Systemic Meds for Optometric Student

Question 1

Definition of pharmacokinetics

Answer 1

What the body does to the drug

Question 2

Definition of pharmacodynamics

Answer 2

What the drug does to the body

Question 3

What is the most common side effect of PCNs? What percentage of people get it and it becomes fatal?

Answer 3

Antibiotic Associated Diarrhea (AAD)

• 35% of ppl get it
• 17% die from it

Question 4

What is the #1 side effect we’re worried about with antibiotics? What % of ppl get it?

Answer 4

Allergic reaction, 5%

Question 5

What class of drugs would we use to restore the norma flora that’s’ damaged in antibiotic use?

Answer 5

Probiotics

Question 6

What are the 3 drugs that cause crystalline retinopathies?

Answer 6

1. Talc
2. Tamoxifen
3. Canthaxanthin

Question 7

Granuloma from talcum powder from the drugs builds up in what organ first before travelling to the eye?

Answer 7

Lungs

Question 8

What is tamoxifen used for? Where are the talc deposits found in the retina?

Answer 8

Used for breast cancer

found in a circular shape around the macula

Question 9

What is the treatment for a patient presenting with crystalline retinopathy?

Answer 9

Stop the drug

Question 10

What’s the cause of an allergic rxn to an PCN?

Answer 10

From degraded beta lactams

Question 11

What’s the dialy dose of tamoxifen for retinopathy to occur?

Answer 11

10-20mg daily

Question 12

What are the ocular manifestations of estrogen and progestrogens?

Answer 12

1. Decreased Vision
2. Retinal Vascular Problems
3. PTC, hypercoagulable state
4. Arterial dissection
5. CL intolerance

Question 13

What are the main SEs of allergy medications?

Answer 13

1. Pupillary dilation
2. Anisocoria
3. Decreased mucoid/lacrimal secretion
4. Blepharospam in large dose
5. Decreased Vision & Acc.

Question 14

What antidepressants cause blurred vision, mydriasis, photophobia, keratitis sicca, unilateral ptosis?

Answer 14

Fluxetine Hydrochloride (Prozac) and Sertraline (Zoloft)

Question 15

Phenothiazine toxicity is caused by what 4 drugs?

Answer 15

Chlorpromazine (Thorazine)
Thioridaine (Mellaril)
Fluphenazine
Prochlorperazine

Question 16

Which phenothiazine drug is known to cause cornea and lens pigmentary changes?

Answer 16

Chlorpromazine

Question 17

Which phenothiazine drug is known to cause retinal pigmentary changes?

Answer 17

Thioridazine

Question 18

T/F: Toxicity of phenothiazine drugs can progress even after the drug is stopped?

Answer 18

True

Question 19

What layer of the retina is initially lost in phenothiazine toxicity? What two structures go after that?

Answer 19

1. Photoreceptor loss
2. Choriocapillaris
3. RPE loss

Question 20

What drug is used in malaria and collagen vascular disease (lupus/RA/Sjrogrens)?

Answer 20

Chloroquine/Hydroxychloroquine

Question 21

What are the top 3 symptoms of Chlor/Hydrochlor toxicity?

Answer 21

1. Paracentral Scotoma
2. Loss of Acuity
3. Nyctalopia (difficulty seeing at night)

Question 22

What are the 6 clinical findings of chlor/hydrochlor toxicity?

Answer 22

1. Bull’s Eye Mac
2. Arteriolar Narrowing
3. OD Pallor
4. Peripheral RPE loss
5. Poliosis
6. Corneal Deposits

Question 23

Warfarin (Coumadin) is used to prevent clot formation and DVT in patients with what heart disease?

Answer 23

Atrial Fibrillation

Question 24

Most ocular side effects are uncommon in Warfarin, but what was reported?

Answer 24

Massive retinal hemorrhages in AMD patients

Question 25

What ratio do you want to ask a patient about who is taking warfarin?

Answer 25

International Normalized Ratio (INR) - should be between 2.0-3.0

Question 26

Amiodarone is an antiarrythmic med that presents with what 5 ocular SEs?

Answer 26

1. Whorl Keratopathy
2. Yellow/Brown conj. deposits
3. Anterior subcapsular yellow-white opacities
4. Optic Neuropathy
5. Thyroid Dysfunction

Question 27

Amiodarone is used for what 2 cardiovascular issues?

Answer 27

Atrial Fibrillation

Ventricular Tachycardia

Question 28

What bone disorder agent is used for people w/ brittle bones as they get older?

Answer 28

Aledronate (Fosamax)

Question 29

What are the ocular side effects of Fosamax?

Answer 29

1. Anterior uveitis (w/in 24-48 hrs of usage)
2. Episcleritis (w/in 1 wk)
3. Scleritis (w/in 1 wk)
   4 Ocular Pain
4. Irritation of mucous membranes (dry eye)

Question 30

Use of Interferon A has been indicated in what conditions?

Answer 30

Leukemia
Hep B & C (liver disease)
Malignant Melanoma
MS

Question 31

What are the ocular findings of Interferon usage?

Answer 31

1. Interferon Retinopathy
2. Blurred Vision
3. Eye Pain
4. Photophobia

Question 32

How late can radiation retinopathy present after treatment?

Answer 32

7 years later

Question 33

Premarin/Prempro are hormone therapy drugs to reduce what?

Answer 33

reduces hot flashes, vaginal dryness and osteoporosis

Question 34

What are the ocular SEs of Premarin/Prempro?

Answer 34

Effects meibomian gland receptors = dry eye…

PTC can occur

Question 35

Radiation can cause what 6 anterior segment ocular findings?

Answer 35

1. Trichiasis
2. Epiphora
3. Ectropion
4. Dry Eye
5. Iritis
6. Cataract

Question 36

Sildenafil citrate (viagra) can cause what 3 ocular SEs?

Answer 36

1. Bluish tint to vision
2. Hypersensitivity to light
3. NAION (Non-Arteritic Anterior Ischemic Optic Neuropathy)

Question 37

Name the 5 drugs that can cause PTC

Answer 37

1. Tetracycline
2. Minocycline
3. Vitamin A (Accutane)
4. Steroid Use (withdrawal)
5. Ciprofloxicin
6. Naladixic Acid

Question 38

The main ocular SE for the chemo agent, Cyclophosphamide (cytoxan) is what?

Answer 38

SEVERE dry eye

Question 39

What is the main ocular SE of Topiramate (topamax/topiragen)?

Answer 39

Acute angle-closure glaucoma

Question 40

What are the 3 risk factors of getting an NAION when taking Viagra/Cialias?

Answer 40

1 .Small ON & Small Cup

2. Blood Pressure Meds
3. Old Age