Pharmacology Flashcards
Flourescein
Orange dye that when used with a woods lamp, corneal abrasions, foreign bodies, ulcers, infection and herpatic dendrites can be seen.
Topical anesthetic MOA
Stabilizes neuronal membranes inhibiting nerve impulses.
Short-acting topical anesthetics
Proparacaine (Alcaine)
Oxybrupocaine/Benoxinate (novesin, novesine)
Very short acting
-Benoxinate comes in combo with flourescine
-Proparicaine is most often used because there is less stinging on application.
Tetricaine (pontocaine)
Longer acting topical anesthetic
Topical Anesthetic SE
- Stinging, irritation
- Hypersensitivity rxn
- Prolonged use may inhibit healing
- Must protect eye from irritants until it wears off.
Topical Anesthetic CI
- *Never write a script for these!**
- Any hypersensitivity to anesthetics
- liver disease
- Anticholinesterases
- Dry eye
- Perforating eye injury
Diclofenac (Voltaren)
NSAID used for post-op pain/inflammation after cataract surgery
Ketorlac (acular)
NSAID: Can be used for allergic conjunctivitis.
Dont use opth. NSAIDS for longer than _______ weeks
two. can cause corneal injury
Corticosteroids
Use of corticosteroids should be reserved for an opthalmologist
Corticosteroid indications
- Acute iritis
- Stromal keratitis
- Chemical burns
- (Epi)scleritis
Prednisolone acetate 1% soln (Pred Forte)
- Most commonly used opthalmic corticosteroid
- Dexamethasone and Flourometholone are also used.
Corticosteroid SE
Short-term: Mydriasis, Ptosis, healing inhibition.
Long-term: Cataracts, corneal thinning/rupture, glaucoma, immmunosuppression, keratitis.
Corticosteroid CI
Viral or fungal disease of cornea or conjunctiva
Decongestants MOA
Over the counter
Causes pupil dilation, increase outflow of aqueous humor, vasoconstriction.
Decongestant Indications
Allergic conjunctivitis (redness, itching, burning, excessive tearing)
Decongestant SE
Burning, blurred vision, pupil dilation, rebound congestion.
Not to be used with glaucoma
Antihistamines
Prescription and OTC
Patanol (prescription)
Ketotifen (OTC)
Antihistamine SE
Eye irritation, stinging upon application.
Most antihistamines can be used with ______ ______ _____.
Contact lens wearers. Must take out for 10 minutes before and after application.
Mast Cell Stabilizer
Cromolyn Sodium (Opticrom)
Inhibits mast cell degranulation
Must take 4x per day
Can use long-term
Sulfonamide MOA
ABx: Inhibits synthesis of folic acid
Sulfonamide Indication
Lid infxns
Conjunctivitis
Corneal abrasion, ulcer
Infxn prevention
Sulfacetamide
Bleph-10, Ocu-Sul, Sodium Sulamyd, Sulf-10
Sulfonamide SE
Local irritation, stinging, burning
Flouroquinolones MOA
ABx: Inhibits DNA synthesis
Flouroquinolones Indications
Lid infxns Conjunctivitis (not 1st line) Corneal abrasion, ulcer Prevent infxns *Should be used in pseudomonas is suspected.* **contact lens wearers = pseudomonas**
Flouroquinolone types
Ciproflaxacin, Ofloxacin, Levofloxacin, Moxifloxacin
Flouroquinolones SE
Burning, stinging, foreign body sensation, photophobia
Aminoglycosides MOA
Bind to ribosomes and inhibit tRNA synthesis
Aminoglycosides indications
Lid infxns
Conjunctivitis
Corneal abrasion, ulcer
Infxn prevention
Aminoglycosides types
Gentamycin, Tobramycin,
Neomycin (high incidence of allergy)
Aminoglycosides SE
Generally avoid these for run of the mill conjunctivitis
Burning, itching, erythema
Macrolides MOA
Inhibits tRNA synthesis
Macrolide Types
Erythromycin (cheap), Azythromycin (spendy)
Macrolide Indications
Same as the others
Bacitracin MOA
Inhibits bacterial cell wall synthesis
Bacitracin Indications
Lid infxns
Conjunctivitis
Corneal abrasion, ulcer
Prevent infxns
Trimethoptrim Sulfate (Polytrim)
Combo of two antibiotics
Ok for sulfa allergies!!
Used for the same stuff.
Idoxuridine (Dendrid)
- Antiviral
- Used for herpes simplex keratitis
- Blocks reproduction of HSV
Trifuridine (Viroptic)
- Antiviral
- Used for keratoconjunctivitis, keratitis
- May cause burning, stinging
Used if vidarabine is ineffective
Vidarabine (Vira-a)
- Used for keratoconjunctivitis and keratitis
- May cause haze, burning
You should never treat ocular herpes in a _____ _____ setting.
Primary care. refer to optho.
Cycloplegics MOA
Paralyze the ciliary muscles and cause dilation of the pupil.
Cycloplegic Indications
- Dilation before eye exam
- Pre and post-op
- Pain relief for abrasions/iritis/uveitis
Cycloplegic types
Atropine, Scopolamine, Cyclopentolate, Mydriacyl
Cycloplegic CI
- Angle closure glaucoma
- People w/ narrow angles
- Caution in children and elderly
Cycloplegic SE
Blurred vision Burning/stinging Eye irritation Photophobia Swelling of eyelids
Agents for glaucoma
1st line: Prostaglandin Analogs
2nd line: Beta Blockers
Prostaglandin Analog MOA
Increase uveoscleral flow
Prostaglandin types
Latanoprost (Xalatan)
Bimatoprost (Lumigan)
Tafloprost (Zioptan)
Prostaglandin SE
Decreased visual acuity
Eye discomfort
Dry eye
Foreign body sensation
Prostaglandin may decrease efficacy of ________.
NSAIDS
Beta Blocker MOA
May decrease aqueous humor formation or increase outflow.
Beta Blocker types
Betaxolol (Betoptic) - selective Timolol maleate (Timoptic) - non Levobunolol (Betagan) - non
Beta Blocker SE
Decrease Cardiac output Bronchospasm Bradycardia Heart block Hypotension
Beta Blocker CI
Asthma COPD Sinus bradycardia 2nd or 3rd degree AV block Overt cardiac failure
Alpha Andrenergic Agonists MOA
- Reduces intraocular pressure (IOP) by increasing outflow and reducing aqueous humor production
- 3rd line for glaucoma
- effective but not commonly used due to SE, many drug interactions
Alpha Andrenergic Agonist Types
Brimonidine (Alphagan P)
Apraclonidine (Iopidine)
Cholinergic Agonists MOA
Contract ciliary muscle, allowing increased outflow.
out of favor
Cholinergic Agonists SE
Brow ache, Induced Myopia, Decreased vision in low light.
Out of favor
Carbonic anhydrase inhibitirs
Acetazolamide. Do not appear to be as effective as other therapies, but can be used when treatment of angle closure glaucoma is delayed
T or F: Eye drops do not have systemic effects
False. They do. Look that shit up.
