Z - Medications

Question 1

Bacitracin (2)

Answer 1

Mainly for gram +

Effective for staph bleph with warm compresses

Question 2

Aminoglycosides (4)

Answer 2

Broad coverage

Significant HS: neo > genta > tobra
—> fluoros are now preferred for broad coverage

Tobramycin: less HS, covered by many insurances

Neo doesn’t cover pseudomonas

Question 3

Fluoroquinolones (6)

Answer 3

Besivance (suspension)

Ciloxan

Moxifloxacin: Vigamox/Moxeza

• preservative fre
• Moxeza can be used >/= 4mo

Ocuflox

Zymaxid

C and O generics are covered by insurances

Question 4

Polymixin B (3)

Answer 4

Gram -

Usually coupled with gram + agent

Use as little as 2 mo

Question 5

Polysporin (3)

Answer 5

Polymixin B + Bacitracin

Often used in peds

Useful for nighttime coverage

Question 6

Neosporin (2)

Answer 6

Polymixin B + Bacitracin + Neomycin

Not commonly used due to neo HS

Question 7

Erythromycin (4)

Answer 7

Approved for infants and adults

Gentle ointment with less toxicity

Ineffective against pseudomonas

Ung only

Question 8

NLDO (4)

Answer 8

Topical ABs for discharge (not obstruction)

Any broad spec

ung polysporin, trobramycin, or erythromycin BID

Parent massage, clean area

Question 9

Bacterial conjunctivitis (3)

Answer 9

Copious discharge

Culture severe cases

Topical agents: polymyxins, erythromycin, bacitracin, FLUOROs!

Question 10

Medications NOT ON THE LIST for children and why (2)

Answer 10

Sulfacetamide -> Stevens-Johnson

Chloramphenicol -> aplastic anemia, may lead to death

Question 11

Oral antibiotics

• why
• what
• can also use

Answer 11

Acute hordeolum, preseptal

Cephalosporin (g+)

• Keflex BID x 7 days (or Augmentin)
• if insurance issue -> PCN
• if PCN allergy: erythro, fluoro

Warm compresses
Can add trobradex BID

Question 12

Allergy meds

• topicals (3)
• combos (3)
• vasoconstrictor
• NSAID

Answer 12

Mast cell stabilizers = alomide, alamast, crolom

MCS + H1 blockers = pataday, bepreve, zaditor

Opcon A (similar to Visine action)

Acular

Question 13

Allergies

-steroids (5)

Answer 13

FML, lotemax, alrex, pred

Dose on severity, taper
Q2hrs -> QID -> BID, etc

Can switch to MCS/H1 when stable

Severe = topical steroids

Contraindicated in epithelial herpetic disease

Question 14

Allergies
-steroids
—Dr O uses this for Trantas Dots
—needs shaken

Answer 14

Alrex

Pred forte

Question 15

HSV keratitis (3)

Answer 15

Ganciclovir (Zirgan)
-dosed as gel 5x/day

Less frequent dosing = decr toxicity

Ointment only

Question 16

Antivirals for skin disease (2)

Answer 16

Acyclovir (Zovirax)

• good choice for children
• covered by insurances, works well

Oral therapy for skin disease for 7-10 days