Mukhammad Arif Hadi Khoiruddin
Department of Public Health, Faculty of Medicine, University of Jember, Jember, Indonesia

Yusi Windya Febriyanti
Faculty of Medicine, University of Jember, Jember, Indonesia

DOI: https://doi.org/10.19184/ams.v10i2.44078

Abstract

Anticholinergic toxicity can be the result of antihistamines use. Anticholinergic toxicity is rare in second-generation antihistamines such as cetirizine. Cetirizine usage exceeding the recommended dose will cause anticholinergic syndrome. A 16-year-old girl was brought to The Emergency Department dr. Soebandi Hospital Jember with a history of fainting at school after consuming 5-6 tablets cetirizine 5 mg. When the patient fainted, he was brought to the Community Health Center, then the patient regained consciousness and vomited. Patients also experienced dizziness, nausea, and dry mouth. Because it had not improved, the patient was referred to The Emergency Department dr. Soebandi Hospital Jember. On physical examination, it was found that a heart rate of 105 beats per minute and hollow eyes. We examined liver and kidney function tests, which showed that BUN, serum creatinine, SGOT, and SGPT levels were normal. Symptoms that arise due to antihistamine toxicity include redness of the skin, anhidrosis, lack of sweat production, hyperthermia, mydriasis, hallucinations, delirium, and urinary retention. Antihistamines are anticholinergics working as antimuscarinics. The action of cetirizine on M1, M2, and M3 muscarinic receptors affects clinical manifestations of the patient. Cetirizine can also induce liver and kidney toxicity. Further understanding regarding the dosage and use of cetirizine is needed to reduce adverse drug effects.

Keyword: Antihistamine; cetirizine; anticholinergic syndrome.

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