Ocular Anti-inflammatories

Question 1

Name the six Ocular NSAID anti-inflammatory drugs?

Answer 1

Diclofenac sodium(Voltaren) Ketorolac tromethamine (Acular) Flurbiprofen sodium (Ocufen) Bromfenac (Bromday) Bromfenac sodium (Prolensa, Xibrom) Nepafenac (Nevanac, ILevro)

Question 2

What are the indications for Ocular NSAIDs?

Answer 2

Pain and inflammation relief (pre and post ocular surgery) Pain relief in corneal abrasion ( Ketorolac and Diclofenac) Blepharitis Allergic conjunctivitis (decreases itching and conjunctival injection (occassionally))

Question 3

What are the contraindications for Ocular NSAIDs?

Answer 3

Low systemic absorption

No dual diagnosis pts. with an eye infection

Bromfenac is contraindicated w/ sulfite allergy

Question 4

What are the cautions for Ocular NSAIDs?

Answer 4

Delayed healing Keratitis Corneal melt : Corneal stromal ulceration ,Ulcer progressively takes over the cornea, Occurs with epithelial defect, Linked to cataract surgery, RK Rare: Seen with generic diclofenac

Question 5

What are the ADRs for Ocular NSAIDs?

Answer 5

• Stinging and burning
• Keratitis (Many cases present prior to NSAID treatment)
• Lacrimation
• Post-op foreign body sensation
• Increased IOP ( worry about with glaucoma pts)
• Corneal edema
• Ocular inflammation/irritation
• Superficial infections
• Headache, blurred vision, corneal ulcer/infiltrates