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ophtho > eye drugs > Flashcards

eye drugs Flashcards

1
Q

what is the drug name for fluorescein dye

A

sodium fluorescien

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2
Q

why do we use fluorescein dye

A

to detect abrasions on the cornea (must remove contacts before using)

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3
Q

name two ocular anesthetics

A

proparacaine hydrochloride 0.5%

tetracaine 0.5%

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4
Q

what should you NOT do with ocular anesthetics

A

prescribe for repeated use

also do not rub eye for 10 min after use

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5
Q

what are the two types of dilating agents (mydriatics)

A
  1. cholinergic blocking

2. adrenergic stimuating

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6
Q

name 3 types of cholinergic blocking dilating agents/ mydriatics

A
  1. tropicamide 0.5% or 1%
  2. cyclopentolate hydrochloride 0.5%, 1%, 2%
  3. homatropine hydrobromide 2% or 5%
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7
Q

name one type of adrenergic stimulating dilating agents/ mydriatics

A

phenylephrine hydrochloride 2.5-10%

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8
Q

how do the cholinergic blocking dilating agents work

A

dilation by paralyzing the iris sphincter

referred to as cycloplegics –> produce paralysis of accommodation

can also be used for pain relief as it paralyzes the ciliary spasm during iritis etc

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9
Q

how do adrenergic stimulating dilating agents work

A

stimulates the pupillary dilator muscles

no effect on accommodation

dilatory effect is not as strong

mydriatic but NOT cycloplegic

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10
Q

how should you introduce drops to the eye

A

avoid dropping them directly on cornea as it is the most sensitive part of the eye

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11
Q

what do you use if maximum mydriasis is required

A

phenylephrine and tropicamide in combo

in peds, use cyclopentolate and phenylephrine

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12
Q

what drug should never be used by a primary care physician

A

topical ocular corticosteroids

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13
Q

what drug should you use to treat ophthalmic herpes SIMPLEX viral infection

A

topical trifluridine (viroptic)

use only under direction of ophtho

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14
Q

what should you never use to dilate the pupil for a fundus exam

A

atropine or scopolamine

the dilatory effects can last up to 1-2 weeks

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15
Q

what side effects are associated with regular beta blockers?

how does this differ for betaxolol?

A

regular beta blockers have pulmonary SEs and are thus contraindicated in asthma and COPD

betaxolol is cardioselective so less pulm SEs

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16
Q

what is tamsulosin

A

alpha 1a antagonist for BPH

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17
Q

what are the ocular ramifications of tamsulosin

A

can cause intraoperative floppy iris syndrome

flaccid iris–> prolapse from surgical wounds and poor pupillary dilation

higher risk of intraoperative complications for example during cataract surgery

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18
Q

what are the ocular ramifications of thioridazine

A

pigment retinopathy at high doses

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19
Q

list the types/classes of glaucoma meds

A
  1. beta blockers
  2. cholinergic stimulating
  3. alpha 2 agonists
  4. adrenergic stimulating
  5. prostaglandin inhibitors
  6. carbonic anhydrase inhibitors
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20
Q

name beta blockers used to treat glaucoma

A

topical timolol, levobunolol, metipranolol, carteolol

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21
Q

name a cholinergic stimulating drug used to treat glaucoma

A

pilocarpine

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22
Q

how does pilocarpine work

A

increases aqueous flow through the trabecular meshwork

unpleasant SEs in eye and thus unpopular–> often less systemic PNS side effects

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23
Q

name 2 alpha-2 agonist drugs used to treat glaucoma

A

brimonidine tartrate

apraclonidine

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24
Q

how does apraclonidine work

A

decreases aqueous formation and increases outflow

used in critical situations in pressure spikes

25
Q

what drug is used in critical situations of pressure spikes in glaucoma

A

apraclonidine –> used in ER for temporary control of IOP

26
Q

who should you not give apraclonidine to

A

infants due to risk of severe hypotension and apnea

27
Q

SEs of apraclonidine

A

orthostatic hypotension

fairly high sensitivity reactions

28
Q

name two adrenergic stimualting drugs used to treat glaucoma

A

epinephrine

dipivefrine

29
Q

how are prostaglandin analogues used to treat glaucoma

A

increase aqueous outflow through the uveoscleral pathway

have no major systemic toxicities

have more unique local effects like iris darkening, eyelash lengthening, inflammation/ swelling of eye

30
Q

name two PO carbonic anhydrase inhibitors used to treat glaucoma

A

PO acetazolamide and methazolamide

used for chronic glaucoma management, limited by side effects

31
Q

side effects of PO carbonic anhydrase inhibitors used to treat glaucoma

A

paresthesia

anorexia

renal calculi/bone marrow

32
Q

name two intraocular carbonic anhydrase inhibitors used to treat glaucoma

A

IO dorzolamide, brinzolamide

33
Q

what is the benefit to IO carbonic anhydrase inhibitors to treat glaucoma

A

similar therapeutic effect but less systemic SEs

altered taste is main adverse reaction

34
Q

what ocular effect can the following drug have:

amiodarone

A

optic neuropathy–>

mildly decreased vision, visual field defects, bilateral optic disc swelling

produces WHORL SHAPED pigmented deposits on the corneal epithelium

35
Q

what should you think of if you see whorl shaped pigmented deposits on the corneal epithelium

A

amiodarone side effect

36
Q

what is amiodarone

A

cardiac anti arrhythmic

37
Q

what ocular effect can the following drug have:

bisphosphonates

A

associated with conjunctivitis, scleritis, uveitis

symptoms are red eye, photophobia, decreased vision, deep eye pain

38
Q

what do bisphosphonates treat

A

osteoporosis

39
Q

what ocular effect can the following drug have:

chloroquine

A

can produce corneal deposits and retinopathy

retinal damage is insidious, slowly progressive and usually irreversible

BULLS EYE macular lesions when damage has already occurred

all patients on chloroquine should be referred to ophtho to determine baseline and f/u intervals

40
Q

what should you think of if you see bulls eye lesions on the macula

A

damage from chloroquine drug

41
Q

what is chloroquine used to treat

A

rheumatoid

42
Q

what ocular effect can the following drug have:

chlorpromazine

A

produces punctate opacities in the corneal epithelium after long term use

reversible with discontinuation

43
Q

what ocular effect can the following drug have:

corticosteroids

A

long term use can cause POSTERIOR SUBCAPSULAR CATARACTS

also may cause central serous retinopathy and related macular edema

44
Q

what ocular effect can the following drug have:

digitalis

A

blurred vision

abnormally coloured vision

objects can appear frosted or have white halo

45
Q

what is digitalis used for

A

cardiac–arrhythmias etc

46
Q

what ocular effect can the following drug have:

diphenyhydantoin

A

can cause dosage related cerebellar-vestibular effects (nystagmus)

47
Q

what ocular effect can the following drug have:

ethambutol

A

dosage related optic neuropathy

48
Q

what is ethambutol used for

A

chemo of TB

49
Q

what ocular effect can the following drug have:

statins

A

associated with cataracts when given in excessive doses (not proven)

50
Q

what ocular effect can the following drug have:

rifabutin

A

uveitis

51
Q

what is rifabutin used for

A

MAC infections

52
Q

what ocular effect can the following drug have:

viagra

A

at peak plasma levels may experience transient impairment of colour discrimination (blue colour tinge)

rare at normal dose

53
Q

what ocular effect can the following drug have:

tamoxifen

A

high doses can cause whorl-shaped opacities, retinal crystalline deposits, macular edema, cataracts, optic neuritis

rare at normal dose

54
Q

what ocular effect can the following drug have:

topiramate

A

shown to induce acute bilateral angle closure glaucoma

55
Q

what is topiramate used for

A

treatment of seizure

56
Q

define epiphora

A

chronic tearing

57
Q

define amblyopia

A

loss of visual acuity not correctable by glasses in an otherwise healthy eye

58
Q

define photopsias

A

flashes of light

ophtho (5 decks)

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