Ocular Side Effects of Systemic Drugs COPY Flashcards
whorl keratopathy
F CHAI T + R
chloroquine, hydroxychloroquine, amiodarone, tamoxifen, indomethacin
Fabry’s disease, Rho kinase inhibitors
dry eye disease
all drugs preserved with BAK, including topical ophthalmic glaucoma medications
superficial punctate keratitis (SPK)
isotretinoin (Accutane), topical ophthalmic aminoglycosides (Tobradex)
endothelial/Descemet membrane pigmentation, also on lens and retina
“-azine” drugs
chlorpromazine, thioridazine, promethazine (Phenergan)
stromal gold deposits
gold salts can result in yellow-brown deposits between the stroma and Descemets (ocular chrysiasis)
delayed corneal healing
topical ophthalmic and oral corticosteroids
Amiodarone
an anti-arrhythmic drug that can cause whorl keratopathy (epithelium), anterior subcapsular lens deposits, and NAAION (1-2% of cases)
anterior subcapsular effects/cataracts
“May trigger ant. cataract” = miotics (vacuoles), thioridazine, amiodarone (deposits), chlorpromazine
posterior subcapsular cataracts
corticosteroids
Isotretinoin (Accutane)
blepharoconjunctivitis, dryness, lid edema, loss of colour vision, nyctalopia, intracranial hypertension
subconjunctival hemorrhage
NSAIDs, warfarin (Coumadin), clopidogrel (Plavix), dipyridamole (Persantine), Sildenafil (Viagra)
sulfonamides
Stevens-Johnson syndrome and lid edema
tetracyclines
pigmented cysts on the conjunctiva, pseudotumor cerebri, papilledema
conjunctival hyperemia
Sildenafil, prostaglandin analogues
Tamiflu
(antiviral for influenza) can cause conjunctivitis in 1% of pts
decrease tear secretion
anticholinergics, TCAs, antihistamines, phenothiazines, isotretinoin, beta-blockers, hormone therapies (HRT, contraceptives), ADHD meds (methylphenidate, dextroamphetamine), diuretics (HCTZ, furosemide, triamterene)
miosis
opiates (morphine, heroine, codeine), acetylcholinesterase inhibitors
mydriasis
anticholinergics, antihistamines, SSRIs, SNRIs, TCAs, phenothiazines, benzos, dopamine agonists
nystagmus
phenytoin (Dilantin), phenobarbital (Luminal), salicylates (NSAIDs)
diplopia
antidepressants, antianxiety agents, phenytoin (Dilantin), pseudoephedrine
smooth pursuit impairment
alcohol
oculogyric crisis
phenothiazines, cetirizine (Zyrtec)