Burn wound itch control using H1 and H2 antagonists

• Published in: Journal of burn care & rehabilitation Vol. 22; no. 4; p. 263
• Main Authors: Baker, R A, Zeller, R A, Klein, R L, Thornton, R J, Shuber, J H, Marshall, R E, Leibfarth, A G, Latko, J A
• Format: Journal Article
• Language: English
• Published: United States 01.07.2001
• Subjects: Administration, Cutaneous; Administration, Oral; Adolescent; Adult; Burns - complications; Cetirizine - administration & dosage; Cetirizine - therapeutic use; Child; Cimetidine - administration & dosage; Cimetidine - therapeutic use; Cross-Over Studies; Diphenhydramine - administration & dosage; Diphenhydramine - therapeutic use; Double-Blind Method; Female; Histamine H1 Antagonists - administration & dosage; Histamine H1 Antagonists - therapeutic use; Histamine H2 Antagonists - administration & dosage; Histamine H2 Antagonists - therapeutic use; Humans; Male; Middle Aged; Pruritus - drug therapy; Pruritus - etiology; Time Factors; Treatment Outcome
• ISSN: 0273-8481; 1534-5939
• DOI: 10.1097/00004630-200107000-00003

This study investigated the use of a combination of H1 and H2 antagonists and topical medications to control burn wound itch. Graeco-Latin square assignment provided an oral combination of 1) cetirizine and cimetidine or 2) diphenhydramine and placebo in four divided doses. The study protocol lasted 16 days divided into 4-day intervals, scoring itch before the initial dose of medication and at 1-hour, 6-hour, and 12-hour intervals after the first medication. A significant difference between mean itch scores across the four times was observed (Wilks' Lambda F = 26.52, df = 3, P <.0005). A three-way nested repeated measures interaction effect (Wilks' Lambda F = 9.85, df = 9, P <.0005) was observed representing a significantly different pattern on days 1 to 4 of the study compared with the remaining days. Controlling for the effect of topical medications, the cetirizine/cimetidine combination demonstrated a dramatic improvement at 1 and 6 hours, and a moderate improvement at 12 hours after initial medication for the day when compared with the diphenhydramine/placebo combination.