Antihistamines glaucoma with

The antihistamines are used cautiously in patients with bronchial asthma, cardiovascular disease, narrow-angle glaucoma, symptomatic prostatic hypertrophy, hypertension, impaired kidney function, peptic ulcer, urinary... 

Special risk patients Use antihistamines with caution in patients with narrow-angle glaucoma, stenosing peptic ulcer, pyloroduodenal obstruction, symptomatic prostatic hypertrophy, bladder neck obstruction, bronchial asthma, increased intraocular pressure, hyperthyroidism, cardiovascular disease, and hypertension. 

Acetylcholine-blocking drugs should be avoided in patients with prostatic hyperplasia, obstructive gastrointestinal disease (eg, pyloric stenosis or paralytic ileus), or angle-closure glaucoma. In parkinsonism patients receiving antimuscarinic medication, concomitant administration of other drugs with antimuscarinic properties (eg, tricyclic antidepressants or antihistamines) may precipitate some of the complications mentioned above. 

Ocular side effects relate primarily to the anticholinergic properties of the Hi antihistamine. Accordingly, one can anticipate decreased secretion of tears and mucus and mydriasis with the potential of acute angle-closure glaucoma. Continued use can bring about decreased accommodation and decreased vision. Usually the therapy can continue, because the effects typically diminish with time. 

Antihistamines that produce sedation should not be used with alcohol or any other sedating drug, such as opioid analgesics. Antihistamines with strong anticholinergic effects should be avoided in patients with peptic ulcer disease, prostatic hypertrophy, or bladder or pyloro-duodenal obstruction and in patients who have the potential for acute angle-closure glaucoma. 

Both hyoscine and antihistamines should be avoided in patients suffering from glaucoma or prostatic hypertrophy, are not recommended for use by pregnant or breastfeeding women, and should be used with caution in the elderly and patients with epilepsy or cardiac or cardiovascular disease. 

Because of side-effects, cough preparations containing antihistamines should not be recommended to patients with glaucoma or prostate problems and should be used with caution in older patients. 

Antihistamines should be used with caution in people with epilepsy, enlargement of the prostate, urinary retention, glaucoma and hepatic disease. Children and older people are more susceptible to the adverse effects. 

Like other antihistamines, promethazine has signih-cant anticholinergic effects it should be used with caution in patients with narrow-angle glaucoma, peptic ulcer, or pyloroduodenal obstruction or urinary bladder obstruction from prostatic hypertrophy or narrowing of the bladder neck. It also should be used with caution in patients with CVD or hypertension because of the risk of palpitations with acute or chronic respiratory dysfunction (especially children) as promazine may depress the cough reflex. 

The cannabinoids act on the cerebral cortex and have the same side effects and adverse reactions as antihistamines and anticholinergic. These include drowsiness, dry mouth, blurred vision, tachycardia, and constipation. Caimabinoids include dronabinol and nabilone. These drugs should not be administered to glaucoma patients because they dilate the pupils (mydriasis). They are contraindicated for use in patients with psychiatric disorders and also used as an appetite stimulant for patients with AIDS. Side effects include mood changes, euphoria, drowsiness, dizziness, headaches, depersonalization, nightmares, confusion, incoordination, memoiy lapse, dry mouth, orthostatic hypotension, hypertension, and tachycardia. Less common symptoms include depression, anxiety, and manic psychosis. 

Immunologic Ocular administration of dorzolamide and timolol (doses not stated) in a woman with glaucoma led to the development of a disseminated eruption associated with severe thrombocytopenia [4 ]. A skin biopsy showed hyperkeratosis, acanthosis, and perivascular and periadnexal infiltrates without vasculitis. The skin reaction resolved after withdrawal of dorzolamide and treatment with an antihistamine, but the thrombocytopenia persisted. Subsequent treatment with dapsone led to a recurrence of the skin changes this pattern is consistent with sulfonamide hypersensitivity syndrome [SEDA-30, 252]. 

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