Pharm 3 Topical Agents pt1 Flashcards
Name 5 common classes of Anti-infectives
quinilones, sulfanomides, aminoglycosides, macrolides, combinations, and antivirals
6 categories of Opthalmic drugs
Anti-infectives
Anti-inflammatory/anti-infective combinations
Non-steroidal Anti-inflammatories (NSAIDS)
Steroid Anti-inflammatories
Mast cell wall stabilizers
Antiglaucoma agents
4 classes of Antiglaucoma agents
-adrenergic blocking agents, parasympathomemetics, carbonic anhydrase inhibitors, cholinesterase inhibitors
5 types of other opthalmic meds that don’t belong to any of the already-mentioned categories
sympathomemetic agents, vasoconstrictors, lubricants, eye-irrigation solutions, anesthetics
Bacterial conjunctivitis is most often caused by (3). Which is common in children?
Streptococcus pneumonia, Haemophilus pneumonia, or Staphylococcus aureus
Gram-positives more common than gram-negatives
Haemophilus is common in children
Defining characteristics to distinguish btwn viral and bacterial conjunctivitis
Viral conjunctivitis: clear/yellow, stringy discharge,
Bacterial conjunctivitis: any color, preauricular lymphadenopathy
The first thing to write when writing up a description of an eye complain is __. Then do what?
Make sure and write: “Globe and Lids intact.”
Then do visual acuity.
Open angle glaucoma vs narrow angle glaucoma (obstructions)
Open-angle glaucoma has no mechanical obstruction to outflow
Narrow-angle glaucoma results from a mechanical obstruction by the iris
Open angle glaucoma’s pathology
The trabecular network does not permit adequate rapid egress (exiting) of aqueous with a resultant pressure elevation
Aqueous secretion by the ciliary body is normal
Flow between the lens and iris thru the pupil into the anterior chamber is normal
What are the s&s of someone who presents with acute angle glaucoma
headache, nausea, they see yellow haloes around lights.
Closed angle glaucoma pathology
Results from a mechanical aqueous outflow obstruction through the trabecular network by peripheral iris apposition (near) to the cornea
Underlying mechanism is pupillary block
Can be acute, sub-acute or chronic
The __ interferes with the outflow. If we give a drug that changes the size of the __ we can induce glaucoma in a patient who has a predisposition to it.
The iris interferes with the outflow. If we give a drug that changes the size of the pupil we can induce glaucoma in a patient who has a predisposition to it.
Beta-Blocker drops for Glaucoma
Example, Action, how it’s administered, side effects
Example: Timolol ophthamlic drops
Supress aqueous production (so there’s less fluid)
Administered topically
Systemic side effects: acute exacerbation of asthma, CHF, bradycardia, CNS disturbances
Parasympathomemetics for Glaucoma.
Example, action, side effects, common systemic side effects.
Example: Pilocarpine
Increase aqueous outflow (open up the canal)
Side effects: constricted pupils, other ocular effects
Common systemic side effects: diarrhea, sweating, bronchospasm
What’s a problem associated with Pilocarpine?
It constricts the pupil…problem: Patient may not be able to see well in dark environments, such as driving home at night.
Carbonic Anhydrase inhibitors (oral) for Glaucoma.
Example, action, common side effects
Example: Acetazolamide (Diamox)
Suppress aqueous production
Common side effects: electrolyte imbalances
: Cabonic Anhydrase Inhibitors also act as ___.
Diuretics
Prolonged use of topical antibiotics may result in __.
Anti-infectives are limited to:
overgrowth of non-susceptible organisms, including fungi.
limited to no more than 1 week
Quinolone
Example, indication, safety fact
Example: ofloxacin (Ocuflox)
Indicated for the treatment of ocular bacterial infections caused by susceptible bacterial strains, esp. S. aureus, S. epidermidis, S. pneuomnia, H. flu, and others
Safety/effectiveness not established in children < 1 yoa
Take home message: Levofloxacin is FDA approved down to what age orally? Or systemically?
18
However, these ‘eye’ preparations are approved down to age 1 b/c an eyedrop is unlikely to disturb someone’s knee hyaline cartilage formation.
Aminoglycosides
Example, indication
Example: gentamycin (Garamycin)
Indicated for the treatment of ocular bacterial infections caused by susceptible bacterial strains, esp. S. aureus, S. epidermidis, S. pyogenes, S. pneumonia, N. gonorrhea
Gentamycin’s caveats
Bacterial resistance to gentamycin may develop
If purulent discharge, inflammation or pain develops, discontinue medication
Sulfonamides
Example, indication.
What 2 organisms it not adequately cover?
Example: sulfacetamide sodium (Bleph-10)
Indicated for the treatment of ocular bacterial infections caused by a wide range of susceptible gram-positive and gram-negative bacterial strains, esp. E. coli, S. aureus, S. pneumonia, H. flu
Topically applied, sulfonamides do not provide adequate coverage against N. gonorrhea and P. aeruginosa
Macrolides
Example, indication.
This is/isn’t prescribed in whom?
Example: erythromycin
Indicated for the treatment of ocular bacterial infections caused by susceptible bacterial strains, esp. S. pyogenes, S. viridans, S. aureus, S. pneumonia, M. pneumonia, H. flu, N. gonorrhea, C. trachomatis
Tend not to prescribe in adults. But it is prescribed in kids.