Systemic Medication Flashcards
Medication causing Papilledema
CANT C- Contraceptives A- Vitamin A and Accutane N- Naladixic T- Tetracyclines( minocycline, doxycycline)
Medication causing toxicity-optic nerve Pallor
Ethambutol
Isoniazid
Amiodarone
Celexa (Citalopram Hydrobromide)
SSRIs
Mirapex (pramipexole)
Anti-Parkinson Therapies
Plavix (pramipexole)
Blood thinners
Trazodone
antidepressant medicine
Dyrenium (Triamterene)
Diuretic (water pill)
Bactroban (mupirocin topical )
antibiotic
Imitrex (sumatriptan)
Headache medicine that narrows blood vessels around the brain.
Drugs causing NAION
Viagra
Imitrex (sumatriptan)
Amiodarone
Which layers of cornea are Hydrophobic and which are hydrophilic
Epithelium and Endothelium are hydrophobic
Stroma is hydrophilic
What are the side effects of Pilocarpine
Headaches and myopic shift Miosis Cataract( anterior cortical) Retinal detachment Secondary angle closure ( pupillary block)
Pilocarpine is used for diagnosis of
1% to differentiate from CN III palsy from sphincter tear.
0.125% for Adies tonic pupil
Contraindication with Down syndrome patients
Scopolamine
Atropine
CNS toxicity
Standard drug for treating anterior uveitis
Homatropine , effects is 1-3 days
Naphazolin (Naphcon)
Tetrahydrozoline ( Visine)
Phenylephrine
Ocular decongestant used clinically.
Excessive Visine use> fixed dilated pupil . Recurrent subconjhemes.
Brimonidine
Neuro protective properties
Conjunctival follicles, ocular allergic reactions, and ocular pruritus (itching).
Causes Miosis
Dry mouth
headache, blurring, foreign body sensation, fatigue/drowsiness,
Ocular hyperemia, burning and stinging,
Contraindicated using with MOI
TID dosing
Apraclonidine ( Iopidine)
For Acute IOP lowering
Taxhyphylaxis properties
Can be used for diagnosing Horner’s syndrome.
Horner syndrome diagnosis
Cocaine-no dilation Apraclonidine-dilation Hydroxyamphetamine Pre> Dilation Post>no Dilation
The only B-1 selective B-blocker is……….. And is safe to prescribe for Asthma and COPD patients.
Betaxolol ( Betoptic-S)
Has Neuroprotective qualities
Safe for Pulmonary disease, bronchial asthma and severe COPD
Less CNS side effects
Timolol ( Timoptic)
Non-selective B-blocker Morning dosage Crossover effect Mask symptoms of hypoglycemia Mask symptoms of hyperthyroidism Symptoms exacerbated with myasthenia gravies patients
LEVOBUNOLOL ( betagan)
Similar to Timolol
CAIs are…
Topicals
Brinzolamide (Azopt)
Dorzolamide ( Trusopt)
Orals
Acetazolamide( Diamox)
Methazolamide( neptazane)
Prostaglandin Analogs
Latanoprost ( Xalatan 0.005%) Bimatoprost ( Lumigan 0.03%) Travoprost ( Travatan 0.004%) Activate Phospolipase C Bedtime dosing
Prostaglandin Analogs Contraindications
CME patients especially cataract surgery post-op .
Cases of active inflammation
Previous episode of HS keratitis
Conjunctival Hyperemia can occur with which Prostaglandin Analogs
Lumigan
Least common with Xalatan
Pruritis with Lumigan
H1 Antihistamine
Emedastine ( Emadine)
Commonly used with combination
Like Naphcon A
Mast cell stabilizers
Cromolyn sodium( Crolom) QID Lodoxamide (Alomide) QID Pamirolast ( Alamast) Nedocromil ( Alocril)
Preventing Ca2+ influx
Mast cell + Antihistamine
Bepotastine ( Bepreve) Epinastine (Elestat) Ketotifen (Zaditor) Olopatadine ( Patanol) Azelastine (Optivar) Olopatadine 0.20% ( pataday)
Potent steroid
Prednisolone 1%
Rimexolone ( Vexol)
Difluprednate (Durezol)
Dexamethasone ( Maxidex) 0.1%
Soft steroids
Fluorometholone ( FML) 0.1%
Loteprednol ( Lotemax) 0.5%
Topical NSAIDs
- Diclofenac ( voltaren) (qid)
- Ketorolac tromethamine (Acular LS ) (Qid)”approved for seasonal allergic conjunctivitis “
- Nepafenac ( Nevanec) (tid)
- Bromfenac (xibrom) (bid, contains BAK and sodium sulfite) ,Bromday (qd)
- Flurbiprofen (Ocufen) used prior ocular surgery ( contains thimerosal)
Topical NSAIDs side effects
Corneal toxicity
Corneal melting
Stinging upon instillation
Subconjunctival hemorrhage
ARMD treatment injections
Pegaptanib (Macugen)
Ranibizumab ( Lucentis)
Hyperosmotic agents
Glycerine ( osmoglyn)
Isosirbide ( for Diabetic patients )
Sodium Chloride ( Muro) > hypertonic solution used to decrease corneal edema
Patient toxic reaction to preservative
Diffuse SPK and follicles
Bacitracin
prevents transfer of peptidoglycan into the growing cell wall
Toxoplasmosis treatment
Pyrimerhamine (Daraprim) given orally
Sulfadiazine + pyrimethamine
Polytrim is combination drug of
Trimethoprim + Polymyxin B
effective with gram + and -
not effective toward psudomonas
Oral Sulfonamides can cause what in children
Kernicterus in infants from excess bilirubin in brain and myopic changes in ref error
Neosporin
Neomycin added to Polysporin (antibiotic ointment, combination of Bacitracin (G+) + Polymyxin B (G -)
Penicillins
Amoxicillin ( Principen)
Dicloxacillin ( Dynapen)
Augmentin > Clavulanic acid + Amoxicillin
(G+ and G- )
Hypersensitive reaction are common side effect
Dicloxacillin ( Dynapen) is prescribed for ….
eyelid infections
- Hordeola
- blepharitis
1st generation of Cephalosporins
G +
Cephalexin ( Keflex)
used to skin infections
Hypersensitive reaction and alters Vit K absorption
2nd and 3rd generation of Cephalosporins
Ceftriaxone ( Rocephin)
G+ and G-
treatment for Gonorrhea infections
Hypersensitive reaction and alters Vit K absorption
Fluoroquinolones 2nd generation
Gram (-)
Ciprofloxacin ( Ciloxan, Cipro)
-urinary and GI infections
Ofloxacin ( Ocuflox)
Fluoroquinolones 3rd generation
Gram (+)
Levofloxacin (Quixin)
the only Topical NOT approved for 1 year of age and older
Fluoroquinolones 4th generation
Gram (+)
Gatifloxacin ( Zymar)
Moxifloxacin ( Vigamox, Avelox)
Besifloxacin (Besivance)
Fluoroquinolones used for ….
Contact lens related ulcers
corneal abrations
Bacterial conjunctivitis
Oral»> causes Tendinitis, not for pregnancy and children
Prostaglandins side effects
Conjunctival hyperemia Iris color change Eyelash changes Skin pigmentation Deepening of upper eye lid sulcus (DUES)
Prostaglandins side effects
Conjunctival hyperemia Iris color change Eyelash changes Skin pigmentation Deepening of upper eye lid sulcus (DUES)
Prostaglandin systemic side effects
None
Prostaglandin analog reaches systemic circulation
Metabolized by liver
Elimination by kidneys
Half life 17 minutes in human plasma
In contrast to timolol no effect on blood pressure
Prostaglandins drug interdictions
Eye drops containing thimerasol (preservative) will form a precipitate when mixed with latanoprost
Use 5 minutes apart
CNS side effect of beta-blockers
Anxiety, depression, fatigue, lethargy, confusion, sleep disturbance, memory loss and dizziness
Sexual dysfunction
Decreased libido men and women
Impotence in men
Apraclonidine Pharmacology and MOA
More hydrophillic Does not penetrate eyes and blood brain barrier More apha-2 selective Wide therapeutic index Mechanism of action: Decreased aqueous production Improves trabecular outflow Decreases episcleral venous pressure
Angle closure drops
1-Pilocarpine
Angle closure with pupillary block
1 or 2% two to 3 times in 30 minutes
Drugs causing Whorl Keratopathy
CHAI-T
- Chloroquine
- Hydroxy Chloroquine
- Amiodarone
- Indomethacin
- Tamoxifen
Drugs causing “ Blue Sclera”
- topical steroids
- Minocyclin
Systemic SE of steroids
Diabetes or insulin resistance Peptic ulcer Immune suppression Osteoporosis Decrease collagen ( decrease fibroblasts proliferation) Increase HTN
Ocular SE of steroids
PSC cataract
Glaucoma
Increase risk of secondary infection
Triamcinolone (Kenalog) SE
Endopthalmitis
Increased IOP
De pigmentation of eyelid
Periservitives in tear substitute
Methyl cellulose
Polyvinyl alcohol
