Generation Gap
These drugs are notably lipophilic and readily cross the blood-brain barrier, resulting in significant sedation
first-generation antihistamines
This is the only FDA-approved topical cetirizine formulation for the treatment of ocular itching
Zerviate
First-generation antihistamines must be avoided in patients with this condition because they can dilate the pupil enough to precipitate a crisis
angle closure glaucoma
This "strongly sedating" heavyweight is a mainstay for acute reactions but is often repackaged as a sleep aid
diphenhydramine (Benadryl®)
This essential mineral does not cause allergies, though patients often confuse it with drug reactions
sulfur
These agents are active enantiomers or metabolites of second-generation drugs, refined to offer equal efficacy with a better safety profile
third-generation antihistamines
These "dual-action" topical agents provide fast relief via H1 antagonism while also blocking the allergic cascade over time
antihistamine/mast cell stabilizer combinations
This term describes the frustrating cycle of worsening redness that occurs once an OTC vasoconstrictor wears off
Rebound (reactive) hyperemia
Added to "D" formulations to treat congestion, these drugs function as systemic vasoconstrictors and can cause insomnia
decongestants
This specific molecular structure found in antimicrobial sulfa drugs is the primary driver of hypersensitivity
an arylamine group
This drug is the most potent FDA-approved 2nd generation antihistamine, though it is also the most sedating of its class
cetirizine (Zyrtec®)
This "soft steroid" is used for severe ocular allergies because it is rapidly metabolized, minimizing risks like elevated IOP
Loteprednol etabonate (Lotemax®)
Terfenadine and astemizole were pulled from the market due to cardiotoxicity involving a prolonged QT interval
second-generation antihistamines
The FDA recommends that first-generation vasoconstrictors like naphazoline be used no more than this many times daily
four
Cross-reactivity is extremely rare between sulfa antibiotics and these loop or thiazide medications
diuretics
Among third-generation agents, this drug is considered to have the least CNS activity and is a metabolite of terfenadine
fexofenadine (Allegra®)
This 0.1% cyclosporine emulsion is specifically indicated for the management of vernal keratoconjunctivitis
Verkazia
A 2019 lawsuit alleged that withdrawing this drug produces a rebound itch more severe than the original condition
cetirizine
This world's first drug-eluting contact lens released ketotifen for 5 hours before being discontinued in late 2024
ACUVUE® Theravision™
This life-threatening cutaneous reaction is a potential complication of using sulfonamide antibiotics
Stevens-Johnson Syndrome (or Toxic Epidermal Necrolysis)
This third-generation, prescription-only drug is the active metabolite of loratadine
desloratadine (Clarinex®)
This preservative-free hydrogel insert is placed in the canaliculus and releases dexamethasone for up to 30 days
Dextenza
Combining first-generation antihistamines with these supplements increases the risk of GI ulceration or strictures.
potassium supplements
This moderately sedating first-generation drug is the active ingredient in Unisom® SleepTabs
doxylamine
Humans acquire organic sulfur from their diet via this amino acid, which is then used to produce cysteine
methionine