Allergy Therapy 2

Generation Gap

100

These drugs are notably lipophilic and readily cross the blood-brain barrier, resulting in significant sedation

first-generation antihistamines

200

These agents are active enantiomers or metabolites of second-generation drugs, refined to offer equal efficacy with a better safety profile

third-generation antihistamines

300

This drug is the most potent FDA-approved 2nd generation antihistamine, though it is also the most sedating of its class

cetirizine (Zyrtec®)

400

Among third-generation agents, this drug is considered to have the least CNS activity and is a metabolite of terfenadine

fexofenadine (Allegra®)

500

This third-generation, prescription-only drug is the active metabolite of loratadine

desloratadine (Clarinex®)

Ocular Arsenal

100

This is the only FDA-approved topical cetirizine formulation for the treatment of ocular itching

Zerviate

200

These "dual-action" topical agents provide fast relief via H1 antagonism while also blocking the allergic cascade over time

antihistamine/mast cell stabilizer combinations

300

This "soft steroid" is used for severe ocular allergies because it is rapidly metabolized, minimizing risks like elevated IOP

Loteprednol etabonate (Lotemax®)

400

This 0.1% cyclosporine emulsion is specifically indicated for the management of vernal keratoconjunctivitis

Verkazia

500

This preservative-free hydrogel insert is placed in the canaliculus and releases dexamethasone for up to 30 days

Dextenza

Side Effect Showdown

100

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

200

This term describes the frustrating cycle of worsening redness that occurs once an OTC vasoconstrictor wears off

Rebound (reactive) hyperemia

300

Terfenadine and astemizole were pulled from the market due to cardiotoxicity involving a prolonged QT interval

second-generation antihistamines

400

A 2019 lawsuit alleged that withdrawing this drug produces a rebound itch more severe than the original condition

cetirizine

500

Combining first-generation antihistamines with these supplements increases the risk of GI ulceration or strictures.

potassium supplements

OTC Confusion

100

This "strongly sedating" heavyweight is a mainstay for acute reactions but is often repackaged as a sleep aid

diphenhydramine (Benadryl®)

200

Added to "D" formulations to treat congestion, these drugs function as systemic vasoconstrictors and can cause insomnia

decongestants

300

 The FDA recommends that first-generation vasoconstrictors like naphazoline be used no more than this many times daily

four

400

This world's first drug-eluting contact lens released ketotifen for 5 hours before being discontinued in late 2024

ACUVUE® Theravision™

500

This moderately sedating first-generation drug is the active ingredient in Unisom® SleepTabs

doxylamine

The "Sulfa" Story

100

This essential mineral does not cause allergies, though patients often confuse it with drug reactions

sulfur

200

This specific molecular structure found in antimicrobial sulfa drugs is the primary driver of hypersensitivity

an arylamine group

300

Cross-reactivity is extremely rare between sulfa antibiotics and these loop or thiazide medications

diuretics

400

This life-threatening cutaneous reaction is a potential complication of using sulfonamide antibiotics

Stevens-Johnson Syndrome (or Toxic Epidermal Necrolysis)

500

Humans acquire organic sulfur from their diet via this amino acid, which is then used to produce cysteine

methionine