locally applied antihistamines for nasal and ophthalmic use

Question 1

nasal antihistamines

Answer 1

azelastine

Question 2

ophthalmic antihistamines

Answer 2

H1-antagonists & mast cell stabilizers
ketotifen (zaditor) rx and otc
olopatadine
azelastine

Question 3

similar but less used ophthalmic drops

Answer 3

alcaftadine, bepotastine, epinastine, emedastine.

Question 4

azelastine nasal spray adverse effects

Answer 4

bitter taste

mildly sedating in some clinical trials this is a first generation

Question 5

nasal spray effects and benefits

Answer 5

similar to oral antihistamines for allergic rhinitis
advantages:
modest local anti-inflammatory effects can improve nasal congestion
-rapid onset of action can be administered on demand

Question 6

azelastine nasal spray adverse effects

Answer 6

headache, somnolence, nasal burning, xerostomia, fatigue, dizziness, epistaxis, cough

Question 7

three main groups of ophthalmic medications

Answer 7

• antihistamines with mast cell-stabilizing
• vasoconstrictor/antihistamine combination
• mast cell stabilizers

Question 8

vasoconstrictor/antihistamine combinations

Answer 8

the vasoconstriction acts as a redness reliever
if you see an A it means antihistamine with a decongestant
rarely are recommended by providers, but pts still select these products
**can increase IOP

Question 9

mast cell stabilizers drops

Answer 9

cromolyn and nedocromil

Question 10

mast cell stabilizers main points

Answer 10

• may take for days for therapeutic effect and require 2-6x day administration
• rx only
• may sting
• users of contact lenses should refrain from wearing lenses while having signs and symptoms of allergic conjunctivitis

Question 11

H1-antagonist drops also have mast cell stabilizing effects

Answer 11

ketotifen, olopatadine, azelastine

remove contacts/wait 10-15 min before reinserting

Question 12

ketotifen

Answer 12

the only OTC antihistamine/mast cell stabilizer without a vasoconstrictor

• least expensive
• may sting
• require 2x-3x daily

Question 13

opthalmic gels

Answer 13

gels are composed of mucoadhesive polymers that provide localized delivery of an active ingredient to the eye
eg: lotemax ophth. gel

Question 14

ophthalmic formulations

Answer 14

oily substance coats the eye and causes blurred vision
long lasting and soothing-but challenging to apply
good for infections/irritations in or around the eye