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Year 2 Ocular Pharmacology > Ocular side effects of Systemic medications > Flashcards

Ocular side effects of Systemic medications Flashcards

1
Q

What are the factors that contribute to the likelihood of ADRs occurring?

A

Older age
Very young age
Female gender
Increased weight
Poor general/ocular health
Genetic factors
Dose and duration of meds
Interactions with other meds

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2
Q

What are the types of anti-depressants?

A

Tricyclines
MonoAmine Oxidase Inhibitors (MAOIs)
Selective Serotonin Reuptake Inhibitors (SSRIs)

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3
Q

Give an example of a Trycycline

A

Amitriptyline
Clomipramine

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4
Q

When are tricyclines contraindicated?

A

Angle-closure risk
Glaucoma

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5
Q

What are the ADRs for antidepressants?

A

Mydriasis - all
Photophobia - MAOIs and SSRIs
Blurred vision - tricyclic and MAOIs
Cycloplegia - tricyclic only
Dry eye - tricyclic and SSRIs
Increased IOP - tricyclic only

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6
Q

What is the mechanism of antidepressants?

A

Anticholinergic

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7
Q

When are MAOIs contraindicated?

A

Mydriatics
Careful with certain foods (e.g. cheese)

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8
Q

When are SSRIs contraindicated?

A

Poorly controlled epilepsy
Manic phase

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9
Q

What can oral contraceptives be used for in addition to contraception?

A

Control of heavy bleeding and menstrual pain, menstrual cycle control, anaemia prevention

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10
Q

What are the types of oral contraception? Give an example of each

A

Combined (oestrogen and progesterone) e.g. ethinyloestradiol/norethisterone
Progesterone only e.g. norethisterone

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11
Q

What are the ADRs of oral contraceptives?

A

Systemic: DVT
Ocular: Reduced tear quality/quantity (dry eye, CL intolerance), retinal vein occlusion

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12
Q

Give two examples of Anti-Tuberculosis drugs

A

Ethambutol
Rifampicin

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13
Q

What are the contraindications for Ethambutol?

A

Optic Neuritis
Poor vision

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14
Q

What are the ADRs for Ethambutol?

A

Reduced VA
Optic neuritis: axial (central VA reduction, CV loss) or paraxial (VF constriction)

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15
Q

What are the contraindications for Rifampicin?

A

Jaundice

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16
Q

What are the ADRs for Rifampicin?

A

Discolouration of soft CLs - pink

17
Q

What are the other categories of drugs which can cause ocular side effects?

A

Anti-inflammatories - NSAIDs and corticosteroids
Anti-infectives
Anti-cancer
Erectile dysfunction agents
Anti-convulsive
Anti-psychotics
Hypnotics
Cardiovascular agents
Antihistamines
Anti-hypertensives
Antimalarials
Bronchodilators
Anti-Parkinson’s

18
Q

What are some ADRs of anti-infectives?
Give an example of a drug.

A

e.g. doxycycline
diplopia
blurred vision
VF loss

19
Q

What are some ADRs of anti-hypertensives?
Give an example of a drug.

A

e.g. timolol
reduced VA
IOP changes
photophobia
visual disturbances
conjunctival and palpebral changes

20
Q

What are some ADRs of cardiovascular agents?
Give an example of a drug.

A

e.g. amiodarone
CV changes
hazy vision
haloes
corneal deposits
lens opacities
optic neuropathy

21
Q

What are some ADRs of anti-malarials?
Give an example of a drug.

A

e.g. chloroquine
Bull’s eye maculopathy
corneal deposits
blurred vision
CV defects
VF loss

22
Q

What are some ADRs of bronchodilators?
Give an example of a drug.

A

e.g. ventolin
ocular pain
mydriasis

23
Q

What are some ADRs of anti-inflammatories?
Give an example of a drug.

A

e.g. ibuprofen, prednisolone
NSAIDs: dry eye, CV changes, rx changes
Corticosteroids: steroidal glauc/cats, corneal thinning, increased IOP, immunosuppression

24
Q

What are some ADRs of anti-psychotics?
Give an example of a drug.

A

e.g. chlorprozamine
blurred vision
mydriasis
reduced accom
reduced lacrimation (so dry eye)
corneal, lens and conjunctival deposits

25
Q

What are some ADRs of hypnotics?
Give an example of a drug.

A

e.g. diazepam
reduced accom
EOM dysfunction
diplopia
allergic conjunctivitis

26
Q

What are some ADRs of anti-Parkinson’s?
Give an example of a drug.

A

e.g. levodopa
mydriasis
ptosis
hallucinations
blurred vision

27
Q

What are some ADRs of anti-convulsants?
Give an example of a drug.

A

e.g. vigabatrin
diplopia
blurred vision
VF constriction
reduced VA and CV

28
Q

What are some ADRs of antihistamines?
Give an example of a drug.

A

e.g. ceritzine, loratadine
reduced lacrimation (so dry eye)
increased corneal and conjunctival staining
blurred vision
mydriasis

29
Q

What are some ADRs of erectile dysfunction agents?
Give an example of a drug.

A

e.g. Viagra
increased light senstivity
blurred vision
conjunctival hyperaemia
pain
CV change
NAION

30
Q

What are some ADRs of anti-cancer drugs?
Give an example of a drug.

A

Tamoxifen:
crystalline retinopathy
VF changes
CV changes
whorl corneal opacities
posterior subcapsular cataracts

Year 2 Ocular Pharmacology (20 decks)

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