Ocular Adverse Drug Reactions Flashcards
What is an ocular adverse drug reaction?
ADRs is the negative reaction of a drug that is meant to be used for therapy. These effects could be: conjunctivitis, keratitis, palpebral and periocular eczema.
What is the pharmacodynamics of ADRs?
A graph with two curves. These two curves can be used to help determine the right therapeutic dose. Usually a drug has two dose response curves efficacy (desired clinical effect) &
‘toxicity’ (unwanted / adverse effects). Too little/too much can have no effect (efficacy not strong enough) or unwanted effects (toxicity too strong).
What are ‘on target’ ADRs?
On-target refers to exaggerated and adverse pharmacologic effects at the target of interest in the test system.
What are ‘off target’ ADRs?
Off-target refers to adverse effects
as a result of modulation of other targets; these may be related
biologically or totally unrelated to the target of interest.
What are idiosyncratic responses?
Reactions that are not allergic in nature.
What are harmful immune responses?
hypersensitivity (I and IV).
What are metabolite-related responses?
responses that are related to the metabolite, not the drug.
Type of on target ADRs and its causes?
DIGOXIN - used for mx of arrythmia, heart failure. Causes reduced IOP, CVD, retrobulbar/optic neuritis.
Type of off target ADRs and its causes?
PHENOTHIAZINES - used for mx of schizophrenia and psychoses. Causes pupil miosis/mydriasis, retinal corneal and lenticular deposits.
Type of immune ARDs and causes?
ATROPINE - used for amblyopia mx and pre-med uveitis. Causes type I and IV hypersensitivity.
PHENYTOIN - used for epilepsy. Causes Stevens-Johnson syndrome.
What is Stevens-Johnsons syndrome?
a skin disorder that starts with flu-like symptoms, followed by painful rash and blisters
Type of idiosyncratic response and its causes?
CORTICOSTERIOD - use for mx of inflammation. Causes raised IOP and cataract.
Type of metabolic-related DRs and its causes?
SULFONAMIDES - antibiotics. Causes uveitis and transient myopia.
AMIODARONE - used for arrythmia. Causes corneal deposits (verticillate).
Tips for optoms and ADRs?
- elderly are more prone to ADRs
-chloramphenicol and pregnancy is dangerous AVOID - identify if there is a problem and assess its extent/severity, determine appropriate management (communicate with prescriber, referral urgency)
Drugs of particular importance for ADRs?
hydroxychloroquine
phenothiazine
amiodarone
digoxin
corticosteroids
ethambutol
tamoxifen
