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Spring 15 - Pharm Unit II > Eye Meds > Flashcards

Eye Meds Flashcards

1
Q

Key Factors in Ophthalmic Drugs

A
  • effectiveness
  • toxicity
  • propensity to cause allergic reactions
  • availability in ointment or solution form
  • cost
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2
Q

Aminoglycosides MOA

A

inhibit bacterial protein synthesis

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3
Q

Examples of Aminoglycosides

A

Tobramycin (Tobrex)
Gentamicin (high ocular toxicity)
Neomycin (high ocular toxicity)

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4
Q

Aminoglycoside Uses

A
  • most effective against G- (esp Pseudomonas)

- also synergy against some G+

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5
Q

Aminoglycoside AEs

A
  • localized ocular toxicity and hypersensitivity
  • lid itching, lid swelling, conjunctival erythema
  • bacterial/fungal corneal ulcers
  • nonspecific conjunctivitis
  • conjunctival epithelial defects
  • conjunctival hyperemia
  • superficial punctate keratitis
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6
Q

Fluoroquinolone MOA

A

inhibit bacterial DNA gyrase

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7
Q

Fluoroquinolone Uses

A
  • corneal infections/ulcers

- severe conjunctivitis

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8
Q

Fluoroquinolone AEs

A
  • white crystalline precipitates, lid margin crusting, crystals/scales
  • FB sensation, corneal infiltrates
  • conjunctival hyperemia
  • bad/bitter taste
  • corneal staining, keratopathy/keratitis, allergic reactions
  • lid edema, tearing, photophobia, decreased vision
  • nausea, chemosis
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9
Q

Can Fluoroquinolones be used for conjunctivitis?

A

not used first line due to poor Strep coverage, expense, resistance concern

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10
Q

Trimethoprim/Polymyxin B Uses

A
  • Gram pos and neg (except Pseudo, but polymyxin covers pseudomonas)
  • very effective against H flu, S pneumo
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11
Q

Trimethoprim/Polymyxin B Overall Comments

A
  • first line tx for conjunctivitis
  • low toxicity
  • good for kids
  • cost effective
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12
Q

Erythromycin Ointment

A
  • first line treatment for conjunctivitis
  • very gentle on the cornea
  • cost-effective
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13
Q

Bacitracin Ointment Use

A
  • first line for conjunctivitis

- use for blepharitis

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14
Q

Bacitracin Ointment Cautions

A

-avoid long term use due to resistance development

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15
Q

Trifluridine/Viroptic Class and Use

A
  • topical antiviral

- dendritic HSV keratitis

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16
Q

Famciclovir/Famvir Class and Use

A
  • oral antiviral
  • safe for kids
  • effective with HSV and Varicella zoster
17
Q

What is the gold standard ophthalmic medication?

A

prednisolone acetate (Pred Forte)

18
Q

Corticosteroid AEs

A
  • cataracts (long-term)
  • elevated IOP
  • optic nerve damage
  • papilledema assoc w/ pseudotumor cerebri
19
Q

What must be monitored with corticosteroids and when?

A
  • IOP at baseline and qweek until therapy stopped

- taper corticosteroid if therapy duration prolonged

20
Q

What is the downfall of corticosteroid treatment?

A

can mask infx –> turn into more severe infx

21
Q

Which corticosteroid forms provide better penetration?

A

acetate corticosteroids better than EtOH

22
Q

NSAID Uses

A

tx of eye pain or itching

23
Q

NSAID AEs

A
  • transient burning or stinging upon instillation

- other minor sxs of ocular irritation

24
Q

Treatment of Allergic Conjunctivitis (steps)

A
  1. remove/avoid allergen
  2. artificial tears
  3. topical antihistamine
  4. mast cell stabilizer or MCS/antihistamine
  5. trial of topical NSAID
  6. short term topical corticosteroid and immunotherapy
25
Q

Cycloplegics MOA

A

anticholinergic agents block the responses of the sphincter muscle of the iris and muscle of ciliary body –> produces pupillary dilation and paralysis of accommodation

26
Q

Cycloplegic Examples

A
  • atropine
  • homatropine
  • cyclopentolate
  • tropicamide
27
Q

Cycloplegic Use

A

for reduction of inflammation and pain

28
Q

Cycloplegic AEs

A
  • increase IOP
  • transient stinging/burning
  • irritation w/ prolonged use: allergic lid rxns, hyperemia, follicular conjunctivitis, blepharoconjunctivitis, vascular congestion, edema, exudate
29
Q

Cycloplegic Special Info

A

all of them have red caps

30
Q

Bimatoprost Use

A

-increasing eyelash growth

31
Q

Bimatoprost MOA

A

adverse effect of prostaglandin analog eye drops

32
Q

Bimatoprost Trade Name

A

Latisse

33
Q

Bimatoprost AEs

A
  • may darken iris and skin around eyes
  • skin effects can be reversible
  • iris effects usually permanent
34
Q

Bimatoprost Cautions

A
  • with use in pts getting prostaglandin eyedrops for glaucoma
  • prostaglandin exposure > qd can decrease efficacy
35
Q

AREDS Vitamin Supplements

A
  • vitamin A, C, E
  • zinc
  • copper
36
Q

Use of Vitamin Supplements

A

-does not prevent age-related macular degeneration but does slow rate of progression

37
Q

Cautions for Vitamin Supplements

A

vitamins A, D, E, K are fat soluble and can accumulate to toxic levels

Spring 15 - Pharm Unit II (9 decks)

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