EM Ophtha 3: eye drugs

Question 1

mydriatic drug

Answer 1

2.5% phenylephrine
1 drop
onset 20-30 mins

Question 2

mydriatic-cycloplegic drugs

Answer 2

1% cyclopentolate

0. 5-1% tropicamide
   * 2% homatropine

*also for treatment of iritis

Question 3

antihistamine drugs

Answer 3

naphazoline
pheniramine
-both 1 drope 3-4x a day
-do not use >72 hours

0. 1% olopatadine
   - 1 drop twice daily

Question 4

topical anesthetics

Answer 4

tetracaine ophthalmic solution
0.5% solution
1-2 drops
OOA 1 minute
DOA 30 mins

proparacaine ophthalmic solution
0.5% solution
1-2 drops
onset 20s
DOA 15 mins

Question 5

eye antibiotics

Answer 5

ERYTHROMYCIN ophthalmic ointment
-not agent of choice for contact lens wearers
1/2 in applied to lower eyelid 2-4 timex a day
the ff used for both conjunctivitis and corneal abrasion if a contact lens user:
CIPROFLOXACIN
solution:
1-2 drops when awake every 2 hours for 2 days
ointment:
1/2 in applied to lower eyelid 3x a day for 2 days

TOBRAMYCIN
one drop per time period is sufficient is most cases
0.3% solution
1-2 drops every 4 hours
0.3% ointment
1/2 in. applied to lower lid 2-3x/day

GENTAMICIN
one drop per time period is sufficient in most cases
0.3% solution
instill 1-2 drops every 4 h
0.3% ointment
1/2 in. applied to lower lid 2-3/day

Question 6

eye antivirals

Answer 6

For Hepes simplex keratitis:
Idoxuridine (1 drop q1)
Trifluridine (1 drop q2)
Ganciclovir (1 drop 5x a day)

Question 7

eye antibiotic-steroid combination

Answer 7

dexamethasone, neomycin sulfate, polymyxin b sulfate
do NOT use for corneal abrasion if a contact lens wearer
ointment: 1/2 inch in conjunctival sac up to 3-4x a day
suspension: instill 1-2 drops 4-6x a day up to every hour

dexamethasone, tobramycin
same precaution
suspension: 1-2 drops every 4-6 h
ST: 1 drop every 4-6 h
ointment: 12 in ribbon 3-4x/day

Question 8

GLAUCOMA MEDS

Answer 8

nonselective beta blockers

• levobunolol
• timolol
• carteolol
• metipranolol

selective B1 blockers (safe for COPD or asthma)
-betaxolol

selective a2 agonists

• brimonidine
• apraclonidine

combination a2 agonist-nonselective b blocker
Brimonidine+timolol

carbonic anhydrase inhibitor

• brinzolamide
• drozolamide

cholinergic agents
-pilocarpine

prostaglandin analogs

• bimatoprost
• travopost
• latanoprost