E3: Antihistamines Flashcards
What are the clinical indications for antihistamines?
- Allergic conditions
- Hypersensitivty
- Anaphlaxis
- urticaria
- Motion sickness
- Vertigo
- Insomnia
What kind of drugs are Benadryl, Dramamine, Chlorpeniramine, Promethazine, meclizine, and Hydroxyzine?
1st generation H1 blockers
What kind of drugs are Loratadine, Cetirizine, and Fexofenadine?
2nd generation H1 blockers
What are the two routes of administration for Azelastine?
Nasal spray and eye drops
How are Ketotifen, Naphazoline, and Olapatadine administered?
Eye drops
How is azelastine + Fluticasone administered?
Nasal spray
What are the two approved antihistamines for airline pilots?
Loratadine and Fexofenadine
Why should 1st generation antihistamine and nasal decongestants be avoided in patients with BPH?
They can cause urinary retention
What would be the first line treatment for someone with seasonal allergies and a history of BPH?
Nasal steroid
Can are decongestants, antihistamines, and steroids problematic in patients with glaucoma?
They can increased IOP
-For patients with glaucoma and allergies, speak with their ophthalmologist for best plan
What are the common non-allergic conditions that antihistamines are used for?
Gastroenteritis, labyrinthitis, motion sickness, and insomnia
What is the treatment for scabies?
- Permethrin cream 5% for 8-10 hours
- Consider Hydroxyzine or Benadryl for itching
What is the difference between chronic and acute hives?
- Acute: Less than 6 weeks, more than 2/3 of cases are self limited within 6 weeks
- Chronic: More than 6 weeks
If a patient with chronic hives and a negative Leroy work up, what should you consider?
Chronic urticaria linked to an autoimmune disease (Autoimmune chronic urticaria), especially if they have a hx of other autoimmune diseases
What is the treatment for poison ivy rash?
- Steroid cream
- Non-sedating oral antihistamine
- possible oral steroid taper if not improving
