8 - Toxicology Flashcards
Cornea
-whorl keratopathy (5 drugs, 1 systemic dz)
CHAI-T Chloroquine Hydroxychloroquine Amiodarone Indomethacin (gout) Tamoxifen
Systemic dz: Fabry’s
Cornea
-dry eye disease
All drugs preserved with BAK, incl topical ophthalmic glaucoma meds
Cornea
-SPK (2)
Isotretinoin: severe dryness (MGs)
Topical ophthamic aminoglycosides: TobraGent = ocular surface disease
Cornea
-endothelial/descemet’s membrane pigmentation (3)
ChlorpromaZINE
ThioridaZINE
PromethaZINE (1st gen antihistamine)
Cornea
-stromal gold deposits
Gold salts
-can result in visual asymptomatic yellow-brown deposits within posterior stroma/descemet’s (ocular chrysiasis)
Cornea
-delayed corneal healing
Topical ophthalmic and oral corticosteroids
Amiodarone
- use
- ocular SEs (3)
Anti-arrhythmic
Whorl K
Anterior subcapsular lens deposits
NAION (1-2%)
Lens
-anterior subcapsular effects (4)
“May Trigger Anterior Cataracts” Miotics (vacuoles) Thioridazine Amiodarone Chlorpromazine
Lens
-posterior subcapsular cataracts
Corticosteroids
-dose-dependent, irreversible, Hispanics at highest risk
Conj and Lids
-blepharoconj-itis, dryness, lid edema
Isotretinoin (MGs + Zeis)
Conj and Lids
-subconj hemorrhage (1 drug, 2 other)
NSAIDs/blood thinners (warfarin, clopidogrel, dipyradimole)
Valsalva
Clotting dz
Conj and Lids
-Steven-Johnson syndrome, lid edema (rare)
Sulfonamides
Conj and Lids
-pigmented cysts on conj
Tetracyclines
Conj and Lids
-subconj hemorrhage, conj hyperemia
Sildenafil (vasodilates)
Conj and Lids
-conj hyperemia, incr growth of lashes, incr periorbital pigmentation
PGAs
Conj and Lids
-conj-itis in 1% of pts
Tamiflu
Lacrimal system
-decr tear secretion (6 categories)
Anticholinergic effects (decr PNS): ANTI-cholinergics, ANTI-depressants, ANTI-histamines, ANTI-psychotics
Isotretinoin
Beta blockers (doesn’t make sense, just know it)
Hormone therapies: oral contraceptives, replacement therapies
ADHD meds: methylphenidate, dextroamphetamine
Diuretics: HCTZ, chlorothiazide, furosemide, triamterene
Pupil size
-mydriasis
Anticholinergic effects (decr PNS): ANTI-cholinergics, ANTI-depressants, ANTI-histamines, ANTI-psychotics
*watch for angle closure with narrow angles
Pupil size
-miosis (3)
Opiates: morphine, heroine, cocaine
AChase inhibitors (indirect cholin agonists)
Pilocarpine
EOMs/eye movements
-nystagmus (3)
Phenytoin (“funnytoin”)
Phenobarbital
Salicylates (NSAIDs)
EOMs/eye movements
-diplopia (3)
Phenytoin
Anti-depressants
Anti-anxiety
EOMs/eye movements
-smooth pursuit impairment
Alcohol
EOMs/eye movements
-oculogyric crisis (2)
Phenothiazines
Cetirizine
*oc = EOMs undergo spastic, abnorm musc contractions that leave the eye in abnorm positions (esp elev)
Sclera and uvea
-intraoperative floppy eyelid syndrome
Alpha1 blockers (for BPH): tamsulosin, terazosin, prazosin
Sclera and uvea
-blue sclera (2)
Corticosteroids
Minocycline (tetracycline)
Sclera and uvea
-secondary angle closure (1)
Topiramate
- choroidal swelling -> iris forward into apposition with TM
- also myopic shift
Optic nerve
-retrobulbar optic neuritis, B/Y defects, entopic phenomena
Digoxin
Optic nerve
-optic neuritis (4 + 2 unlikely)
Ethambutol = retrobulbar, bilateral
Chloramphenicol
Streptomycin
Sulfonamides
Unlikely: isoniazid, methotrexate
Optic nerve
-NAION (4)
VIAgra Viagra Vardenafil Imitrex Amiodarone
Optic nerve
-optic neuritis, papilledema, pseudotumor cerebri
Oral contraceptives
Retina
-bull’s eye maculopathy
Chloroquine»_space;> hydroxy
Retina
-CME (esp topical ophthalmic in aphakic eyes)
Epinephrine
Retina
-white/yellow crystalline deposits (esp macula), +/- macular edema
Tamoxifen
Retina
-pigementary retinopathy (may app similar to bull’s eye) (3)
ThioridaZINE
ChlropromaZINE
PromethaZINE
Retina
-retinal hemorrhage, pigmentary changes (mottling, esp macular)
Indomethacin (gout, also whorl K)
Retina
-retinopathy: white, shiny emboli w/in arterioles
Talc
Retina
-loss of color vision, nyctalopia
Isotretinoin
Retina
-retinal hemorrhage
NSAIDs
Retina
-vasculopathy (incl A/V occlusions), retinal hemorrhage
Oral contraceptives
Retina
-macular edema
Zidovudine
Intracranial hypertension (6)
CATS Contraceptives Accutane, vit A Tetracycline Synthroid, steroids
IOP
-systemic that decr (4)
BB
Cardiac glycosides (digoxin)
Alcohol
Cannabinoids
IOP
-systemic that incr (4 categories)
Anticholinergics: ANTIs, atropine, scopolamine
Short-acting B2 agonists (albuterol, levalbuterol, terbutaline)
Pseudophedrine
Corticosteroids
