Ophthalmics & Otics Flashcards
Ear drops can be administer into the eyes (t/f)
FALSE
But eye drops can be admin into the ears
Eye drops require a specific pH
Normal range of intraocular pressure (IOP)
12-22 mmHg
Drugs that can increase IOP
anticholinergics (oxybutynin, TCAs) antihistamines scopolamine Chronic steroids (includ prednisolone eye drops) Topiramate
Most effective drugs for decreasing IOP in glaucoma
Prostaglandin analogs
What is the preferred agent for pts that have glaucoma in just one eye?
Beta blockers
bc PG analogs can cause iris discoloration
Difference between open angle glaucoma and close angle glaucoma:
open-angle: most common, treated with eye drops
close-angle: sudden incr in IOP that is treated with emergency surgery
MOA of PG analogs
increase aqueous fluid outflow
Xalatan
latanoprost
PG analog
store unopen bottle in fridge
Xalacom
latanoprost + timolol
Travatan Z
travoprost
PG analog
only PG that does not contain BAK (preservative)
Lumigan
bimatoprost
PG analog dosing
1 drop QHS
except for Unoprostone which is BID
PG analog main side effects
Darkening of iris, eyelashes
incr in eyelash length
blurred vision
stinging
What PG analog is marketed for incr eyelash length?
Bimatoprost (Latisse)
MOA of action of Beta blockers in glaucoma
reduce aqueous humor production
Timoptic
timolol 0.25 %, 0.5% drops
dosed QD or BID
Timoptic XE
timolol gel
dosed daily
Combigan
timolol + brimonidine
Cosopt
timolol + dorzolamide
All OPH beta blockers are non selective, except for….
Betaxolol (Betoptic)
MOA of cholinergics
incr aqueous outflow
Cholinergics used for glaucoma:
Carbachol: up to TID
Pilocarpine: up to 6 times per day
MOA of carbonic anhydrase inhibitors
reduce aqueous humor production
Carbonic anhydrase inhibitors for glaucoma: [4]
Dorzolamide (Trusopt)
Acetazolamide (PO, rarely used for glaucoma)
Brinzolamide (Azopt)
Methazolamide (Neptazane)
Dose BID- TID
Warning for carbonic anhydrase inhibitros
avoid in pts with true sulfa allergy
causes blurred vision, dry eye, discharge
Simbrinza
Brinzolamide + brimonidine
MOA of alpha-2 agonists in glaucoma
incr aqueous outflox
decr aqueous humor production
Available alpha-2 agonist: [3]
Brimonidine (Alphagan)
Dipiverfrin (Propine)
Apraclonidine (Iopidine)
Conjunctivitis can be caused by what?
Viruses
Bacteria
Allergens
Irritants
Common antibiotics used for bacterial conjunctivits
Azithromycin (Azasite) - store in fridge
Ciprofloxacin (Ciloxan)
Ofloxacin (Ocuflox)
Trimethoprim/Polymyxin b (Polytrim)
Products used for allergic conjunctivitis
Mast cell stabilizers (cromolyn)
Antihistamines:
Azelastine (Optivar)
Olopatadine (Patanol)
Agents used for inflammation associated with conjunctivitis
Mild (NSAIDs): Ketorolac Bromfenac Mod-Severe (steroids): Dexamethasone Prednisolone (Pred forte)
Drugs that can cause changes in vision or damage
alpha blockers amiodarone digoxin Hydroxychloroquine PDE-5 inhibitors
When would antibiotic ear drops be used?
outer ear infections (otitis externa)
not otitis media
Common antibiotic ear drops
Cipro + hydrocortisone (Cipro HC)
Cipro + dexamethasone (Ciprodex)
Neomycin + various steroids
What product is used to remove ear wax?
Carbamide peroxide (Debrox)
Difference in ear drop admin in kids less than:
Pull ear lobe down and back
3+ y/o: pull up and back
