Eye Drugs Flashcards
Framycetin
CLASS
Aminoglycoside antibiotic
INDICATION
Bacterial eye infections
DOSE
- 5% 1 drop q2-4h for 2 days, then 1d qid for 5 days
* Comes in Soframycin 0.5%*
MONITORING
Improvement of symptoms
Corneal wounds
COUNSELLING
Can cause occular irrit
How to administer drops
D28
Gentamycin drops
CLASS
Aminoglycoside antibiotic
INDICATIONS
Bact eye infections
proph post surg
DOSAGE
Bact conjunc:
0.3% 1drop q2-4h for 2 days, then 1d qid for 5 days
proph:
1 drop qid up to 4 days
MONITORING
Improvement of infection
Corneal damage
should be reserved for opthamologist use
COUNSELLING
Can cause occular irrit
How to use drops
D28
Tobramycin drops
CLASS
Aminoglycoside antibx
INDICATIONS
bact eye inf
proph post surg
DOSAGE
Bact inf:
0.3% 1 drop q2-4h for 2 days, then 1 drop qid for 5 days
Proph:
0.3% 1d qid until healed (usually not>4 days)
Comes in 0.3% Tobrex drops and oint
MONITORING
Improvement of infection
Corneal wound
COUNSELLING
Can cause occular irritation
How to use drops
D28
Ciprofloxacin drops
CLASS
Quinolone eye drop
INDICATIONS
Keratitis and severe conjunc
DOSAGE
Severe conjunc:
0.3% 1drop q2h for 2 days, then 1d q4h for 5 days
Keratitis:
day 1: 0.3% 1d every 15 minues for first 6 hours, then 1d every 30 minutes
day 2: 1 d every hour
day 3 until healed: 1d q4h
Comes in 0.3% Ciloquin, Ciloxan
MONITORING
Improvement of symptoms
Corneal wounds
COUNSELLING
Can cause occular irritation
How to use drops
D28
Oxfloxacin drops
CLASS
Quinolone antibiotic
INDICATIONS
Keratitis and severe conjunc
DOSAGE
Conjunc:
0.3% 1d q4h for 2 days, then 1d qid for up to 8days
Keratitis:
day 1-2: 1d every 30mins while awake, then at 4 and 6 hours after going to bed
day 3-7: 1d q1h while awake
day8 until healed: 1d qid
Comes in 0.3% Ocuflox
MONITORING
Improvement of symptoms
Corneal wounds
COUNSELLING
Complete course
Can cause occular irritat
How to use drops
D28
Chloramphenicol
CLASS
Broad spectrum antibiotic
INDICATIONS
Bact eye inf
Proph post surg
DOSAGE
Conjunc:
1d q2-4h for 2 days, then 1d qid for 5 days
note: oint at night of tds
Proph:
1d/oint qid until healed (usually 4 days)
Bact blepharitis
massage oint into lid margin daily-BD for 1-3 weeks
Comes in 0.5% drops or 1% oint
MONITORING
COUNSELLING
How to use drops
D28
Propamidine drops
CLASS
Antibacterial
INDICATIONS
Acanthamoeba keratitis (part of combo tx. opthal use)
Mild conjunc
DOSAGE
Acanthamoeba keratitis:
1d every hour until improvement, then grad reduce freq
conjunc:
1d tds-qid for 7 days
comes in 0.1% Brolene
MONITORING
Improvement of symptoms
Corneal wounds
COUNSELLING
Complete course
Can cause occular irrit
How to use drops
D28
Betaxolol drops
CLASS
Beta-blocker (beta1 selective)
INDICATIONS
Glaucoma
Ocular hypertension
DOSAGE
1 drop BD
Comes in 0.25% suspension, 0.5% solution (Betoptic)
MONITORING
Systemic cardiovascular effects (ie bradycard, BP)
Bronchospasm (caution copd/asthma)
ocular pressure / disease progression / co-morbiditids (ie ensure diabetes controlled)
Tolerance (after 1 year)
COUNSELLING
Susp: shake first
How to use drops
Can -> stinging on instillation, blurred vision, fatigue
D28
Timolol drops
CLASS
Beta-blocker (non-selective beta1 and beta2)
INDICATIONS
glaucoma
ocular hypertension
DOSAGE
Conven: 1d 0.5% BD (can reduce to once daily)
XR: 1d 0.25% xr daily - 1d 0.5% xr daily
Gel: 1d 0.1% once daily
Comes in Timoptol-XE 0.25% and 0.5%, Tenopt/Timoptol 0.5% (ir), Nyogel 0.1%, combo preps
MONITORING
Systemic cardiovascular effects (ie bradycard, BP)
Bronchospasm (caution copd/asthma)
ocular pressure / disease progression / co-morbiditids (ie ensure diabetes controlled)
Tolerance (after 1 year)
COUNSELLING
How to use drops
Can -> stinging on instillation, blurred vision, fatigue
D28
Bimatoprost drops
CLASS
Prostaglandin analogue
INDICATIONS
Glaucoma
Ocular hypertension
DOSAGE
1 drop once daily at night
Comes in 0.3% drops and 0.3% MINIMS (pres free) (Lumigan), combo preps with timolol
MONITORING
oedema of macula, eyelid, conjunctiva
intraocular inflammation (precaution)
preservative allergies
ocular pressure / disease progression / co-morbiditids (ie ensure diabetes controlled)
avoid combo of 2 prosta anals
COUNSELLING
Best instilled at night
Can slowly change colour of iris iriversibly (more noticable if using in one eye only)
Can cause eyelashes to darken, thicken, lengthen (this stops when tx does)
Can cause eye irritation, blurry vision, headache
How to use drops
D28
Latanoprost drops
CLASS
Prostaglandin analogue
INDICATIONS
Glaucoma
Ocular hypertension
DOSAGE
1 drop once daily at night
Comes in 0.005% drops (Xalaprost/Xalatan), combo preps with timolol
MONITORING
oedema of macula, eyelid, conjunctiva
intraocular inflammation (precaution)
preservative allergies
ocular pressure / disease progression / co-morbiditids (ie ensure diabetes controlled)
avoid combo of 2 prosta anals
COUNSELLING
Best instilled at night
Can cause bitter taste
Can slowly change colour of iris iriversibly (more noticable if using in one eye only)
Can cause eyelashes to darken, thicken, lengthen (this stops when tx does)
Can cause eye irritation, blurry vision, headache
How to use drops
D28
Tafluprost drops
CLASS
Prostaglandin analogue
INDICATIONS
Glaucoma
Ocular hypertension
DOSAGE
1 drop once daily at night
Comes in 0.0015% minims (Saflutan)
MONITORING
oedema of macula, eyelid, conjunctiva
intraocular inflammation (precaution)
preservative allergies
ocular pressure / disease progression / co-morbiditids (ie ensure diabetes controlled)
avoid combo of 2 prosta anals
COUNSELLING
Best instilled at night
Can slowly change colour of iris iriversibly (more noticable if using in one eye only)
Can cause eyelashes to darken, thicken, lengthen (this stops when tx does)
Can cause eye irritation, blurry vision, headache
How to use drops
D28
Travoprost drops
CLASS
Prostaglandin analogue
INDICATIONS
Glaucoma
Ocular hypertension
DOSAGE
1 drop once daily at night
Comes in 0.004% drops (Travatan), combo preps with timolol
MONITORING
oedema of macula, eyelid, conjunctiva
intraocular inflammation (precaution)
preservative allergies
ocular pressure / disease progression / co-morbiditids (ie ensure diabetes controlled)
avoid combo of 2 prosta anals
COUNSELLING
Best instilled at night
Can slowly change colour of iris iriversibly (more noticable if using in one eye only)
Can cause eyelashes to darken, thicken, lengthen (this stops when tx does)
Can cause eye irritation, blurry vision, headache
How to use drops
D28
Apraclonidine drops
CLASS
Alpha2 agonist
INDICATIONS
Short term (<3month) reduction of intraocular pressure
Acute angle-closure crisis
Preven oc hyperten post laser surgery
DOSE
1 drop 2-3 times daily
Comes in 0.5% drops (Iopidine)
MONITORING
Duration of use (short term only) / tolerance / allergy
Ocular pressure / disease progression / comorbids (ie DM)
BP
Lid retraction
COUNSELLING
Can cause local irritaion, dry mouth and nose, taste disturbance
How to use drops
D28
Brimonidine drops
CLASS
Alpha2 agonist
INDICATIONS
Chronic open-angle glaucoma or ocular hypertension
DOSE
1 drop 0.2% or 0.15% BD
Comes in 0.2%, 0.15% (Alphagan) drops, combo products with timolol and brinzolamide
Note: diff strengths have diff preservatives
MONITORING
Ocular pressure / disease progression / co-morbid (id DM)
allergy
hypotension (BP)
COUNSELLING
Can cause local irritation, blurry vision, dry mouth and nose, taste disturbance, drowsiness, headache
L12
Know how to use drops
D28
Brinzolamide
CLASS
Carbonic anhydrase inhibitor
INDICATIONS
Glaucoma
Ocular hypertension
DOSE
1 drop BD
Comes in 1% (Azopt), combo with brimonidine
MONITORING
Sulfonamide allergy / allergic reactions
Compliance
Disease progression / ocular pressure
Comorbidities (ie diabetes, obesity)
visual changes
COUNSELLING
Use regularly
Can cause discomfort, blurred vision, taste disturbance
Can cause dizziness (caution driving), headache, GI disturbance
Dorzolamide drops
CLASS
Carbonic anhydrase inhibitor
INDICATIONS
Glaucoma
Ocular hypertension
DOSE
Single agent = 1 drop tds
Combo w. BB = 1 drop bd
Comes in 2% Trusamide/Trusopt, combo with timolol
MONITORING
Sulfonamide allergy / allergic reactions
Compliance
Disease progression / ocular pressure
Comorbidities (ie diabetes, obesity)
visual changes
COUNSELLING
Use regularly
Can cause discomfort, blurred vision, taste disturbance
Can cause dizziness (caution driving), headache, GI disturbance
Acetazolamide
CLASS
Systemic carbonic anhydrase inhibitor
INDICATIONS
Perioperative reduction of intraocular pressure (eg acute angle-closure crisis)
Chronic open-angle glaucoma where other tx have failed
Epilepsy
DOSE
Glauc: 125g BD - 250mg QID
or
Periop: 250mg q4h (max 1g daily)
MONITORING
Sulfonamide allergy / allergic reactions
Compliance
Disease progression / ocular pressure
Comorbidities (ie diabetes, obesity)
visual changes
metabolic acidosis
electrolyte balance (K, Na) - acts as a diuretic
gout (can worsen)
dehydration
blood dyscrasia
tolerability (up to 50% do not tolerate)
COUNSELLING
Take with food
Can -> drowsy/dizzy, nvd, bitter/metallic taste, decreased libido
Do not take if you have sulfonamide allergy
Pilocarpine drops
CLASS
Cholinergic
INDICATIONS
Chronic open-angle glaucoma
Acute angle-closure crisis (specialis)
Reversal effect of weak mydriatics (not recommended)
DOSE
1 drop tds-qid
Comes in 1%, 2%, 4% (Isopto Carpine) are strenghts other than 1% even used?
MONITORING
Disease progression, ocular pressure, comorbids
visual acuity for driving (partic in reduced light)
COUNSELLING
Know how to use eye drops
D28
Can -> blurred vision (caution driving), headache, irritation, myopia, miosis (can be perm with long term use)
