wk5: AED - Antibacterial 1 Flashcards
What are the 6 considerations in therapeutic management?
1: Diagnosis (exclusion, provisional, reconsideration)
2: Drug, dose, frequency? (contraindications, interactions, other modifying factors)
3: Px instructions
4: Review schedule (when)
5: Treatment success? (side effects)
6: Sustain or alter approach?
Out of the following antibacterials used in ocular management, which ones are topical?: fluoroquinolones, aminoglycosides, tetracyclins, macrolides, penicillins, cephalosporins, glycopeptides, chloramphenicol, gramicidin, bacitracin, polymixin
Fluoroquinolones
Aminoglycosides
Chloramphenicol
When are sulphonamide drugs considered S3?
When at 10% or less
Can sulphonamide drugs come as eye drops?
yes
What are sulphonamides used against? (2)
Broad spectrum antibiotics - used against staph related blepharitis/conjunctivitis; chlamydial disease - now increasing resistance, other drugs first choice
When is the use of sulphonamides contraindicated? (5)
sulphur allergy pregnancy (near term) infants (less than 2 months) interactions with other topical drugs (precipitation) commonly irritants
Why is the use of sulphonamide contraindicated in pregnancy (near term and infants)?
these drugs displace bilirubin from protein binding sites in neonates, which can lead to hyperbilirubinemea in neonates (i.e. neonatal jaundice)
What is propamidine and what is it used against? (2)
A general ocular disinfectant. Used against conjunctivitis (drops) and blepharitis (ointment). [note: other drugs first choice]
What is povidone-iodine general ocular disinfectant and what percentage solution is available in Aus?
General ocular disinfectant. Betadine antiseptic solution (10%) is available in Aus (note: would have to dilute 1 in 2 with sterile saline)
What drug schedule classification is povidone-iodine listed in when containing:
A: 0.5% active iodine
B: 2.5% or more active iodine
A: No schedule classification
B: S2
When is povidone-iodine contraindicated? (1)
iodine sensitivity
What conditions/organisms is povidone-iodine useful for treating? (3)
Bacterial conjunctivitis
Chlamydial conjunctivitis
Adenovirus (jury still out on this one)
Describe the process of Povidone-iodine administration (4)
Apply local anaesthetic: up to 3 drops in conj. sac
Wait 1 minute with closed eye (wipe lid margins as well)
Then irrigate with saline (one off or can be repeated)
Treatment may spark inflammation
How can you manage inflammation from povidone-iodine administration? (2)
NSAID or soft steroid
What topical multi-use antibacterial formulations are available in Aus? (6)
Gentamicin Tobramycin Framycetin Ciprofloxacin Ofloxacin Chloramphenicol
What topical single-use antibacterials are available in Aus? (2)
Gentamicin
Chloramphenicol
What antibacterial eye ointment formulations are available in Aus? (2)
Tobramycin
Chloramphenicol
What are ‘fortified eye drops’? What does it mean to fortify an eye drop?
strong antibiotic eye drops specifically made by a compounding pharmacy, used for bad infections like corneal ulcer. The act of fortifying an eye drop means to make to make the medication stronger or more intensified
Name 3 fortified antimicrobial eye drop formulations that are available in Aus
Gentamicin 1.3%, Tobramycin 1.3%, Cephazolin 5%
What conditions should you use fluoroquinolones for? (2)
Bacterial keratitis
Severe unresponsive bacterial conjunctivitis
What conditions should you use Aminoglycosides for? (5)
Prophylaxis (e.g. post-surgical/trauma)
Bacterial conjunctivitis
Blepharitis/External hordeola (as ointment)
Canaliculitis/Dacryocystitis (prophylactic)
Endophthalmitis (if amikacin)
What conditions should you use Tetracyclines for?
Blepharitis (oral, as doxycycline)
Chlamydial eye disease (oral)
Chlamydial eye disease keratoconjunctivitis (topically, as adjunct tx)
What type of blepharitis is tetracycline particularly useful in treating?
Meibomianitis/acne rosacea
What conditions should you use Chloramphenicol for? (4)
Same as aminoglycosides, but bacteriostatic rather than bactericidal
(i.e. prophylaxis, bac conj, bleph/hordeola, canalic/dacryo)