8 - Toxicology Flashcards

1
Q

Cornea

-whorl keratopathy (5 drugs, 1 systemic dz)

A
CHAI-T
Chloroquine
Hydroxychloroquine
Amiodarone
Indomethacin (gout)
Tamoxifen

Systemic dz: Fabry’s

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2
Q

Cornea

-dry eye disease

A

All drugs preserved with BAK, incl topical ophthalmic glaucoma meds

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3
Q

Cornea

-SPK (2)

A

Isotretinoin: severe dryness (MGs)

Topical ophthamic aminoglycosides: TobraGent = ocular surface disease

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4
Q

Cornea

-endothelial/descemet’s membrane pigmentation (3)

A

ChlorpromaZINE
ThioridaZINE
PromethaZINE (1st gen antihistamine)

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5
Q

Cornea

-stromal gold deposits

A

Gold salts

-can result in visual asymptomatic yellow-brown deposits within posterior stroma/descemet’s (ocular chrysiasis)

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6
Q

Cornea

-delayed corneal healing

A

Topical ophthalmic and oral corticosteroids

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7
Q

Amiodarone

  • use
  • ocular SEs (3)
A

Anti-arrhythmic

Whorl K
Anterior subcapsular lens deposits
NAION (1-2%)

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8
Q

Lens

-anterior subcapsular effects (4)

A
“May Trigger Anterior Cataracts”
Miotics (vacuoles)
Thioridazine
Amiodarone
Chlorpromazine
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9
Q

Lens

-posterior subcapsular cataracts

A

Corticosteroids

-dose-dependent, irreversible, Hispanics at highest risk

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10
Q

Conj and Lids

-blepharoconj-itis, dryness, lid edema

A

Isotretinoin (MGs + Zeis)

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11
Q

Conj and Lids

-subconj hemorrhage (1 drug, 2 other)

A

NSAIDs/blood thinners (warfarin, clopidogrel, dipyradimole)

Valsalva

Clotting dz

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12
Q

Conj and Lids

-Steven-Johnson syndrome, lid edema (rare)

A

Sulfonamides

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13
Q

Conj and Lids

-pigmented cysts on conj

A

Tetracyclines

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14
Q

Conj and Lids

-subconj hemorrhage, conj hyperemia

A

Sildenafil (vasodilates)

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15
Q

Conj and Lids

-conj hyperemia, incr growth of lashes, incr periorbital pigmentation

A

PGAs

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16
Q

Conj and Lids

-conj-itis in 1% of pts

A

Tamiflu

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17
Q

Lacrimal system

-decr tear secretion (6 categories)

A

Anticholinergic effects (decr PNS): ANTI-cholinergics, ANTI-depressants, ANTI-histamines, ANTI-psychotics

Isotretinoin

Beta blockers (doesn’t make sense, just know it)

Hormone therapies: oral contraceptives, replacement therapies

ADHD meds: methylphenidate, dextroamphetamine

Diuretics: HCTZ, chlorothiazide, furosemide, triamterene

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18
Q

Pupil size

-mydriasis

A

Anticholinergic effects (decr PNS): ANTI-cholinergics, ANTI-depressants, ANTI-histamines, ANTI-psychotics

*watch for angle closure with narrow angles

19
Q

Pupil size

-miosis (3)

A

Opiates: morphine, heroine, cocaine

AChase inhibitors (indirect cholin agonists)

Pilocarpine

20
Q

EOMs/eye movements

-nystagmus (3)

A

Phenytoin (“funnytoin”)

Phenobarbital

Salicylates (NSAIDs)

21
Q

EOMs/eye movements

-diplopia (3)

A

Phenytoin

Anti-depressants

Anti-anxiety

22
Q

EOMs/eye movements

-smooth pursuit impairment

A

Alcohol

23
Q

EOMs/eye movements

-oculogyric crisis (2)

A

Phenothiazines

Cetirizine

*oc = EOMs undergo spastic, abnorm musc contractions that leave the eye in abnorm positions (esp elev)

24
Q

Sclera and uvea

-intraoperative floppy eyelid syndrome

A

Alpha1 blockers (for BPH): tamsulosin, terazosin, prazosin

25
Q

Sclera and uvea

-blue sclera (2)

A

Corticosteroids

Minocycline (tetracycline)

26
Q

Sclera and uvea

-secondary angle closure (1)

A

Topiramate

  • choroidal swelling -> iris forward into apposition with TM
  • also myopic shift
27
Q

Optic nerve

-retrobulbar optic neuritis, B/Y defects, entopic phenomena

A

Digoxin

28
Q

Optic nerve

-optic neuritis (4 + 2 unlikely)

A

Ethambutol = retrobulbar, bilateral

Chloramphenicol
Streptomycin
Sulfonamides

Unlikely: isoniazid, methotrexate

29
Q

Optic nerve

-NAION (4)

A
VIAgra
Viagra
Vardenafil
Imitrex
Amiodarone
30
Q

Optic nerve

-optic neuritis, papilledema, pseudotumor cerebri

A

Oral contraceptives

31
Q

Retina

-bull’s eye maculopathy

A

Chloroquine&raquo_space;> hydroxy

32
Q

Retina

-CME (esp topical ophthalmic in aphakic eyes)

A

Epinephrine

33
Q

Retina

-white/yellow crystalline deposits (esp macula), +/- macular edema

A

Tamoxifen

34
Q

Retina

-pigementary retinopathy (may app similar to bull’s eye) (3)

A

ThioridaZINE
ChlropromaZINE
PromethaZINE

35
Q

Retina

-retinal hemorrhage, pigmentary changes (mottling, esp macular)

A

Indomethacin (gout, also whorl K)

36
Q

Retina

-retinopathy: white, shiny emboli w/in arterioles

A

Talc

37
Q

Retina

-loss of color vision, nyctalopia

A

Isotretinoin

38
Q

Retina

-retinal hemorrhage

A

NSAIDs

39
Q

Retina

-vasculopathy (incl A/V occlusions), retinal hemorrhage

A

Oral contraceptives

40
Q

Retina

-macular edema

A

Zidovudine

41
Q

Intracranial hypertension (6)

A
CATS
Contraceptives
Accutane, vit A
Tetracycline
Synthroid, steroids
42
Q

IOP

-systemic that decr (4)

A

BB
Cardiac glycosides (digoxin)
Alcohol
Cannabinoids

43
Q

IOP

-systemic that incr (4 categories)

A

Anticholinergics: ANTIs, atropine, scopolamine
Short-acting B2 agonists (albuterol, levalbuterol, terbutaline)
Pseudophedrine
Corticosteroids