奥洛他定与氟米龙的区别 | GPT 医学

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在医院跟医生说自己可能是结膜炎，看了眼底，测了干眼、眼压之后，医生开的药里面有（不仅仅有）氟米龙和盐酸奥洛他定。

这俩都是治疗过敏性结膜炎的，就问了问 GPT 它们有啥区别。

答案未经核验。

奥洛他定与氟米龙的区别

氟米龙和奥洛他定都是过敏性结膜炎的药物，但它们有一些区别。根据网络搜索结果，这里有一些：

  • 类型：氟米龙是一种低效类固醇，奥洛他定是一种抗过敏药。
  • 效果：两种药物都能有效缓解急性季节性过敏性结膜炎（SAC）的临床体征和症状，但奥洛他定在8周时比氟米龙更有效地减少红肿。当与奥洛他定同时使用时，氟米龙比奥洛他定更能缓解水肿、粘液分泌和眼睑水肿。
  • 副作用：氟米龙在使用8周后会导致眼内压显著增加，而奥洛他定对眼内压没有显著影响。
  • 其他：氟米龙能改善泪膜状态和泪膜破裂时间，尤其是在泪液功能低下和边缘的患者中，而奥洛他定对泪膜状态没有显著影响。
  • 时代：我找不到这些药物的确切创造日期，但我发现氟米龙是在1970年首次获得FDA批准，奥洛他定是在1996年首次获得FDA批准。所以它们不是在同一个时代创造的。

Fluorometholone and Olopatadine are both medicines for allergic conjunctivitis, but they have some differences. According to the web search results, here are some of them:

  • Types: Fluorometholone is a low-effective steroid¹ and Olopatadine is an anti-allergic agent².

  • Effectiveness: Both drugs are effective in relieving clinical signs and symptoms of acute seasonal allergic conjunctivitis (SAC), but Olopatadine was more effective in reducing redness than Fluorometholone at 8 weeks². Fluorometholone was better than Olopatadine in relieving chemosis, mucus secretion and eyelid edema when concomitantly used with Olopatadine¹.

  • Side effects: Fluorometholone can cause a significant increase in intraocular pressure after 8 weeks of use², while Olopatadine has no significant effect on intraocular pressure³.

  • Others: Fluorometholone can improve tear film status and tear break-up time, especially in patients with subnormal and borderline tear functions², while Olopatadine has no significant effect on tear film status³.

  • Era: I could not find the exact dates of when these drugs were created, but I found that Fluorometholone was first approved by the FDA in 1970 and Olopatadine was first approved by the FDA in 1996. So they were not created at the same era.

    (1) Comparative evaluation of olopatadine 0.01% combined fluorometholone 0. …. https://pubmed.ncbi.nlm.nih.gov/24074291/.
    (2) Comparison of olopatadine and fluorometholone in contact lens … - PubMed. https://pubmed.ncbi.nlm.nih.gov/20531202/.
    (3) Olopatadine - an overview | ScienceDirect Topics. https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/olopatadine.

产品年代

氟米龙和奥洛他定都是治疗过敏性结膜炎的药物，但它们属于不同的药物类别。氟米龙是一种类固醇，可以减轻炎症和红肿¹²，而奥洛他定是一种抗组织胺药，可以阻断组织胺的作用，组织胺是一种导致眼部瘙痒和流泪的化学物质³ 。它们有时会联合使用以达到更好的效果¹²。

我没有找到关于这些药物的代数的信息，但我找到了一些关于其他治疗过敏性结膜炎的药物的信息。根据一些资料⁴⁵，一些较新的药物包括：

  • 西替利嗪眼用溶液0.24%（Zerviate），这是一种抗组织胺药，去年刚刚上市用于治疗过敏性结膜炎。它已经被批准每日两次用药，已经显示出能够减轻眼部瘙痒和红肿⁴。
  • 贝泊他丁盐酸盐眼用溶液1.5%（Bepreve），这是另一种抗组织胺药，于2009年获批。它已经显示出能够有效地减轻眼部瘙痒、红肿和化脓（结膜水肿）⁴。
  • 阿卡替丁眼用溶液0.25%（Lastacaft），这是一种双重作用药物，既有抗组织胺作用，又有肥大细胞稳定作用。肥大细胞稳定剂可以阻止肥大细胞释放组织胺和其他炎症介质，这些介质参与了过敏反应。阿卡替丁于2010年获批，已经显示出能够有效地减轻眼部瘙痒、红肿和流泪⁴。
  • 依那斯汀盐酸盐眼用溶液0.05%（Elestat），这是另一种双重作用药物，于2003年获批。它已经显示出能够有效地减轻眼部瘙痒和红肿⁴。

这些是一些比较旧的药物更有效的新药物，例如酮替芬富马酸盐眼用溶液0.025%（Zaditor），这是一种双重作用药物，于1999年获批⁴。然而，选择哪种药物取决于过敏性结膜炎的严重程度和类型，以及患者的偏好和耐受性。有些患者也可能从非药物措施中受益，例如避免过敏原、使用冷敷或人工泪液⁴⁵ 。

Fluorometholone and Olopatadine are both medicines for allergic conjunctivitis, but they belong to different classes of drugs. Fluorometholone is a steroid that reduces inflammation and redness¹², while Olopatadine is an antihistamine that blocks the effects of histamine, a chemical that causes itching and tearing³⁶. They are sometimes used together for better results¹².

I could not find any information about the generations of these medicines, but I did find some information about other medicines that are used for allergic conjunctivitis. According to some sources⁴⁵, some of the newer drugs include:

  • Cetirizine ophthalmic solution 0.24% (Zerviate), which is an antihistamine that was launched for allergic conjunctivitis last year. It has been approved for twice-daily dosing and has shown to reduce ocular itching and redness⁴.
  • Bepotastine besilate ophthalmic solution 1.5% (Bepreve), which is another antihistamine that was approved in 2009. It has shown to be effective in reducing ocular itching, redness, and chemosis (swelling of the conjunctiva)⁴.
  • Alcaftadine ophthalmic solution 0.25% (Lastacaft), which is a dual-action agent that acts as both an antihistamine and a mast cell stabilizer. Mast cell stabilizers prevent the release of histamine and other inflammatory mediators from mast cells, which are involved in allergic reactions. Alcaftadine was approved in 2010 and has shown to be effective in reducing ocular itching, redness, and tearing⁴.
  • Epinastine hydrochloride ophthalmic solution 0.05% (Elestat), which is another dual-action agent that was approved in 2003. It has shown to be effective in reducing ocular itching and redness⁴.

These are some of the newer medicines that are more effective than older ones, such as ketotifen fumarate ophthalmic solution 0.025% (Zaditor), which is a dual-action agent that was approved in 1999⁴. However, the choice of medicine depends on the severity and type of allergic conjunctivitis, as well as the patient’s preference and tolerance. Some patients may also benefit from nonpharmacological measures, such as avoiding allergens, using cold compresses, or using artificial tears⁴⁵⁷.

(1) Comparative evaluation of olopatadine 0.01% combined fluorometholone 0. .... https://pubmed.ncbi.nlm.nih.gov/24074291/.
(2) Comparison of olopatadine and fluorometholone in contact lens ... - PubMed. https://pubmed.ncbi.nlm.nih.gov/20531202/.
(3) Olopatadine - an overview | ScienceDirect Topics. https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/olopatadine.
(4) Allergic Conjunctivitis Medication - Medscape. https://emedicine.medscape.com/article/1191467-medication.
(5) An Update on Therapies for Ocular Allergies - Review of Ophthalmology. https://www.reviewofophthalmology.com/article/an-update-on-therapies-for-ocular-allergies.
(6) The allergic eye: recommendations about pharmacotherapy and ... - LWW. https://journals.lww.com/co-allergy/Fulltext/2020/08000/The_allergic_eye__recommendations_about.15.aspx.
(7) Allergic conjunctivitis advice and leaflet | Association of ... - AOP. https://www.aop.org.uk/advice-and-support/for-patients/eye-conditions/allergic-conjunctivitis.

教科书怎么说

避免接触已知过敏原、冷敷和使用人工泪液可以减轻过敏性结膜炎的症状，抗原脱敏治疗偶尔有效。局部非处方抗组胺药（如酮替芬）在轻症患者有效如果上述药物效果不明显，可以应用局部处方抗组胺药（如奥洛他定，贝他斯汀，氮卓斯汀、 西替利嗪）、肥大细胞稳定剂（如奈多罗米，色甘酸钠）、或非甾体类消炎药（如酮咯酸）单独使用或联合用药。

顽固病例或有必要快速缓解症状时，可用局部皮质类固醇（如氯替泼诺，0.1%氟米龙，0.12%～1%醋酸泼尼松龙，每日3次）。由于局部皮质类固醇可引起潜在眼单纯疱疹病毒感染发作，可能导致角膜溃疡和穿孔，长期使用还会引起青光眼和白内障，因此必须在眼科医生指导和监测下才能应用。

局部应用环孢霉素滴眼可以有所帮助。将皮质类固醇或他克莫司软膏涂在皮肤上是非常有效的治疗眼睑特应性皮炎的方法。口服抗组胺药（如非索非那定，西替利嗪或羟嗪）可能会有所帮助，尤其是当患者出现其他过敏症状（如流鼻涕）时。

季节性过敏性结膜炎很少需要多种药物或间歇性局部应用皮质类固醇治疗。

其他

据说只有过敏性结膜炎才会眼痒、剧痒，细菌性结膜炎和病毒性结膜炎都不会导致眼痒。

有趣的是，这些药的一些副作用和主治症状相同，如眼痒。