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Ocular Pharmacology > Ocular Side Effects of Systemic Drugs > Flashcards

Ocular Side Effects of Systemic Drugs Flashcards

1
Q

whorl keratopathy

A

F CHAI T + R

chloroquine, hydroxychloroquine, amiodarone, tamoxifen, indomethacin

Fabry’s disease, Rho kinase inhibitors

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2
Q

dry eye disease

A

all drugs preserved with BAK, including topical ophthalmic glaucoma medications

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3
Q

superficial punctate keratitis (SPK)

A

isotretinoin (Accutane), topical ophthalmic aminoglycosides (Tobradex)

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4
Q

endothelial/Descemet membrane pigmentation, also on lens and retina

A

“-azine” drugs

chlorpromazine, thioridazine, promethazine (Phenergan)

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5
Q

stromal gold deposits

A

gold salts can result in yellow-brown deposits between the stroma and Descemets (ocular chrysiasis)

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6
Q

delayed corneal healing

A

topical ophthalmic and oral corticosteroids

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7
Q

Amiodarone

A

an anti-arrhythmic drug that can cause whorl keratopathy (epithelium), anterior subcapsular lens deposits, and NAAION (1-2% of cases)

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8
Q

anterior subcapsular effects/cataracts

A

“May trigger ant. cataract” = miotics (vacuoles), thioridazine, amiodarone (deposits), chlorpromazine

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9
Q

posterior subcapsular cataracts

A

corticosteroids

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10
Q

Isotretinoin (Accutane)

A

blepharoconjunctivitis, dryness, lid edema, loss of colour vision, nyctalopia, intracranial hypertension

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11
Q

subconjunctival hemorrhage

A

NSAIDs, warfarin (Coumadin), clopidogrel (Plavix), dipyridamole (Persantine), Sildenafil (Viagra)

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12
Q

sulfonamides

A

Stevens-Johnson syndrome and lid edema

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13
Q

tetracyclines

A

pigmented cysts on the conjunctiva, pseudotumor cerebri, papilledema

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14
Q

conjunctival hyperemia

A

Sildenafil, prostaglandin analogues

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15
Q

Tamiflu

A

(antiviral for influenza) can cause conjunctivitis in 1% of pts

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16
Q

decrease tear secretion

A

anticholinergics, TCAs, antihistamines, phenothiazines, isotretinoin, beta-blockers, hormone therapies (HRT, contraceptives), ADHD meds (methylphenidate, dextroamphetamine), diuretics (HCTZ, furosemide, triamterene)

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17
Q

miosis

A

opiates (morphine, heroine, codeine), acetylcholinesterase inhibitors

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18
Q

mydriasis

A

anticholinergics, antihistamines, SSRIs, SNRIs, TCAs, phenothiazines, benzos, dopamine agonists

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19
Q

nystagmus

A

phenytoin (Dilantin), phenobarbital (Luminal), salicylates (NSAIDs), topiramate

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20
Q

diplopia

A

antidepressants, antianxiety agents, phenytoin (Dilantin), pseudoephedrine

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21
Q

smooth pursuit impairment

A

alcohol

22
Q

oculogyric crisis

A

phenothiazines, cetirizine (Zyrtec)

23
Q

intraoperative floppy iris syndrome

A

a1 blockers (tamsulosin, terazosin, prazosin)

24
Q

blue sclera

A

corticosteroids, minocycline

25
Q

topiramate (Topamax)

A

secondary angle closure, choroidal swelling moves the iris forward into apposition with the TM

26
Q

Digoxin

A

retrobulbar optic neuritis, B/Y colour defects, entoptic phenomena

27
Q

Ethambutol

A

optic neuritis (typically retrobulbar and bilateral)

28
Q

NAION

A

Sildenafil, vardenafil, sumatriptan, amiodarone

“VIA” - viagra, imitrex (sumatriptan), amiodarone

29
Q

optic neuritis

A

“DICE” digoxin, isoniazid, chloramphenicol, contraceptives, ethambutol

streptomycin, sulfonamides, methotrextrate

30
Q

oral contraceptives

A

decreased tear secretion, optic neuritis, papilledema, pseudotumor cerebri, vasculopathy (RAOs and RVOs), retinal hemorrhage, intracranial hypertension

31
Q

chloroquine

A

bull’s eye maculopathy

32
Q

epinephrine

A

cystoid macular edema

33
Q

tamoxifen

A

white or yellow crystalline deposits (commonly in the macula) with or without macular edema, dry eye, cataracts, keratopathy

34
Q

thioridazine/chlorpromazine/promethazine

A

pigmentary retinopathy that can have an appearance similar to bulls eye maculopathy, cataracts, whorl keratopathy, RP

35
Q

indomethacin

A

retinal hemorrhage, pigmentary changes (especially in the macula)

36
Q

talc

A

retinopathy (white, shiny emboli within arterioles)

37
Q

zidovudine (Retrovir)

“-vudine” drugs

A

macular edema

38
Q

NSAIDs

A

subconjunctival hemes, retinal hemes

39
Q

drugs causing intracranial hypertension

A

tetracyclines, isotretinoin, oral contraceptives, nalidixic acid

40
Q

drugs that decrease IOP

A

systemic beta-blockers, cardiac glycosides (digoxin), alcohol, cannabinoids

41
Q

drugs that increase IOP

A

anticholinergics (atropine, scopolamine), antihistamines, TCAs, antipsychotics (phenothiazines), short-acting b2 agonists (albuterol, levalbuterol, terbutaline), pseudoephedrine, corticosteroids

42
Q

drugs that can cause pseudotumor cerebri/IIH

A

CATS: contraceptives, accutane, tetracyclines, synthroid (<18yo)

43
Q

beta-blockers should be used cautiously in

A

diabetics as it can mask symptoms of fatal hypoglycemia

(can also mask symptoms of hyperthyroid)

myasthenia gravis

44
Q

“-zone” diabetic drugs

A

macular edema

45
Q

ribavirin (hep c therapy) +interferon

A

conjunctivitis, RD, ischemia (CWS), bleeding (retinal hemes), arterial/venous occlusions, and optic neuritis

46
Q

acute secondary angle closure glaucoma

A

topiramate, HCTZ, chlorothiazide

47
Q

myopic shift drugs

A

May Have To See Dimly

miotics, HCTZ, topiramate, sulfa, diamox (CAIs)

48
Q

Stevens-Johnson syndrome

A

Sulfonamide, phenytoin, NSAIDs, penicillin, aspirin, barbiturates, isoniazid, tetracyclines, immunizing vaccinations

49
Q

pseudoephedrine

A

blurry vision, diplopia

50
Q

pigmentary retinopathy

A

chlorpromazine, thioridazine, indomethacin, promethazine

51
Q

promethazine

A

pigment x3 - corneal endo, lens, retinal pigment

antihistamine (symp) effects - dry mouth, mydriasis, dry eyes, tachy cardia, etc.

52
Q

EOM palsies

A

Phenytoin

Ocular Pharmacology (10 decks)

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