NBEO drug list/KMK/Gen Pharm Flashcards
Acetazolamide (Diamox)
Carbonic Anhydrase Inhibitor (Diuretic) –po, inhibits CA enzyme, alkalinization of urine (increased HCO3- in urine), diuretic effect only lasts a few to several days, tx for alkalosis
- decrease in H+ for exchange w/Na+ results in Na+ loss (stops Na+ reabsorption)
- sulfa sensitivity!
-SE: paresthesia!
Brinzolamide (Azopt)
topical Carbonic anhydrase inhibitor - glaucoma drop, decreases aqueous humor production and CSF
-orange cap
Dorzolamide (Trusopt)
topical Carbonic anhydrase inhibitor - glaucoma drop, decreases aqueous humor production and CSF
-orange cap
Methazolamide (Neptazane)
Carbonic anhydrase inhibitor - po, tx glaucoma, decreases aqueous humor production and CSF
Furosemide (Lasix)
Loop Diuretic - blocks the Na+/K+/2Cl- transporter in the thick ascending limb of the loop of Henle, induces kidney prostaglandins (vasodilation) can be used to tx HTN
- causes loss of Ca2+ and Mg2+, also Cl- and K+
- tx for heart failure (edema), and pulmonary edema, tx hypercalcemia
- can cause hypokalemic metabolic alkalosis, hyperuricemia, irreversible ototoxicity, NSAID interference
Hydrochlorothiazide (Esidrix)
Thiazide, most used diuretic, also a common DOC for HTN (C/I for DM pt!)
- inhibits Na+ reabsorption at distal tubule -causes decrease of Na+, CO, decrease in blood volume and so decrease in BP
- increase in ATP-dependent K+ channel opening, causes hyperpolarization (vasodilation in smooth muscle) and also decreases insulin
Chlorothiazide (Diuril)
Thiazide diuretic, also a common DOC for HTN (C/I for DM pt!)
- inhibits Na+ reabsorption at distal tubule -causes decrease of Na+, CO, decrease in blood volume and so decrease in BP
- increase in ATP-dependent K+ channel opening, causes hyperpolarization (vasodilation in smooth muscle) and also decreases insulin
C/I for thiazides
causes dry eye, hyperglycemia (C/I for DM pts), hyperlipidemia, lithium toxicity, digitalis toxicity, hepatic coma in cirrhotic pts, hypokalemic metabolic alkalosis, hyperuricemia! (tell pts to stop thiazide before having a surgical procedure)
Diuretic drug that can be used for patients with a sulfa allergy
Ethacrynic acid (Edecrin)
Triamterene (Dyrenium)
Potassium-sparing Diuretic
-reduces the K+ loss caused by the other diuretics, used in combination as they are weak on their own
-inhibit Na+/K+ exchange independently of aldosterone
C/I for burn patients (already hyperkalemic!)
Spironolactone (Aldactone)
Potassium-sparing Diuretic - competitive inhibitor of aldosterone (anti-androgen)
- tx edema w/HF, hyperaldosteronism, hirsutism, PMS
- SE: occasional hyperkalemia w/ACEI and ARBs
- C/I: liver damage, renal insufficiency
Mannitol (Osmitrol)
Osmotic Diuretic
IV only, keeps water in tubules, large amount of water diuresis, keeps water flowing and protects kidney, can be used as prophylaxis of acute renal failure
-decreases IOP and ICP quickly
-SE: cellular dehydration, edema
-C/I: DON’T USE WITH HF pts!
What is the order of effectiveness for diuretic drugs?
Loops >> thiazides >>> K+ sparing drugs
Hydralazine
Antihypertensive - acts through nitric oxide to cause vasodilation - used during pregnancy for long-term tx of severe HTN in combo with other BP-lowering meds and as a last resort
-SE: Lupus!
Minoxidil (Loniten)
Antihypertensive - acts through opening potassium channels (hyperpolarizes membrane) to cause vasodilation
SE: Hypertrichosis
Nifedipine (Procardia)
Calcium Channel Blocker - Dihydropiridine type
-strong vasodilator, more vascular effects, increases HR
Amlodipine (Norvasc)
Calcium Channel Blocker - Dihydropiridine type
Felodipine (Plendil)
Calcium Channel Blocker - Dihydropiridine type
Verapamil (Calan)
Calcium Channel Blocker - strong cardiac effect, decreases HR
Diltiazem (Cardizem)
Calcium Channel Blocker - effects in between Verapamil and Dihydropiridines
Captopril (Capoten)
Angiotensin-Converting Enzyme Inhibitor - works on the renin-angiotensin system
-good choice of anti-HTN med for DM pts
Enalapril (Vasotec)
Angiotensin-Converting Enzyme Inhibitor - works on the renin-angiotensin system
-good choice of anti-HTN med for DM pts
Quinapril (Accupril)
Angiotensin-Converting Enzyme Inhibitor - works on the renin-angiotensin system
-good choice of anti-HTN med for DM pts
Lisinopril (Zestril)
Angiotensin-Converting Enzyme Inhibitor - works on the renin-angiotensin system
-good choice of anti-HTN med for DM pts
Benazepril (Lotensin)
Angiotensin-Converting Enzyme Inhibitor - works on the renin-angiotensin system
-good choice of anti-HTN med for DM pts
Losartan (Cozaar)
Angiotensin receptor blocker - anti HTN
blocks AT1 receptor but not AT2 (difference from ACEIs)
Valsartan (Diovan)
Angiotensin receptor blocker - anti HTN
blocks AT1 receptor but not AT2 (difference from ACEIs)
Clonidine (Catapres)
Alpha 2 agonist, sympatholytic, anti-HTN
Methyldopa (Aldomet)
Alpha 2 agonist, sympatholytic, anti-HTN
-used in pregnancy
Prazosin (Minipress)
Alpha 1 adrenergic blocker, anti-HTN
also good for tx BPH
Doxazosin (Cardura)
Alpha 1 adrenergic blocker, anti-HTN
Terazosin (Hytrin)
Alpha 1 adrenergic blocker, anti-HTN
Propranolol (Inderal)
nonspecific Beta-blocker, anti-HTN
- reduces sympathetic vasomotor tone but doesn’t cause vasodilation unless with NO
- SE: bronchoconstriction, decreased insulin release, increase of lipids and atherogenesis, masks hypoglycemia
- C/I: asthmatics, DM, hypercholesterolemia, heart block end stage HF
Carvedilol (Coreg)
Combined alpha and beta blocker to tx HTN
Labetalol (Trandate)
Combined alpha and beta blocker to tx HTN, used in pregnancy, HTN emergencies
-SE: hepatotoxicity
Metoprolol (Lopressor)
Cardio specific or B1 blocker for treating HTN
Nebivolol (Bystolic)
Cardio specific or B1 blocker for treating HTN, has NO (vasodilation)
Atenolol (Tenormin)
Cardio specific or B1 blocker for treating HTN
Nitroglycerin
DOC for tx acute anginal attack
Isosorbide dinitrate (Isordil)
tx angina, decreases oxygen demand
SE: headaches, tolerance
Sildenafil (Viagra)
phosphodiesterase type 5 (PDE5) inhibitor
tx - ED, pulmonary HTN
C/I: Nitrates
CYP3A4 interactions
Vardenafil (Levitra)
phosphodiesterase type 5 (PDE5) inhibitor - faster onset than sildenafil
Tadalafil (Cialis)
phosphodiesterase type 5 (PDE5) inhibitor - longer duration
Lovastatin (Mevacor)
HMG-CoA reductase inhibitor - treats hyperlipidemia
Atorvastatin (Lipitor)
HMG-CoA reductase inhibitor - treats hyperlipidemia
Rosuvastatin (Crestor)
HMG-CoA reductase inhibitor - treats hyperlipidemia
Pravastatin (Pravachol)
HMG-CoA reductase inhibitor - treats hyperlipidemia
Simvastatin (Zocor)
HMG-CoA reductase inhibitor - treats hyperlipidemia
Fluvastatin (Lescol)
HMG-CoA reductase inhibitor - treats hyperlipidemia
Cholestyramine (Questran)
bile acid binding resins, very safe but can inhibit other drug absorption
Niacin (Nicotinic acid, Vitamin B3)
impairs synthesis of lipoproteins, effective at increasing HDL and treating hypercholesterolemia
Gemfibrozil (Lopid)
fibric acid derivative - increases catabolism of VLDL, effective at treating hypertriglyceridemia
Fenofibrate (Tricor)
fibric acid derivative - increases catabolism of VLDL, effective at treating hypertriglyceridemia
Warfarin (Coumadin)
clotting factor synthesis inhibitor - anticoagulant, prevention of emboli development
-INR(2-3)
Apixaban (Eliquis)
direct inhibitor of factor Xa, anticoagulant
Aminocaproic acid (Amicar)
inhibits tPA, treatment for bleeding disorders (pro-clotting) can be used for hemophilia
Aspirin
inhibitors of prostaglandin production, antiplatelet agent
-secondary prevention of CV events
Clopidogrel (Plavix)
inhibitor of ADP-induced platelet aggregation, irreversible, used for pts with aspiring allergy
- interacts w/omeprazole
- DOC after coronary stent sx
Ticlopidine (Ticlid)
inhibitor of ADP-induced platelet aggregation, irreversible, used for pts with aspiring allergy
- interacts w/omeprazole
- DOC after coronary stent sx
Dipyridamole
coronary vasodilator, combine with aspirin
Betaxolol (Betoptic)
beta 1 selective blocker, can be used topically in eye to tx glaucoma
Carteolol (Cartol)
partial agonist, beta-blocker, can be used in eye
said to have intrinsic sympathetic activity
Tamsulosin (Flomax)
Alpha 1 adrenergic blocker, little effect on BP but used to tx BPH
Phenoxybenzamine (Dibenzyline)
alpha-receptor blocker, irreversible, very long acting
Leuprolide (Lupron)
GnRH agonist, suppresses LH/FSH release (long term), DOC for endometriosis, IVF, precocious puberty, etc.
Goserelin (Zoladex)
GnRH Agonist
Estradiol (Estraderm)
estrogen given in cream/patches
Ethinyl estradiol
estrogen used in oral contraceptives (not available individually)
Premarin
conjugated estrogens, used for HRT
Tamoxifen (Novaldex)
Antiestrogen - SERM (selective estrogen receptor modulator) tx. pre-menopausal breast cancer, AE: can cause crystalline retinopathy
Raloxifene (Evista)
Antiestrogen, SERM, tx: osteoporosis
Medroxyprogesterone (Provera)
progestin
Drospirenone/ethinyl estradiol (Yasmin, Yaz)
combination oral contraceptive, the only one approved to treat PMDD
Flutamide (Eulexin)
Anti-androgen (androgen receptor antagonist) tx: prostate cancer w/GnRH agonist
Finasteride (Propecia)
5a-reductase inhibitor (stops conversion to DHT) tx: BPH and male pattern baldness
Insulin lispro (Humalog)
Rapid-acting insulin - IV
Insulin, inhaled (Afrezza)
Rapid-acting insulin
Regular insulin (Novolin R, Humulin R)
Short-acting insulin, IV
NPH Insulin (Humulin N, Novolin N, isophane)
Intermediate-acting insulins
Insulin glargine (Lantus)
Long-acting insulins
Insulin detemir (Levemir)
Long-acting insulins
Metformin
a biguanide, oral, DOC, only used in type 2 DM, decreases glucose levels (euglycemia), does not increase weight, decreases risk of CV events
C/I: renal failure
AE: lactic acidosis, diarrhea
Exenatide (Byetta)
glucagon-like peptide-1 receptor agonist (GLP-1 RA), incretin mechanism, stimulates pancreas beta cells, causes weight loss
AE/caution w/pancreatitis
injected
Sitagliptin (Januvia)
dipeptidyl-peptidase-IV (DPP-4) inhibitor, inhibits DPP-4 so glucose gets to beta cells better, no effect on weight
Canagliflozin (Invokana)
SGLT-2 inhibitor, oral, weight loss, decrease risk of CV events
AE: UTIs
C/I: renal impairment
Pioglitazone (Actos)
thiazolidinedione derivative, increases insulin sensitivity
AE: edema, increased heart failure risk, macular edema
- Acarbose (Precose)*
- Miglitol (Glyset)*
alpha-glucosidase inhibitors, delays carb absorption, causes gas and GI issues, no effect on weight
Glyburide, Glipizide, Glimepiride, Tolbutamide, Chlorpropamide
Sulfonylureas, stimulate insulin release from pancreas beta cells. AE: weight gain, hypoglycemia
C/I: sulfa allergy
Repaglinide
meglitinides - bind K+ channels, increases insulin release
Pramlintide (Symlin)
amylin-like peptide (synthetic analogue), only used as an insulin adjunct, can be used in Type 1 DM, injected, causes weight loss
Glucagon injection
hyperglycemic agent to treat hypoglycemia in patients with sufficient glycogen stores, increases glucose levels. produced by alpha cells (pancreas)
Acetaminophen
analgesic and antipyretic, but does NOT have anti-inflammatory properties
AE: hepatotoxicity
Cyclobenzaprine (Flexeril)
tx muscle spasms, MOA - decreases somatic motor activity by inhibiting tonic activity of alpha and gamma motor neurons
AE - anticholinergic effects, caution for pts w narrow angle glaucoma
Tramadol (Ultram)
analgesic, acts as an agonist at Mu opiate receptors (but not a true opiate), and inhibits serotonin and NE uptake in pain pathways
AE: dry mouth, sedation, dizziness, nausea, less miosis than true opiates
Bacitracin
topical antibiotic, CWI, prevents the transfer of peptidoglycan into the bacterial cell wall, acts on gram +, tx blepharitis
often used in Neosporin or Polysporin with polymyxin B (for gram -)
amoxicillin (Principen, Amoxil), ampicillin
oral extended-spectrum penicillin antibiotics, gram + and - , but not resistant to beta-lactamase (penicillinase), often paired with clavulanic acid to inhibit beta-lactamase activity (=Augmentin)
AE - ampicillin rash!
dicloxacillin (Dynapen)
oral penicillinase-resistant penicillin antibiotic, gram + with some gram - coverage but not as much as extended-spectrum, tx - hordeloa, preseptal cellulitis, etc.
DOC - MSSA
oxacillin, nafcillin, cloxacillin, methicillin
oral penicillinase-resistant penicillin antibiotics, gram + with some gram - coverage but not as much as extended-spectrum
DOC - MSSA
MSSA
methicillin-sensitive Staphylococcus aureus
MRSA
methicillin-resistant Staphylococcus aureus
piperacillin, ticarcillin
antipseudomonal penicillins
penicillin G, penicillin V
penicillin antibiotics, CWI, highest activity of the penicillins against gram + bacteria, but is susceptible to beta-lactamase/penicillinase
cephalexin (Keflex)
oral 1st gen cephalosporin, high G+ activity, some G-, inhibits transpeptidase, tx - skin infections, dacryoadenitis/cystitis, preseptal cellulitis
ceftriaxone (Rocephin)
IV/IM, 3rd gen cephalosporin, both gram + and - , inhibits transpeptidase, penetrates CNS, tx - gonorrhea, orbital cellulitis
C/I - neonates (bilirubin displacement), warfarin (excessive blood thinning)
cefazolin (Ancef)
IV/IM 1st gen cephalosporin, high G+ activity, some G-, inhibits transpeptidase, DOC for sx prophylaxis
cefaclor (Ceclor)
oral 2nd gen cephalosporin, G+ activity, some G-, inhibits transpeptidase
cefuroxime (Zinacef)
IV/IM, 2nd gen cephalosporin, G+ activity, some G-, inhibits transpeptidase
cefepime (Maxipime)
IV, 4th gen cephalosporin, antipseudomonal activity, broadest coverage, gram + and - , inhibits transpeptidase
side effects for cephalosporins
GI - anorexia, nausea, diarrhea
superinfections, disulfiram-like reaction after alcohol consumption, allergy cross-reactivity, synergistic nephrotoxicity with aminoglycosides
ceftazidime (Fortaz)
IV/IM, 3rd gen cephalosporin, both gram + and - , inhibits transpeptidase
vancomycin
IM or po, exclusively gram +, prevents transpeptidation of peptidoglycan chains (not PBPs), DOC - MRSA, and C. diff superinfections
AE - Red man syndrome, oto- and nephrotoxicity
gentamycin (Garamycin)
aminoglycoside, binds to 30S subunit, inhibits protein synthesis, effective against gram + and -, mostly aerobic G- , including Pseudomonas , bactericidal
tobramycin (Tobrex)
aminoglycoside, binds to 30S subunit, inhibits protein synthesis, effective against gram + and -, mostly aerobic G- , including Pseudomonas , bactericidal
streptomycin, amikacin, neomycin
aminoglycoside, binds to 30S subunit, inhibits protein synthesis, effective against gram + and -, mostly aerobic G- , bactericidal
TobraDex
tobramycin 0.3% and dexamethasone 0.1%
tx - inflammatory ocular conditions w assoc bacterial infection such as marginal keratitis, corneal infiltrates
side effects for aminoglycosides
oto- and nephrotoxicity, weakness, GI, allergy
caution with loop diuretics, cephalosporins, vancomycin, cidofovir, for doubling risk
ocular - SPK, delayed corneal re-epithelialization
tetracycline
tetracycline antibiotic, inhibit protein synthesis, bacteriostatic, bind 30S subunit, broad spectrum
doxycycline
tetracycline antibiotic, inhibit protein synthesis, bacteriostatic, bind 30S subunit, broad spectrum
minocycline
tetracycline antibiotic, inhibit protein synthesis, bacteriostatic, bind 30S subunit, broad spectrum
side effects of tetracyclines
C/I in pregnancy and children <8yo!
AE - pseudotumor cerebri, inhibited bone growth, discolouring of teeth, minocycline may cause blue sclera or pigmented cysts on the conjunctiva
chloramphenicol (Chloromycetin, Chloroptic)
bacteriostatic, inhibits protein synthesis, binds 50S subunit, broad spectrum G+/-, aerobic and anaerobic, reaches CNS, restricted to life-threatening conditions due to “grey baby” syndrome and fatal aplastic anemia
erythromycin
macrolide antibiotic, bacteriostatic, inhibits protein synthesis by binding to the 50S subunit, mostly gram + coverage
AE - drug interactions (CYP3A4), diarrhea/GI, QT prolongation (more azithro), ototoxicity
azithromycin
macrolide antibiotic, bacteriostatic, inhibits protein synthesis by binding to the 50S subunit, mostly gram + coverage
AE - diarrhea/GI, QT prolongation, ototoxicity
clarithromycin
macrolide antibiotic, bacteriostatic, inhibits protein synthesis by binding to the 50S subunit, mostly gram + coverage
AE - drug interactions (CYP3A4), diarrhea/GI, QT prolongation (mostly azithro), ototoxicity
clindamycin (Cleocin)
anaerobic G+/- and aerobic G+, inhibits protein synthesis, binds 50S subunit, tx - osteomyelitis, MRSA
toxicity - C. diff! immediately stop and switch to vancomycin
linezolid (Zyvox)
bacteriostatic antibiotic, aerobic G+, reversible nonselective inhibitor of MAO similar AE to MAOIs, drug interactions with antidepressants and risk for serotonin syndrome
Bactrim
sulfamethoxazole and trimethoprim
sulfisoxazole
bacteriostatic sulfonamide antibiotic, inhibits dihydropteroate synthase which converts PABA to dihydrofolic acid (1st step in folic acid synthesis), gram + and - , used to treat blepharitis or conjunctivitis but not as much anymore
sulfacetamide
bacteriostatic sulfonamide antibiotic, inhibits dihydropteroate synthase which converts PABA to dihydrofolic acid (1st step in folic acid synthesis), gram + and - , used to treat blepharitis or conjunctivitis but not as much anymore
(Blephamide)
sulfamethoxazole
bacteriostatic sulfonamide antibiotic, inhibits dihydropteroate synthase which converts PABA to dihydrofolic acid (1st step in folic acid synthesis), gram + and - , with trimethoprim in Bactrim
sulfadiazine
bacteriostatic sulfonamide antibiotic, inhibits dihydropteroate synthase which converts PABA to dihydrofolic acid (1st step in folic acid synthesis), gram + and - , rx with pyrimethamine to tx toxoplasmosis
side effects of sulfonamides
kernicterus in infants due to bilirubin accumulation (C/I during pregnancy), myopic shift, Stevens-Johnson syndrome
trimethoprim
antibiotic, inhibits dihydrofolate reductase (2nd step in folic acid synthesis), gram + and - but not against Pseudomonas, makes up Polytrim with polymyxin B, and Bactrim with sulfamethoxazole
pyrimethamine
antibiotic, inhibits dihydrofolate reductase (2nd step in folic acid synthesis), gram + and - but not against Pseudomonas, given orally for toxoplasmosis
most potent ophthalmic antibiotics against MRSA
trimethoprim, tobramycin, then besifloxacin and vancomycin
ciprofloxacin (Ciloxan, Cipro)
2nd gen fluoroquinolone, aerobic G+/- , inhibits DNA gyrase and topoisomerase IV, tx CL-related corneal ulcers, abrasions, bacterial conjunctivitis, etc. also gram - urinary infections
AE - tendinitis, C/I in pregnancy and children <18yo, inhibition of bone growth
ofloxacin (Ocuflox)
2nd gen fluoroquinolone, aerobic G+/- , inhibits DNA gyrase and topoisomerase IV, tx CL-related corneal ulcers, abrasions, bacterial conjunctivitis, etc.
AE - tendinitis, C/I in pregnancy and children <18yo, inhibition of bone growth
levofloxacin (Quixin)
3rd gen fluoroquinolone, aerobic G+/- , inhibits DNA gyrase and topoisomerase IV, tx CL-related corneal ulcers, abrasions, bacterial conjunctivitis, etc.
AE - tendinitis, C/I in pregnancy and children <18yo, inhibition of bone growth
gatifloxacin (Zymar)
4th gen fluoroquinolone, anaerobic G+/- , inhibits DNA gyrase and topoisomerase IV, tx CL-related corneal ulcers, abrasions, bacterial conjunctivitis, etc.
AE - tendinitis, C/I in pregnancy and children <18yo, inhibition of bone growth
moxifloxacin (Vigamox, Avelox)
4th gen fluoroquinolone, anaerobic G+/- , inhibits DNA gyrase and topoisomerase IV, tx CL-related corneal ulcers, abrasions, bacterial conjunctivitis, etc.
AE - tendinitis, C/I in pregnancy and children <18yo, inhibition of bone growth
besifloxacin (Besivance)
4th gen fluoroquinolone, anaerobic G+/- , inhibits DNA gyrase and topoisomerase IV, tx CL-related corneal ulcers, abrasions, bacterial conjunctivitis, etc.
AE - tendinitis, C/I in pregnancy and children <18yo, inhibition of bone growth
TB medications
rifampin, isoniazid, pyrazinamide, ethambutol
rifampin (Rifadin)
tx TB, inhibits mRNA synthesis by binding DNA-dependent RNA polymerase (rpoB subunit)
AE - hepatotoxicity, orange-pink secretions, drug interactions
isoniazid (Nydrazid)
tx TB, CWI, inhibits mycolic acid synthesis
AE - hepatotoxicity, vitamin b6 deficiency - peripheral neuropathy, optic neuritis/atrophy
Ethambutol (Myambutol)
tx TB, CWI inhibits arabinosyl transferase
AE - optic neuritis (pts on med should have periodic assessments of VA and R/G colour discrimination)
oseltamivir (Tamiflu)
antiviral, tx influenza, inhibits viral neuraminidase and prevents spread of virus, needs to be given within 72 hours before viral load is too high
zidovudine (Retrovir, AZT)
HIV therapy, is a nucleoside analogue of thymidine that acts as a potent inhibitor of viral RNA-dependent DNA polymerase (reverse transcriptase)
AE - bone marrow suppression, lactic acidosis, muscle breakdown
ribavirin (Copegus, Rebetol, Virazole)
Hep C therapy (with interferon), inhibits viral RNA polymerase
AE - conjunctivitis common, can have retinopathy, teratogenic
RIBAViriN = RD, Ischemia (cws), Bleeding (hemes), Arterial and Venous occlusions, and optic Neuritis
trifluridine (Viroptic)
topical antiviral, inhibits DNA polymerase, tx HSV-1 keratitis
acyclovir (Zovirax)
systemic DNA polymerase inhibitors, tx HSV, VSV
AE - decrease dose in pts with kidney disease
valacyclovir (Valtrex)
systemic DNA polymerase inhibitors, tx HSV, VSV
AE - decrease dose in pts with kidney disease
famciclovir (Famvir)
systemic DNA polymerase inhibitors, tx HSV, VSV
AE - decrease dose in pts with kidney disease
Ganciclovir (Zirgan)
ophthalmic gel, inhibits DNA polymerase, reduced corneal toxicity compared to trifluridine, tx HSV keratitis, also as an intraocular sustained-release tx in CMV retinitis
foscarnet (Foscavir)
IV antiviral, DNA polymerase inhibitor, tx CMV retinitis
amphotericin B
broad-spectrum antifungal, binds to ergosterol (fungus version of cholesterol), and forms pores causing cellular components to leak out and cause cell death, tx fungal keratitis
AE - nephrotoxicity in IV tx
natamycin
antifungal, binds to ergosterol (fungus version of cholesterol), and forms pores causing cellular components to leak out and cause cell death, tx fungal blepharitis, conjunctivitis, keratitis
nystatin
antifungal, binds to ergosterol (fungus version of cholesterol), and forms pores causing cellular components to leak out and cause cell death, not in ophthalmic use but for oral thursh and yeast infections
norfloxacin
1st gen fluoroquinolone, aerobic G+/- , inhibits DNA gyrase and topoisomerase IV, tx UTIs
AE - tendinitis, C/I in pregnancy and children <18yo, inhibition of bone growth
metronidazole
bactericidal antibiotic, G+/- , metronidazole metabolites are taken up into bacterial DNA and form unstable molecules, needs ferredoxin to work (only in anaerobes)
2nd choice for tx C. diff after vancomycin
ketoconazole
antifungal, inhibits ergosterol synthesis, tx severe fungal corneal ulcers, systemic fungal infections, acanthamoeba
fluconazole
antifungal, inhibits ergosterol synthesis, tx severe fungal corneal ulcers, systemic fungal infections, acanthamoeba
increasing resistance :(
miconazole
antifungal, inhibits ergosterol synthesis
griseofulvin (Grifulvin)
oral agent that inhibits fungal mitosis by interfering with microtubule formation during cell wall synthesis, tx - fungal skin or scalp infections
chloroquine (Aralen)
MOA - causes a build-up of heme that is toxic to Plasmodium parasite that causes malaria. also inhibits phospholipase A to decrease inflammation
AE - bull’s eye maculopathy (first sign is RPE mottling at macula), whorl keratopathy
risk of bullseye maculopathy increases with:
- a dosage >3mg/kg of ideal body weight or 2.3 mg/kg of real body weight
- tx duration >5yrs, abnormal renal function, high body fat %, age >60yo, liver disease, concomitant retinal disease
lindane (Kwell)
tx lice and scabies, lipophilic structure that gets absorbed through exoskeleton of insects and causes death, causes conjunctivitis if used on lashes
hydroxychloroquine
like chloroquine, inhibits phospholipase A2 and causes a build-up of heme, tx rheumatoid arthritis, lupus, malaria
AE - whorl keratopathy, bullseye maculopathy
hydrocortisone
anti-inflammatory, tx adrenal insufficiency
triamcinolone (Kenalog)
steroid injection, can be used for mac edemas, Graves’, posterior uveitis, chalazia, etc.
AE - elevated IOP, depigmentation if injecting eyelid
fluticasone
intranasal corticosteroid, tx allergic rhinitis
aspirin
NSAID, salicylate that inhibits Cox1 and Cox2 and so prostaglandins and thromboxanes, used as a fever and pain reliever, also reduces risk of recurrent heart attacks in pts with known heart disease
AE - GI effects, bleeding, Reye’s syndrome in peds
indomethacin
NSAID, reversible Cox1 and Cox2 inhibitor,
acetylcysteine (Mucomyst)
mucolytic agent that breaks disulfide bonds in proteins of mucus in order to reduce its viscosity. can be rx’d topically for filamentary keratitis, dry eye, or corneal burns
pilocarpine
direct cholinergic agonist, opens corneal scleral pathway increasing aqueous outflow.
SE: RD, AAC, ASC, miosis, headache/brow ache
direct cholinergic agonists
pilocarpine, acetylcholine, bethanechol, carbachol
“PABC”
indirect cholinergic agonists
donepezil, echothiophate, edrophonium, pyridostigmine, isofluorophate, neostigmine
“DEEP IN”
phenylephrine
a1 agonist, dilates and vasoconstriction (C/I in heart arrhythmia/HTN, Graves, people on MAOI or TCAs), blanches episcleritis, dx Horners, 10% breaks synechiae
NE does not act on
beta 2
brimonidine
a2 agonist (which is inhibitory) so decrease in aqueous production, and increase in uveoscleral outflow, neuroprotective
apraclonidine
a2 agonist mostly but some a1 (weak but can be used to dx Horners), effect does not last long enough to be used chronically for glaucoma
polysporin
bacitracin + polymixin b
antibiotic ointment
polytrim
polymixin b + trimethoprim
neosporin
neomycin + polysporin
