Module 9 Unit B/C/D Flashcards
What drugs can be prescribed for Blepharitis?
Topical antibiotics Erythromycin 0.5% and Bacitracin-polymyxin B 0.1% ophthalmic drops
What is the MOA of Bacitracin-polymyxin B 0.1% ophthalmic drops?
Antibacterial: Inhibits cell wall synthesis
What medications can be used for Bacterial conjunctivitis?
Erythromycin 0.5%
Bacitracin-polymyxin B 0.1% ophthalmic drops
Ofloxacin 0.3% ophthalmic drops or Ciprofloxacin 0.3%
Sulfacetamide (Bleph-10)
Which antibiotic is preferred for bacterial conjunctivitis in contact wearers?
Fluoroquinolones: Ofloxacin 0.3% ophthalmic drops or Ciprofloxacin 0.3%
What is the MOA of Sulfacetamide (Bleph-10)?
Inhibits tetrahydrate
Which medications can be used for allergic conjunctivitis?
Mast cell stabilizers (Cromolyn, lodoxamide) and Antihistamine (Azelastine, olopatadine)
What is the MOA of Mast cell stabilizers (Cromolyn, lodoxamide)?
Prevent the release of inflammatory mediators.
What is the MOA of ocular decongestant (phenylephrine, naphazoline)?
Adrenergic antagonist to constrict dilated blood vessels
What medications are used to treat dry eyes?
Ocular Lubricants
-OTC: artificial tears
-RX: Topical cyclosporine ophthalmic solution (Restasis), used for dry eyes from inflammation
What is the MOA of artificial tears?
Lubricate eyes
What is the MOA of Restasis (ocular lubricant)?
Suppresses immune system
What medication is first-line use for glaucoma?
Open-angle: Topical beta-blocers (Timolol or Betaxolol)
Glaucoma: Prostaglandin analogs (Xalatan)
What is the MOA of the topical beta-blockers (timolol and betaxolol)?
Lower IOP by decreasing the production of aqueous humor
What adverse effects are associated with topical beta-blockers?
heart block, bradycardia, hypotension, stinging, may cause conjunctivitis, blurred vision, photophobia, and dry eyes. Additive effect with systemic beta-blockers.
What is the MOA of prostaglandin analog (Xalatan)?
Facilitates aqueous humor outflow by relaxing the ciliary muscle.
How is Xalatan and topical beta-blockers prescribed?
Xalatan:Daily
BB: BID
What is the concern with optic glucocorticoids?
Can cause blindness if used with a viral infection.
**Refer to Ophthalmologist*
What medications are used for mild otitis externa?
Treatment and prevention: 2% solution of acetic acid.
Treatment: Acetic acid 2% solution and hydrocortisone 1%
What is the MOA of drying agents (2% solution of acetic acid)?
Dries and changes pH
What is the MOA of the drying agent/steroid (Acetic acid 2% solution and hydrocortisone 1%)?
Dries and changes pH plus anti-inflammatory action of steroid
When should the drying agent/steroid (Acetic acid 2% solution and hydrocortisone 1%) not be used?
Do not use if TM is not intact
Do not use if varicella-zoster is suspected
What medication can be used for mild to moderate otitis externa?
Acetic acid + propylene glycol + hydrocortisone (VoScol)
What is the MOA of VoScol?
Dries and changes pH plus anti-inflammatory action of steroid
When should VoScol not be used?
Do not use if TM is not intact
Do not use if varicella-zoster is suspected
What medication can be used for moderate to severe acute otitis externa?
-Cipro otic drops
-CIPRO-HC otic
-Ciprodex
Which medication can be used for otic pain?
Antipyrine/benzocaine otic drops (Auralgan)
What medications can be used for Ceruminosis (excess ear wax)?
Cerumenolytic:
-Cerumenex (triethanolamine polypeptide oleate)
-Carbamide peroxide otic (Debrox)
What medications can be used for acute otitis media?
PO antibiotics: Amoxicillin, Clavulanate, Ceftriaxone
Topical antibiotics: Ciprodex-for perforated TM in children
Which medications are neurotoxic to lice?
-Permethrin 1% (Nix)
-Pyrethrins 0.3%/piperonyl butoxide 4% (Rid)
-Malathion 0.5% lotion (Ovide)
-Ivermectin (Stromectol)
-Spinosad 0.9% (Natroba)
How does Benzyl alcohol (Ulesfia) 5% lotion work on lice?
Suffocation of lice
What adverse effects are associated with Nix?
Contact dermatitis, asthma exacerbation, mild and transient burning, stinging, and pruritis.
Which lice medication can be used in pregnancy?
Nix (promethrin)
When should the lice medication Rid be avoided?
Avoid in patients with chrysanthemum allergy.
What adverse effects are associated with the lice medication Rid?
Contact dermatitis, asthma exacerbation, mild and transient burning, stinging, and pruritis.
What patients should not be treated with Ulesfia (Benzol alcohol lotion)?
Do not use in infants younger than six months because it contains benzyl alcohol.
Safe for use in children four years and older.
What pregnancy category is Ivermectin?
Pregnancy cate C: no well-controlled studies
What is Ivermectin FDA approved for?
-FDA approved for Onchocerciasis and strongyloidiasis
-Lice and mites (OFF label)
Why may Natroba not be accessible to everyone with lice?
It is expensive
What is the MOA of Gammaxene (Lindane)?
CNS stimulant when absorbed systemically, resulting in convulsions and death.
What are the contraindications of Lindane?
Not safe during pregnancy.
Lindane Lotion is contraindicated for patients
with crusted (Norwegian) scabies and other skin conditions (e.g., atopic dermatitis, psoriasis) that may increase systemic absorption of the drug.
Premature infants and individuals with known uncontrolled seizures
What are the adverse effects of Lindane?
Dizziness, pruritis, seizure. Ophthalmic reactions are possible.
When should Lindane be used?
only when patients who cannot tolerate or have failed first-line treatment with safer medications for the treatment of scabies.
What is the indication for Permethrin 5% (Elimite)?
1st line for Scabies
What is the MOA of Elimite (permethrin 5%)?
Nuerotoxicity to scabies bug
What patient education should be reviewed for Elimite?
It should be applied to all areas of the body from the neck down, remain on the skin for eight to 14 hours or overnight, washed off, and
reapplied in one week. Patients should be told that they may continue to itch for up to two weeks, even after appropriate and effective treatment.
How is Ivermectin prescribed for Scabies?
200 mcg per kg, two doses 14 days apart
What is the pregnancy category for Ivermectin?
Pregnancy cat C: no well-controlled studies
What is the meaning of ovicidal?
capable of killing eggs
Which lice medications are partially ovicidal?
Ivermectin
Which lice medication is ovicidal?
Natroba
