Module 9 Unit B/C/D

Question 1

What drugs can be prescribed for Blepharitis?

Answer 1

Topical antibiotics Erythromycin 0.5% and Bacitracin-polymyxin B 0.1% ophthalmic drops

Question 2

What is the MOA of Bacitracin-polymyxin B 0.1% ophthalmic drops?

Answer 2

Antibacterial: Inhibits cell wall synthesis

Question 3

What medications can be used for Bacterial conjunctivitis?

Answer 3

Erythromycin 0.5%
Bacitracin-polymyxin B 0.1% ophthalmic drops
Ofloxacin 0.3% ophthalmic drops or Ciprofloxacin 0.3%
Sulfacetamide (Bleph-10)

Question 4

Which antibiotic is preferred for bacterial conjunctivitis in contact wearers?

Answer 4

Fluoroquinolones: Ofloxacin 0.3% ophthalmic drops or Ciprofloxacin 0.3%

Question 5

What is the MOA of Sulfacetamide (Bleph-10)?

Answer 5

Inhibits tetrahydrate

Question 6

Which medications can be used for allergic conjunctivitis?

Answer 6

Mast cell stabilizers (Cromolyn, lodoxamide) and Antihistamine (Azelastine, olopatadine)

Question 7

What is the MOA of Mast cell stabilizers (Cromolyn, lodoxamide)?

Answer 7

Prevent the release of inflammatory mediators.

Question 8

What is the MOA of ocular decongestant (phenylephrine, naphazoline)?

Answer 8

Adrenergic antagonist to constrict dilated blood vessels

Question 9

What medications are used to treat dry eyes?

Answer 9

Ocular Lubricants
-OTC: artificial tears
-RX: Topical cyclosporine ophthalmic solution (Restasis), used for dry eyes from inflammation

Question 10

What is the MOA of artificial tears?

Answer 10

Lubricate eyes

Question 11

What is the MOA of Restasis (ocular lubricant)?

Answer 11

Suppresses immune system

Question 12

What medication is first-line use for glaucoma?

Answer 12

Open-angle: Topical beta-blocers (Timolol or Betaxolol)
Glaucoma: Prostaglandin analogs (Xalatan)

Question 13

What is the MOA of the topical beta-blockers (timolol and betaxolol)?

Answer 13

Lower IOP by decreasing the production of aqueous humor

Question 14

What adverse effects are associated with topical beta-blockers?

Answer 14

heart block, bradycardia, hypotension, stinging, may cause conjunctivitis, blurred vision, photophobia, and dry eyes. Additive effect with systemic beta-blockers.

Question 15

What is the MOA of prostaglandin analog (Xalatan)?

Answer 15

Facilitates aqueous humor outflow by relaxing the ciliary muscle.

Question 16

How is Xalatan and topical beta-blockers prescribed?

Answer 16

Xalatan:Daily
BB: BID

Question 17

What is the concern with optic glucocorticoids?

Answer 17

Can cause blindness if used with a viral infection.

**Refer to Ophthalmologist*

Question 18

What medications are used for mild otitis externa?

Answer 18

Treatment and prevention: 2% solution of acetic acid.

Treatment: Acetic acid 2% solution and hydrocortisone 1%

Question 19

What is the MOA of drying agents (2% solution of acetic acid)?

Answer 19

Dries and changes pH

Question 20

What is the MOA of the drying agent/steroid (Acetic acid 2% solution and hydrocortisone 1%)?

Answer 20

Dries and changes pH plus anti-inflammatory action of steroid

Question 21

When should the drying agent/steroid (Acetic acid 2% solution and hydrocortisone 1%) not be used?

Answer 21

Do not use if TM is not intact
Do not use if varicella-zoster is suspected

Question 22

What medication can be used for mild to moderate otitis externa?

Answer 22

Acetic acid + propylene glycol + hydrocortisone (VoScol)

Question 23

What is the MOA of VoScol?

Answer 23

Dries and changes pH plus anti-inflammatory action of steroid

Question 24

When should VoScol not be used?

Answer 24

Do not use if TM is not intact
Do not use if varicella-zoster is suspected

Question 25

What medication can be used for moderate to severe acute otitis externa?

Answer 25

-Cipro otic drops -CIPRO-HC otic -Ciprodex

Question 26

Which medication can be used for otic pain?

Answer 26

Antipyrine/benzocaine otic drops (Auralgan)

Question 27

What medications can be used for Ceruminosis (excess ear wax)?

Answer 27

Cerumenolytic: -Cerumenex (triethanolamine polypeptide oleate) -Carbamide peroxide otic (Debrox)

Question 28

What medications can be used for acute otitis media?

Answer 28

PO antibiotics: Amoxicillin, Clavulanate, Ceftriaxone Topical antibiotics: Ciprodex-for perforated TM in children

Question 29

Which medications are neurotoxic to lice?

Answer 29

-Permethrin 1% (Nix) -Pyrethrins 0.3%/piperonyl butoxide 4% (Rid) -Malathion 0.5% lotion (Ovide) -Ivermectin (Stromectol) -Spinosad 0.9% (Natroba)

Question 30

How does Benzyl alcohol (Ulesfia) 5% lotion work on lice?

Answer 30

Suffocation of lice

Question 31

What adverse effects are associated with Nix?

Answer 31

Contact dermatitis, asthma exacerbation, mild and transient burning, stinging, and pruritis.

Question 32

Which lice medication can be used in pregnancy?

Answer 32

Nix (promethrin)

Question 33

When should the lice medication Rid be avoided?

Answer 33

Avoid in patients with chrysanthemum allergy.

Question 34

What adverse effects are associated with the lice medication Rid?

Answer 34

Contact dermatitis, asthma exacerbation, mild and transient burning, stinging, and pruritis.

Question 35

What patients should not be treated with Ulesfia (Benzol alcohol lotion)?

Answer 35

Do not use in infants younger than six months because it contains benzyl alcohol. Safe for use in children four years and older.

Question 36

What pregnancy category is Ivermectin?

Answer 36

Pregnancy cate C: no well-controlled studies

Question 37

What is Ivermectin FDA approved for?

Answer 37

-FDA approved for Onchocerciasis and strongyloidiasis -Lice and mites (OFF label)

Question 38

Why may Natroba not be accessible to everyone with lice?

Answer 38

It is expensive

Question 39

What is the MOA of Gammaxene (Lindane)?

Answer 39

CNS stimulant when absorbed systemically, resulting in convulsions and death.

Question 40

What are the contraindications of Lindane?

Answer 40

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

Question 41

What are the adverse effects of Lindane?

Answer 41

Dizziness, pruritis, seizure. Ophthalmic reactions are possible.

Question 42

When should Lindane be used?

Answer 42

only when patients who cannot tolerate or have failed first-line treatment with safer medications for the treatment of scabies.

Question 43

What is the indication for Permethrin 5% (Elimite)?

Answer 43

1st line for Scabies

Question 44

What is the MOA of Elimite (permethrin 5%)?

Answer 44

Nuerotoxicity to scabies bug

Question 45

What patient education should be reviewed for Elimite?

Answer 45

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.

Question 46

How is Ivermectin prescribed for Scabies?

Answer 46

200 mcg per kg, two doses 14 days apart

Question 47

What is the pregnancy category for Ivermectin?

Answer 47

Pregnancy cat C: no well-controlled studies

Question 48

What is the meaning of ovicidal?

Answer 48

capable of killing eggs

Question 49

Which lice medications are partially ovicidal?

Answer 49

Ivermectin

Question 50

Which lice medication is ovicidal?

Answer 50

Natroba