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Allergic Rhinitis

Antihistamines

BrandGenericMechanismNotes
Benadryl Diphenhydramine First Generation Antihistamine Sedation and anticholinergic
Chlorpheniramine Chlor- Trimeton First Generation Antihistamine Sedation and anticholinergic
Dimetapp Brompheneramine First Generation Antihistamine Sedation and anticholinergic
Tavist Clemastine First Generation Antihistamine Sedation and anticholinergic
Zyrtec Cetirizine Second Generation Antihistamine Mild sedation and anticholinergic
Allegra Fexofenadine Second Generation Antihistamine No Sedation/ anticholinergic
Clarinex Desloratadine Second Generation Antihistamine Mild Sedation / anticholinergic
Claritin Loratadine Second Generation Antihistamine Mild Sedation/ Anticholinergic Rapid effect < 1 hr for nasal and ocular symptoms
Astelin, Astepro Azelastine Intranasal antihistamine > 6 yoa AE: Drowsiness, Bitter taste Epistaxis, nasal discomfort
Patanase Olopatadine Intranasal antihistamine > 6 yoa AE: Bitter tase, drowsiness, epistaxis
1st generation antihistamines Avoid in: heavy machinery/ extensive driving/ pilots, pre-existing mental impairment, BPH, elevated Intraocular pressure Limited treatment in Allergic Rhinitis May produce performance impairment
2nd Generation Antihistamines Drug Interactions: CNS depressants, MAOI's, Phenytoin, Ketoconazole, Erythromycin, Cimetidine, St. Johns Wort
Intranasal Antihistamines equal or superior to 2nd generation PO antihistamines Less effective than nasal steroids for nasal symptoms
Optivar Azelastine MastCell Stabilizer -Opth antihistamine > 3 yoa Used for itching associated w/ allergic conjunctivitis wait at least 10 mins before inserting contacts
Patanol, Pataday Olopatadine Mast Cell Stabilizer > 3 yoa Wait at least 10 mins before inserting contacts
Lastacaft Alacftadine Opth antihistamine Wait at least 10 mins before inserting contacts
Emadine Emedastine Opth antihistamine > 3 yoa MastCell Stabilizer -Opth antihistamine
Naphcon-A, Opcon-A, Visine- A Nephazoline/ Pheniramine Opth antihistamine Can Cause Rebound
Decongestants Topical / systemic formulations Vasoconstriction of andrenergic receptor in nasal mucosa Reduce nasal congestion some rhinorrhea Minimal effect on sneezing, itching, or ocular symptoms
Oral Decongestants Use with caution in: Cardiovascular disease Hyperthyroidism Glaucoma Any Bladder/ neck obstruction DO NOT use within 14 days of MAOI's ADE's: Nervousness, Insomnia, irritability, headache, palpitations, tachycardia, increased blood pressure, increase interocular pressure, aggravate urinary obstruction Pseudophedrine Phenylephrine: oral efficacy not well established
Created by: daynasf
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