, Costa EA. Piperazine derivatives with central pharmacological activity used as therapeutic tools. Fundam Clin Pharmacol 2019;33(1):13-24. doi: 10.1111/fcp.12408. Epub 2018 Sep 17. google scholar
- 2. Singh K, Siddiqui HH, Shakya P, Bagga P, Kumar A, Khalid, M et al. Piperazine - A biologically active scaffold. Int J Pharm Sci Res 2015;6(10);4145-58. google scholar
- 3. Fitzsimons R, van der Poel LA, Thornhill W et al. Antihistamine use in children. Arch Dis Child Educ Pract Ed 2015;100(3):122-31. doi: 10.1136/archdischild-2013-304446. Epub 2014 Aug 21. google scholar
- 4. Kawauchi H, Yanai K, Wang DY, Itahashi K, Okubo K. Antihistamines for allergic rhinitis treatment from the viewpoint of nonsedative properties. Int J Mol Sci 2019;20(1). pii: E213. doi: 10.3390/ ijms20010213. google scholar
- 5. Yanai K, Yoshikawa T, Yanai A, Nakamura T, Iida T, Leurs R, et al. The clinical pharmacology of non-sedating antihistamines. Pharmacol Ther 2017;178:148-56. google scholar
- 6. Rajan S, Kaas B, Moukheiber E. Movement disorders emergencies. Semin Neurol 2019;39(1):125-36. doi: 10.1055/s-0038-1677050. Epub 2019 Feb 11. google scholar
- 7. Sharawat IK, Dawman L. Acute focal dystonia after a single dose of oral cetirizine in a 9-year-old boy. Pediatr Emerg Care 2019;35(2):e30-e31. doi: 10.1097/PEC. 0000000000001062 google scholar
- 8. Esen I, Demirpence S, Yis U, Kurul S. Cetirizine-induced dystonic reaction in a 6-year-old boy. Pediatr Emerg Care 2008;24(9):627-8. doi: 10.1097/PEC.0b013e3181850c35. google scholar
- 9. Rajput A, Baerg K. Cetirizine-induced dystonic movements. Neurology 2006;66:143-44. google scholar
- 10. Yılmaz-Topal Ö, Tuygun N, Akça H, Polat E, Karacan CD. Cetirizine and albendazole induced dystonia in a child. Turk J Pediatr 2015;57(4):407-8. google scholar
- 11. Sânchez-Borges M, Ansotegui IJ. Second generation antihistamines: An update. Curr Opin Allergy Clin Immunol 2019;19(4):358-64. doi: 10.1097/ACI.0000000000000556. google scholar
- 12. Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981;30(2):239-45. google scholar