Ocular Lubricants

Question 1

Give the generic names for an anti-inflammatory drugs used to treat keratoconjunctivitis sicca.

Answer 1

Cyclosporine

Lifitegrast (Xiidra)

Question 2

What is the MOA of cyclosporine?

Answer 2

Increase tear production in patients whose tear production suppressed by ocular inflammation associated with keratoconjunctivitis sicca

Question 3

What contraindications are associated with cyclosporine?

Answer 3

Patients with known or suspected hypersensitivity

Question 4

What warnings/ precautions should be given when prescribing Cyclosporine or Lifitegrast?

Answer 4

Don’t touch tip of the applicator to eye
Take out contacts prior to administering drops
(can insert 15 min after administration)

Question 5

What are the adverse effects associated with cyclosporine?

Answer 5

Ocular burning
Conjunctival hyperemia (red eye)
Discharge
Epiphora (watery eyes)
Eye pain
Foreign body sensation
Pruritus
Stinging
Visual distrubance (most common, most severe
Post-marketing: hypersensitivity, superficial eye injury

Question 6

What are the Pregnancy category and the toxicity concerns for cyclosporine?

Answer 6

Pregnancy category C
Caution with nursing mothers
Do not use in pts< 16yrs

Question 7

What is the mechanism of action (MOA) for Lifitegrast.

Answer 7

Lifitegrast is a Lymphocyte function associated antigen-1 antagonist (LFA-1). Lifitegrast bind to LFA-1 receptor and inhibits the binding of ICAM-1, which may help prevent the inflammatory cascasde

Question 8

What are the adverse reactions (ADRs) associated with Lifitegrast?

Answer 8

Most common
Site irritation
Dysgeusia (bad taste in your mouth)
Reduced visual acuity
Others less common
Blurred vision
Conjunctival hyperemia, 
Eye irritation/discharge/discomfort
Headache, increased lacrimation, sinusitis