Ocular ADRs

Question 1

Amiodarone (Cordarone)

Answer 1

Anti-arrhythmic - vortex keratopathy

Question 2

digoxin, digitoxin

Answer 2

Anti-arrhythmic, CHF - color changes = toxicity

Question 3

tamsulosin (Flomax)

Answer 3

benign prostatic hypertrophy, HTN - floppy iris syndrome. Watch out in cataract surgery

Question 4

sildenafil (Viagra)

Answer 4

Colour perception (transient), NAION.

Question 5

hydroxychloroquine (Plaquenil)

Answer 5

Whorl opacity in cornea, bullous maculopathy (do 10-2)

Question 6

quinine

Answer 6

Leg cramps, malaria, suicide - VA decrease, flickering vision, sudden complete loss of vision and fixed pupils, VF loss, night vision problems

Question 7

Gold salts

Answer 7

RA - stromal deposits

Question 8

indomethacin (Indocin)

Answer 8

NSAID - RPE changes perifoveally, CV loss, VA and VF defects

Question 9

clomiphene (Clomid)

Answer 9

Infertility - ocular migraine Sxs

Question 10

COX2 inhib - ‘coxibs’…Vioxx, Celebrex, Bextra, Prexige

Answer 10

Blurred vision, conjunctivitis

Question 11

Retinoids (isotretinoin/Accutane, Vit A, vesanoid, Soriatane, Tegison)

Answer 11

Dry eye, corneal opacities, ICH, CV loss temporary

Question 12

topiramate (Topomax)

Answer 12

Epilepsy, migraines, weight loss - bilateral acute angle closure glaucoma secondary to AC shallowing secondary to suprachoroidal effusion and acute myopia.Treatment = hyperosmotics, cycloplegics, IOP lowering agents

Question 13

vigabatrin (Sabril)

Answer 13

Anticonvulsant - VF constriction (irreversible) bilateral w/temporal and macular sparing. CV loss. Do baseline VF and CV…FU q6mnths.

Question 14

pamidronate disodium (Aredia) and other bisphosphates (the ‘dronates’)

Answer 14

Decreased calcium absorption in malignancy, Paget Dx, bone metastasis) - blurred vision, pain, photophobis, uveitis, lid edema, RETROBULBAR NEURITIS, diplopia, visual hallucinations

Question 15

cetirizine (Zrtec/Reactin)

Answer 15

oculogyric crisis/rolling back eyes. Stop taking it.

Question 16

tamoxifen (Nolvadex)

Answer 16

Chemo for primary metastatic breast cancer. Crystalline retinopathy, PSC, whorl keratopathy. May want to do amsler and CV

Question 17

carmustine (BiCNU)

Answer 17

IV chemo agent. Vision loss, retinal complications include infarction, phlebitis, BRAO, NFL hem, mac edema)

Question 18

ethambutol (Myambutol)

Answer 18

Anti-TB - optic neuropathy (usually retrobulbar, bilateral w/ dec VA, CV, or central scotoma or bilateral temp defect)

Question 19

rifabutin

Answer 19

TB treatment - UVEITIS, optic neuropathy, endothelial deposits, pink tears

Question 20

methotrexate

Answer 20

RA or inflammation - optic neuritis

Question 21

isoniazid

Answer 21

anti-TB - optic neuritis

Question 22

tetracyclines (doxy, mino)

Answer 22

blue discoloration of sclera with minocycline, conjunctival deposits with tetracycline. ICH!!!! Tell them to come in if they experience blurred vision, HAs, diplopia

Question 23

chloramphenicol

Answer 23

Antibacterial - optic neuritis

Question 24

atvaquone (Mepron)

Answer 24

Antiparasitic - whorl keratopathy

Question 25

sulfonamides

Answer 25

antibacterial - allergic rxn, SJ synd and possible uveitis. Japanese and Korean ppl more likely to get SJ synd. Oc surface Dx...

Question 26

CAIs - acetazolamide (Diamox), dichlorphenamde (Daranide), methazolamide (Neptazane, Glauctabs)

Answer 26

Anticonvulsant, ICH - SJ synd, myopia, aplastic anemia.

Question 27

cidofovir (Vistide)

Answer 27

Treatment of cytomegalovirus in AIDS Pxs - uveitis (immune recovery), macular edema, macular gliosis.

Question 28

Oral contraceptives, Hormone replacement therapy

Answer 28

Dryness.

Question 29

chlorpromazine (Thorazine)

Answer 29

antipsychotic - corneal pigment, anterior SC. Advise UV protection

Question 30

thiordazine (Mellaril)

Answer 30

anti-psychotic - pigmentary retinopathy than can lead to dec VA, CV, dark adaptation

Question 31

All phenothiazines

Answer 31

Antipsychotic - trouble focusing, mydriatic. Check angles.

Question 32

lithium

Answer 32

Jerk nystagmus, blurred vision

Question 33

talc

Answer 33

Emboli. May also have macular edema, blood problems. Glaucoma risk

Question 34

Weed

Answer 34

25% IOP lowering for 3-4 hrs

Question 35

canthaxanine

Answer 35

(Herbal) Crystalline retinopathy

Question 36

chamomile

Answer 36

allergic conjunctivitis

Question 37

Datura

Answer 37

(Herbal) Mydriasis

Question 38

Echinacea

Answer 38

conjunctivitis

Question 39

ginko

Answer 39

Hyphema, retinal hem

Question 40

licorice

Answer 40

migraine Sxs

Question 41

niacin

Answer 41

Cystoid macular edema, dry eye

Question 42

Vit A

Answer 42

ICH