Medications Flashcards
What are two classes of mydriatics?
anticholinergics
direct-acting sympathomimetics
what drugs are anaesthetics?
proparacaine (duration- 20 min)
tetracaine (duration 30 min)
* tetracaine may sting when instilled
what are the clinical uses for anesthetics?
provide pain relief
anesthesia for intraocular pressure checks
anesthesia for surgical procedures (FB removal)
chronic use is toxic to cornea
what are the clinical uses of fluorescein?
corneal abrasion/ ulcers
IOP pressure check
What three medications are anticholinergic mydriatic drops?
atropine (7-14 days)
cyclopentolate (12 hours)
tropicamide (4-6 hours)
what is the mechanism of action of anticholinergic mydriatics?
paralysis of the iris sphincter by inhibition of parasympathetic innervation
cycloplegia by paralyzing the ciliary muscle (loss accommodation = blurred vision)
what are the clinical uses of anti-cholinergic mydriatics?
fundoscopic examination
treatment of uveitis for photophobia
cycloplegic refraction (peds)
complications of anti-cholinergic mydriatics?
complications are rare but
neurological problems (ataxia, confusion, psychosis)
anti-cholinergic effects (tachycardia, dry mouth, urinary retention, constipation)
can precipitate angle-closure glaucoma (rare)
which medication is a mydriatics- sympathomimetics?
phenylephrine
what is the mechanism of action of mydriatics- sympathomimetics?
stimulates iris dilator muscle (alpha -1 adrenergic)
NO cycloplegia (no paralysis of ciliary muscles)
what are clinical uses of sympathomimetics?
dilation
what are some complication of of sympathomimetics?
may elevate BP
use lower concentration in infants
for routine dilated exams which medication should be used? what about for kids?
phenylephrine (2.5%) and tropicamide (0.5% or 1%)
for kids use cyclopentolate (1%)
what are the two mechanisms to decrease IOP?
decrease aqueous prodcution
increase aqueous outflow
what beta blocker medications are used for glaucoma?
timolol (nonselective beta 1 and beta 2)
betaxolol (mainly blocks beta 1)
what is the mechanism of action of beta blocker medications for glaucoma?
reduce aqueous production
what are some complications of beta blocker medications for glaucoma?
arrhythmia, bradycardia, hypotension
asthma, bronchospasm
mask diabetic hypoglycemic response!
which medication is Alpha- 2 agonists? and what is the mechanism of action?
brimonidine (alphagan)
reduce aqueous production
complications alpha 2- agonist?
AVOID in children <4 years- apnea
headache
fatigue, muscle pains
dry nose and dry mouth
follicular conjunctivitis
What medication is a carbonic anhydrase inhibitors (CAI)
Dorzolamide
brinzolamide
what is the mechanism of action of carbonic anhydrase inhibitors?
reduce aqueous production
what are complications of carbonic anhydrase inhibitors?
ocular burning
bitter taste
consider sulfa allergies
what medications for glaucoma are prostaglandins?
latanoprost
bimatoprost
travoprost
what is the mechanism of action of medications for glaucoma that are prostaglandins?
increase aqueous outflow
what are some complications to be aware of for prostaglandins?
ocular burning/redness
darkening of the iris
hypertrichosis- eyelash growth
orbital fat atrophy
which medications are cholinergics for glaucoma?
pilocarpine
what is the mechanism of action of pilocarpine (cholinergic medication of glaucoma)
increase aqueous outflow
induce miosis (stretches trabecular meshwork)
What are some complications to be aware of for pilocarpine
brow ache
neurologic problems: confusion; tremor
parasympathetic effects: diarrhea, bradycardia, hypotension, bronchospasm
associated with higher rate of retinal detachment
which medications are steroids?
prednisolone acetate
durezol
dexmethasone
what is the mechanism of action of steroids?
decrease inflammation
what are complications of steroid eye drops?
increased intraocular pressure
cataracts acceleration
exacerbation of viral (HSV) and/or bacterial infections
slows down healing
DON’T use if patient has corneal abrasion
what medications are antibiotic eye drops?
bacitracin, bacitracin/polymixin
erythromycin, tobramycin, gentamicin
ciprofloxacin, moxifloxacin, ofloxacin, gatifloxacin
what are clinical uses of antibiotic eyedrops?
corneal/ conjuctival/ eyelid infections
postoperative prophylaxis
what are some clinical considerations to consider with antibiotics?
choice of ointment vs drops
* if contact lens wearer, NEED fluroquinolone for pseudomonas coverage
what is the dosage of antibiotic eyedrops?
dosage is usually 4x/ day- but can be used up to hourly
combination antibiotic/steroids should be prescribed by an opthalmologist
what medications are NSAIDs?
Diclofenac
ketorolac
nipafenac
bromfenac
what are the clinical use of NSAIDS for eyedrops?
pain
inflammation
macular edema
pre/post operatively
what are some clinical considerations for NSAIDs?
epithelial toxicity
what can be used to treat MRSA?
Vancomycin, Daptomycin, ceftaroline
What antibiotics can be used in community acquired MRSA?
TMP-Sulfa, doxycycline, clindamycin
What antibiotics can be used to treat pseudomonas?
Ciprofloxacin, levofloxacin, gentamycin, tobramycin
ceftazidime, cefepine, Aztreonam, zosyn (pip/tazo)
what antibiotics are used for C-diff?
vancomycin
metronidazole
What is the best antibiotic for a non-pregnant patient with an uncomplicated UTI
TMP- Sulfa
Barrier to antibiotics that want to treat gram negative organisms
down-regulated porins
efflux pumps
and beta lactamase
