Abstract
The symptom of nasal obstruction induced by allergic rhinitis could disturb not only upper respiratory function, but also sleep qualities including sleep apnea, sleeplessness, daytime sleep tendency. The patients with severe motor and intellectual disabilities (SMID) might be affected by the symptom of nasal obstruction with same or above degree. Fexofenadine hydrochloride (histamine H1-receptor antagonist) / pseudoephedrine hydrochloride (α adrenergic agonist) combination drug could be useful for the patients with allergic rhinitis presenting nasal obstruction without major side effect. And it was reported that the side effect induced by the stimulation of the sympathetic nerve might not be affected by this drug, except for the patients with severe hypertension and coronary vascular disease, glaucoma, or ischuria. However, we experienced the crisis of unexpected abnormal behaviors after administration of this drug in the treatment of allergic rhinitis for the patients with SMID (three in five patients). They presented self-harm, aggressive behavior, running away suddenly, and sever irritation after administration of this drug. Those symptoms disappeared after the discontinuance of this drug within two days. Thus, it could be suggested that even if this drug might be safe in general patients, it could be harmful to the patients with SMID, because the conditions of the autonomic nerve in the patients with SMID should be very unstable.
