What should be avoided in patients under 2 years or the elderly when considering first generation antihistamines?

First generation antihistamines are known for their sedative effects and have been associated with a higher risk of adverse effects in certain populations, particularly in patients under 2 years of age and in the elderly. The central nervous system (CNS) side effects of these medications can lead to increased risks of sedation, confusion, and falls, which are particularly dangerous in the elderly population. In young children, the use of first generation antihistamines can impact the developing nervous system and may lead to adverse reactions such as paradoxical excitability or sedation.

Therefore, avoiding the use of first generation antihistamines in these vulnerable populations helps to minimize the risk of harmful side effects and promotes safer treatment options for managing allergic symptoms. This precaution emphasizes the need for healthcare providers to carefully consider the age and overall health status of the patient when prescribing medications. Instead, these groups often benefit from the use of second generation antihistamines, which have fewer CNS side effects and are considered safer alternatives.