Term
| 50% of cases of allergic conjunctivitis will be due to… |
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Definition
| SAC (Seasonal Allergic Conjunctivitis) |
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Term
| Eczema and asthma have a strong association with what type of ocular allergy? |
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Definition
| Atopic Keratoconjunctivitis (AKC) |
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Term
| When Al Lergen shows up at your house and meets your roommate MC, who does MC text to make the party rockin'? |
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Definition
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Term
| Are topical antihistamines vasoconstrictive or vasodilative? |
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Definition
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Term
| Why are antihistamines short duration? |
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Definition
| Because they don't prevent inflammation or the release of the histamines in the first place - they just take care of what's already there. |
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Term
| Topical antihistamines are not approved for folks under __ years old. |
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Definition
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Term
| What's the biggest difference between Livostin and Emadine, our two topical antihistamines? |
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Definition
| Mainly potency. Emadine is supposedly 5000 times more potent than Livostin. |
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Term
| Mast cell stabilizers prevent inflow of _________. |
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Definition
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Term
| Mast cell stabilizing antihistamines are not approved for folks under __ years old. |
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Definition
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Term
| Patanol and Pataday are examples of what kind of drop? |
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Definition
Mast Cell Stabilizing Antihistamines
Pataday is once a day |
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Term
| This mast cell stabilizing antihistamine stings like a mother. |
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Definition
Optivar
As in, I would like to stay as (opti)var away from this painful drop as I can. |
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Term
| This MC stabilizing antihistamine makes a point of advertising that it's an H1 histamine receptor antagonist. |
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Definition
| Lastacaft (alcaftadine 0.25%) |
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Term
| What's the big deal about the MC stabilizing antihistamine Ketotifen fumarate 0.025%? |
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Definition
*****
It's OTC
*****
Because of this, it's always a good thing to name drop this one to patients, even if you Rx a different MC stabilizer. |
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Term
| What type of drop is particularly helpful in severe cases of VKC, AKC, GPC, and allergic contact dermatitis? |
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Definition
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Term
| What caveat must you keep in mind when treating an ocular allergic situation with topical steroids? |
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Definition
*****
Steroids should be limited to ACUTE suppression of symptoms
*****
This is because of the potential for side effects |
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Term
| Lotemax and Alrex are topical steroids for tx of ocular allergies, but it's important to remember that they are rarely ____________ ________. |
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Definition
prescribed alone
Ideally, put the patient on a mast-cell stabilizer near the beginning of the steroid treatment. |
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Term
| What's the only NSAID approved for the treatment of (I'm assuming ocular) itch? |
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Definition
| Acular (ketorolac tromethamine 0.5%) |
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Term
| What are the two topical NSAIDs that we might pull out of our utility belt (assuming we are ODs /and/ Batman (which is to say, assuming we're Dax))? |
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Definition
| Acular (ketorolac) and Voltaren (diclofenac) |
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Term
What are some downsides to topical decongestants?
Are topical decongestants really the best choice for ocular allergy? Really? …Really??
REALLY????? |
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Definition
(Think about Visene for these)
Rebound redness
Dilation
C/I for narrow-angle glaucoma
…and more!
Really… no. Overall, they're not the best choice. They don't last very long and have a handful of side-effects including that rebound redness. |
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Term
| What's the active ingredient in Visene? |
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Definition
| Tetrahydrozoline (Not phenyl?!! *mind blown*) |
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Term
| Chronic use of this type of ocular allergy drop can lead to toxic, follicular reactions or even a contact dermatitis. |
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Definition
| Antihistamine-Decongestant Combos |
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Term
| When you hear oral antihistamines, you should probably go ahead and think _____ _____. |
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Definition
dry eyes
'Sleepy head' (diphenhydramine (Benadryl)) would have been an ok answer, but loratadine (Claritin) did some work to kick that. |
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Term
| First-generation prescription mast cell stabilizers (eg. lodoxamide or cromolyn sodium) are approved for one thing and one thing only. What is that one thing? |
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Definition
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Term
| Would it be best to start prescription mast cell stabilizers before the allergy season at all or right when you start experiencing symptoms? |
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Definition
| Start 1 week before the season begins since it takes 1-2 weeks for them to kick in fully. |
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Term
| What kind of drop is Alocril (nedcromil sodium 2%) and what is its dosing? |
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Definition
It's a prescription mast cell stabilizer.
*****
Sig: bid
***** |
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Term
| What kind of drug is Zyrtec (cetirizine) and how can you get a hold of it? |
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Definition
Oral antihistamine
***** (as written in the PPT)
OVER THE COUNTER
(30 TABS FOR $20 ($0.67 / TAB)
***** |
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Term
| Do you need a prescription for Allegra? (An oral antihistamine) |
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Definition
*****
No - Allegra is now OTC
***** |
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Term
| A patient comes into your office with "itchy eyes." What clinical pearls did Dr. Horn drop on us about this? |
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Definition
First, if the patient is actually seeking medical care, the severity is probably moderate at least.
Second, distinguish between itching and burning, because the patient may get them mixed up. |
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Term
| What would you prefer a patient use between oral antihistamines and nasal sprays? |
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Definition
| Go for nasal sprays, since the orals tend to end up with dry eye side effects. |
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