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312 Eye/ENT/Dental/Pain > Drug List > Flashcards

Drug List Flashcards

1
Q

Acetazolamide (Diamox)
Brinzolamide (Azopt)
Dorzolamide (Trusopt)

Indication

A

Glaucoma (open angle & angle closure)

[Open angle glaucoma; 2nd line after PGAs & BBs, alternative to AAs]

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2
Q

Acetazolamide (Diamox)
Brinzolamide (Azopt)
Dorzolamide (Trusopt)

Mechanism of action

A

CARBONIC ANHYDRASE INHIBITOR

Inhibits carbonic anhydrase in ciliary processes –> reduces HCO3- production –> reduces aqueous production –> reduces IOP

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3
Q

Acetazolamide (Diamox)
Brinzolamide (Azopt)
Dorzolamide (Trusopt)

Main side effects

A

Parasthesia (“pins & needles”) –> reversible upon discontinuation
Burning, stinging [brinzolamide less than acetazolamide, dorzolamide]
Blurred vision [brinzolamide more likely –> suspension formulation]

Nausea, vomiting, diarrhoea
Headache, dizziness

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4
Q

Acetazolamide (Diamox)
Brinzolamide (Azopt)
Dorzolamide (Trusopt)

Contraindications

A

[A] Severe hepatic impairment
- Reduces ammonia clearance –> increased risk of hepatic encephalopathy

Severe renal impairment
- Risk of acidosis due to electrolyte imbalance

Long-term administration in PACG

Sulfonamide hypersensitivity

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5
Q

Baclofen (Pacifen)

Indication

A

Neuropathic pain [trigeminal neuralgia; 2nd line after carbamazepine/phenytoin]

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6
Q

Baclofen (Pacifen)

Mechanism of action

A

MUSCLE RELAXANT

Derivative of GABA –> stimulates GABA receptors –> inhibits neurotransmission –> decreases muscle spasm –> antinociceptive

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7
Q

Baclofen (Pacifen)

Main side effects

A

Sedation

GI disturbances, nausea
Dry mouth
Confusion

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8
Q

Baclofen (Pacifen)

Contraindications

A

Refractory epilepsy

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9
Q

Bimatoprost
Latanoprost
Travoprost

Indication

A

Ocular hypertension, raised IOP

[Primary open-angle glaucoma]

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10
Q

Bimatoprost
Latanoprost
Travoprost

Mechanism of action

A

PROSTAGLANDIN ANALOGUE

Synthetic prostamide
- Increases aqueous outflow through both trabecular & uveoscleral outflow –> decrease IOP

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11
Q

Bimatoprost
Latanoprost
Travoprost

Main side effects

A

Iris pigmentation esp. of mixed colour → become more brown

Longer, thicker eyelashes → reversible upon discontinuation

Conjunctival hyperaemia (less likely with latanoprost)

Sunken appearance of eyes
Red eyes, irritation (due to benzalkonium preservative)

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12
Q

Bimatoprost
Latanoprost
Travoprost

Contraindications/cautions

A

CI: History of recurrent HSV associated with PGAs

C: Macular oedema –> disruption of blood-aqueous humour barrier

C: Active intraocular inflammation eg. iritis, uveitis (middle tissue layer of eye wall)

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13
Q

Brimonidine

Indication

A

Ocular hypertension, raised IOP

[Primary open-angle glaucoma]

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14
Q

Brimonidine

Mechanism of action

A

ALPHA AGONIST

Alpha 2-adrenoceptor agonist

  • Reduces aqueous production
  • Increases aqueous outflow by uveoscleral outflow
  • -> Decrease IOP
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15
Q

Brimonidine

Main side effects

A

Dry mouth
Ocular hyperaemia
Burning/stinging

–> Reversible upon discontinuation

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16
Q

Brimonidine

Contraindications/cautions

A

CI: MAOI treatment within 14 days

C: Severe CVD

C: Postural hypotension

C: Depression

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17
Q

Carbamazepine (Tegretol)

Indication

A

Trigeminal neuralgia (1st line)

[Antiepileptic]

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18
Q

Carbamazepine (Tegretol)

Mechanism of action

A

ANTIEPILEPTIC

Blocks voltage-gated Na+ channels –> prevents action
potentials –> prevents nerve activity

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19
Q

Carbamazepine (Tegretol)

Main side effects

A

CNS disturbances

  • Poor balance
  • Dizziness, drowsiness
  • Fatigue

GI effects

  • Nausea
  • Vomiting

Allergic skin reactions

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20
Q

Carbamazepine (Tegretol)

Contraindications/cautions

A

CI: AV conduction abnormalities

CI: MAOI use within 14 days

C: Potent CYP3A4 inducer –> OCs, warfarin

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21
Q

Carbomer (Poly Gel)

Indication

A

Dry eye, unstable tear film

[Meibomian gland dysfunction may be a consequence of blepharitis]

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22
Q

Carbomer (Poly Gel)

Mechanism of action

A

Thickening agent –> occlusive barrier –> reduces dryness of eyes

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23
Q

Carbomer (Poly Gel)

Main side effects

A

Irritation, blurred vision –> transient

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24
Q

Chloramphenicol (Chlorafast, Chlorsig)

Indication

A

Bacterial eye infections

[Conjunctivitis]

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25
Q

Chloramphenicol (Chlorafast, Chlorsig)

Mechanism of action

A

BROAD-SPECTRUM ANTIBIOTIC

Prevents tRNA attachment to ribosome –> stop protein synthesis [bacteriostatic]

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26
Q

Chloramphenicol (Chlorafast, Chlorsig)

Main side effects

A

Transient stinging

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27
Q

Choline salicylate (Bonjela)

Indication

A

Oral & perioral lesions

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28
Q

Choline salicylate (Bonjela)

Mechanism of action

A

ANTI-INFLAMMATORY

Relieves pain/discomfort with ulcers

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29
Q

Choline salicylate (Bonjela)

Main side effects

A

Stinging upon application

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30
Q

Choline salicylate (Bonjela)

Contraindications/cautions

A

CI: Under 4 months old

C: 30mins before reinsertion of dentures

C: frequent dosing –> salicylate poisoning

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31
Q

Codeine
Morphine
Oxycodone

Indication

A

Pain

[Dental pain]

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32
Q

Codeine
Morphine
Oxycodone

Mechanism of action

A

OPIOID AGONIST
Codeine is a prodrug of morphine

Bind to opiate receptors in CNS –> inhibit ascending pain pathways –> modulates pain perception & decreases response

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33
Q

Codeine
Morphine
Oxycodone

Main side effects

A

Tolerance, dependence

Constipation (more with codeine)
Drowsiness

Nausea, vomiting

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34
Q

Codeine
Morphine
Oxycodone

Contraindications/cautions

A

Ci: acute head injury

CI: intestinal colitis

CI: under 12 yo

C: asthma, COPD –> increased risk of respiratory depression

C: ultra-rapid metabolisers –> increased risk of morphine toxicity

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35
Q

Dexamethasone (in Sofradex)

Indication

A

Otitis externa

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36
Q

Dexamethasone (in Sofradex)

Mechanism of action

A

CORTICOSTEROID

Increased lipocortin production –> suppresses phospholipase –> suppresses conversion of phospholipids into arachidonic acid → no COX/LOX pathways → inflammation is suppressed

37
Q

Dexamethasone (in Sofradex)

Main side effects

A

Local sensitivity reactions

Systemic effects:

  • Taste distortion
  • Dizziness
  • Headache
38
Q

Dexamethasone (in Sofradex)

Cautions

A

Prolonged use –> max 2 weeks

Application to broken skin –> dampen inflammatory response

39
Q

Fusidic acid (Fucithalmic)

Indication

A

Bacterial eye infections

[Conjunctivitis]

40
Q

Fusidic acid (Fucithalmic)

Mechanism of action

A

NARROW-SPECTRUM ANTIBIOTICS

Inhibits bacterial protein synthesis

41
Q

Fusidic acid (Fucithalmic)

Main side effects

A

Burning, stinging –> transient

42
Q

Fusidic acid (Fucithalmic)

Contraindications

A

Contact lenses for duration of treatment –> scratches on lenses (also includes benzalkonium preservative)

43
Q

Gabapentin
Pregabalin

Indication

A

Neuropathic pain

[Trigeminal neuralgia]

44
Q

Gabapentin
Pregabalin

Mechanism of action

A

ANTIEPILEPTIC

Blocks voltage-gated Ca2+ channels –> reduce Ca2+ influx –> decrease release of neurotrasmitters associated with neuropathic pain

45
Q

Gabapentin
Pregabalin

Main side effects

A 
Dry mouth
Peripheral oedema
Weight gain
Abnormal gait
Confusion, dizziness, drowsiness
46
Q

Gabapentin
Pregabalin

Contraindications/cautions

A

C: severe renal impairment –> reduce dose

C: abrupt withdrawal –> taper over 1 week+

C: tolerance, dependence

47
Q

Hypromellose (Poly-Tears)

Indication

A

Dry eye

48
Q

Hypromellose (Poly-Tears)

Mechanism of action

A

ARTIFICIAL TEARS

Swells & absorbs water –> expand thickness of tear film –> extended lubricant time on cornea –> reduced eye irritation due to dry eye

49
Q

Hypromellose (Poly-Tears)

Main side effects

A

Blurred vision

Ocular discomfort/irritation

50
Q

Hyperosmotic agents –> mannitol

Indication

A

Angle-closure glaucoma (fast onset of action)

51
Q

Hyperosmotic agents –> mannitol

Mechanism of action

A

OSMOTIC DIURETIC

Increases water excretion –> decreases IOP

52
Q

Hyperosmotic agents –> mannitol

Main side effects

A

Hypotension

Fluid & electrolyte imbalance

53
Q

Hyperosmotic agents –> mannitol

Contraindications/cautions

A

CI: heart failure, pulmonary oedema

CI: dehydration

C: renal impairment

54
Q

Levocabastine (Livostin)

Indication

A

Allergic conjunctivitis

55
Q

Levocabastine (Livostin)

Mechanism of action

A

ANTIHISTAMINE

Binds to H1 receptors –> decreases histamine release –> reduces inflammation associated with allergies

56
Q

Levocabastine (Livostin)

Main side effects

A

Stinging upon administration

57
Q

Lignocaine

Indication

A

Dental anaesthesia

58
Q

Lignocaine

Mechanism of action

A

LOCAL ANAESTHETIC

Block propagation of nerve fibres –> prevent depolarisation of action potentials –> block nerve activity & pain

59
Q

Lignocaine

Main side effects

A

Allergic reactions (rare)

60
Q

Lignocaine

Cautions

A

Tongue numbness may increase risk of bite trauma

61
Q 
Lodoxamide (Lomide)
Sodium cromoglycate (Cromo-Fresh, Rexacrom)

Indication

A

Allergic conjunctivitis, esp. seasonal

62
Q 
Lodoxamide (Lomide)
Sodium cromoglycate (Cromo-Fresh, Rexacrom)

Mechanism of action

A

MAST CELL STABILISER

Decreases mast cell activity –> less histamine released –> reduces inflammation associated with allergies

63
Q 
Lodoxamide (Lomide)
Sodium cromoglycate (Cromo-Fresh, Rexacrom)

Main side effects

A

Burning, stinging, itching

Blurred vision, tear production disturbance, ocular discomfort (more with lodoxamide)

64
Q 
Lodoxamide (Lomide)
Sodium cromoglycate (Cromo-Fresh, Rexacrom)

Cautions

A

Adherence & up to 1 week to see effect

Benzalkonium preservative –> 15 mins for contact lenses

65
Q

Macrogol 400 & propylene glycol (Systane)

Indication

A

Dry eye

66
Q

Macrogol 400 & propylene glycol (Systane)

Mechanism of action

A

Protects ocular surface & replenishes tear film lipids –> compensate for Meibomian gland dysfunction

67
Q

Macrogol 400 & propylene glycol (Systane)

Main side effects

A

Burning, stinging upon application

68
Q

Olopatadine (Patanol)

Indication

A

Allergic conjunctivitis

69
Q

Olopatadine (Patanol)

Mechanism of action

A

ANTIHISTAMINE & MAST CELL STABILISER

Binds to histamine receptors –> no inflammation associated with allergies

Stabilise mast cells –> no histamine released –> no inflammation associated with allergies

70
Q

Olopatadine (Patanol)

Main side effects

A

Headache

Blurred vision
Burning, stinging, local irritation

71
Q

Paracetamol (Panadol)

Indication

A

Pain [dental pain, trigeminal neuralgia]

72
Q

Paracetamol (Panadol)

Contraindications/cautions

A

CI/C: liver impairment

C: overdose

73
Q

Pilocarpine

Indication

A

Glaucoma

[most usually in PACG]

74
Q

Pilocarpine

Mechanism of action

A

Stimulate ciliary muscles –> opens trabecular meshwork –> increase aqueous outflow –> decrease IOP

75
Q

Pilocarpine

Main side effects

A

Excessive pupil constriction –> lead to frontal headache

Blurred vision

Loss of accommodation –> lou fa

76
Q

Pilocarpine

Contraindications/cautions

A

CI: Acute iritis

CI: Retinal detachment

C: GI spasm

C: asthma

C: CVD

77
Q

Retinol palmitate (VitA POS)

Indication

A

Ocular lubricant [dry eye]

78
Q

Retinol palmitate (VitA POS)

Mechanism of action

A

VITAMIN A [found in natural lacrimal fluid]

Occlusive barrier over cornea –> stops evaporation of tears overnight

79
Q

Retinol palmitate (VitA POS)

Main side effects

A

Blurred vision (ointment) –> apply at night

80
Q

Timolol

Indication

A

Glaucoma

81
Q

Timolol

Mechanism of action

A

BETA BLOCKER (NONSELECTIVE)

Binds beta-adrenoceptors in ciliary processes –> reduce aqueous production –> decrease IOP

82
Q

Timolol

Main side effects

A

Dryness, irritation
Blurred vision
Macular oedema

83
Q

Timolol

Contraindications/cautions

A

CI: bradycardia, heart block, uncontrolled heart failure

CI: asthma, COPD

C: diabetes

84
Q

Tramadol (Tramal SR)

Indication

A

Pain

85
Q

Tramadol (Tramal SR)

Mechanism of action

A

OPIOID AGONIST & OTHER CNS EFFECTS

Bind to opiate receptors in CNS –> inhibit ascending pain pathways –> modulates pain perception & decreases response

Also inhibits reuptake of noradrenaline & serotonin –> further contributes to analgesic activity

86
Q

Tramadol (Tramal SR)

Main side effects

A

Drowsiness
Nausea
Vomiting

87
Q

Tramadol (Tramal SR)

Contraindications/cautions

A

CI: uncontrolled epilepsy

C: impaired respiratory function eg. asthma, COPD –> increased risk of respiratory depression

88
Q 
Chlorobutanol (Cerumol)
Docusate sodium (Waxsol)

Indication

A

Removal of ear wax [otitis; especially if impacted, hard for doctor to see]

89
Q 
Chlorobutanol (Cerumol)
Docusate sodium (Waxsol)

Mechanism of action

A

WAX SOFTENERS

Increases absorption of water into ear wax –> softens & breaks it up

312 Eye/ENT/Dental/Pain (9 decks)

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