I'd like to give a little bit of background on antihistamines. I took a little bit of liberty here to have maybe a touch of fun. Antihistamines, I don't think I have to tell anybody in this room, are among the most widely used medications in the world and it's amazing, I was talking to Dr. Simons who's done extensive traveling throughout the world and how many other antihistamines we don't even use here are out at different parts of the world and under different names as Dr. Meltzer had informed me. And over the past 60 plus years, there have been many directions in antihistamine therapy. And again I think I'm preaching to the choir when I say that. So I looked back in the text book and in 1921 Frederick Tyes wrote this, "How do you treat allergies?' at least in 1921, it would have been probably in my father's childhood, you wear eyeglasses, nasal protection, topical adrenaline, topical cocaine, in severe cases, climate change. You know I still like that ideal of warm sunny weather of Arizona. An allergic substance given regularly 6 weeks before the attack.

The first antihistamine was discovered by Bovet and Staub in 1937, however it was not clinically useful. And phenbenzamine or antigen was the first antihistamine used in the treatment of allergic disease in 1942. And just a side bar, it amazes me in the history of medicine, how many developments came in or about the time of World War II. It just seems to be a very industrious time for things happening, not only in the world, but medicine as well.

This is a traditional structure of an antihistamine that I think each and everyone of us if nothing else, for board examinations, have kind of earned the breakdown categories that antihistamines traditionally have fit into. And then along with that, we begin to break these down further to first generation antihistamines and these came along great, however, I don't think again I have to tell anybody in this room, they come with baggage. Sedation, anticholenergic side affects and concerns began to arise about first generation antihistamines.

Along came second-generation antihistamines and we're about 13-14 years into this now. The names continue to increase and they change a little bit. But, the key is they come with less sedation, less anticholergenic activity and you will be hearing more about that today.

However, when you think things are perfect, the big bear arises and kind of blocks the wall. And you begin to think about complications that occur, even with the second-generation antihistamines. And again as everybody knows terfenadine got dinged, began with problems. Astemizole came into play along with that. Traditional medications fell by the waste side, so even newer and more revved up antihistamines, if you will, came into sight and absolutely minimized the side effects that one might get into. And I think in this direction, is when I think of going into the next generation and that's what this symposium is about. The improved chemical entities where you begin to take the molecule, that maybe had a problem before work with to refine this molecule trying to improve it. And get a clear cut therapeutic index. In other words, it works great and the side effects profile is minimal. And through that at least we all learned that, at least in my childhood, we all try to do better living through chemistry.