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312 Eye/ENT/Dental/Pain > Drug List > Flashcards

Drug List Flashcards

(89 cards)

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1
Q

Acetazolamide (Diamox)
Brinzolamide (Azopt)
Dorzolamide (Trusopt)

Indication

A

Glaucoma (open angle & angle closure)

[Open angle glaucoma; 2nd line after PGAs & BBs, alternative to AAs]

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2
Q

Acetazolamide (Diamox)
Brinzolamide (Azopt)
Dorzolamide (Trusopt)

Mechanism of action

A

CARBONIC ANHYDRASE INHIBITOR

Inhibits carbonic anhydrase in ciliary processes –> reduces HCO3- production –> reduces aqueous production –> reduces IOP

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3
Q

Acetazolamide (Diamox)
Brinzolamide (Azopt)
Dorzolamide (Trusopt)

Main side effects

A

Parasthesia (“pins & needles”) –> reversible upon discontinuation
Burning, stinging [brinzolamide less than acetazolamide, dorzolamide]
Blurred vision [brinzolamide more likely –> suspension formulation]

Nausea, vomiting, diarrhoea
Headache, dizziness

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4
Q

Acetazolamide (Diamox)
Brinzolamide (Azopt)
Dorzolamide (Trusopt)

Contraindications

A

[A] Severe hepatic impairment
- Reduces ammonia clearance –> increased risk of hepatic encephalopathy

Severe renal impairment
- Risk of acidosis due to electrolyte imbalance

Long-term administration in PACG

Sulfonamide hypersensitivity

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5
Q

Baclofen (Pacifen)

Indication

A

Neuropathic pain [trigeminal neuralgia; 2nd line after carbamazepine/phenytoin]

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6
Q

Baclofen (Pacifen)

Mechanism of action

A

MUSCLE RELAXANT

Derivative of GABA –> stimulates GABA receptors –> inhibits neurotransmission –> decreases muscle spasm –> antinociceptive

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7
Q

Baclofen (Pacifen)

Main side effects

A

Sedation

GI disturbances, nausea
Dry mouth
Confusion

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8
Q

Baclofen (Pacifen)

Contraindications

A

Refractory epilepsy

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9
Q

Bimatoprost
Latanoprost
Travoprost

Indication

A

Ocular hypertension, raised IOP

[Primary open-angle glaucoma]

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10
Q

Bimatoprost
Latanoprost
Travoprost

Mechanism of action

A

PROSTAGLANDIN ANALOGUE

Synthetic prostamide
- Increases aqueous outflow through both trabecular & uveoscleral outflow –> decrease IOP

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11
Q

Bimatoprost
Latanoprost
Travoprost

Main side effects

A

Iris pigmentation esp. of mixed colour → become more brown

Longer, thicker eyelashes → reversible upon discontinuation

Conjunctival hyperaemia (less likely with latanoprost)

Sunken appearance of eyes
Red eyes, irritation (due to benzalkonium preservative)

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12
Q

Bimatoprost
Latanoprost
Travoprost

Contraindications/cautions

A

CI: History of recurrent HSV associated with PGAs

C: Macular oedema –> disruption of blood-aqueous humour barrier

C: Active intraocular inflammation eg. iritis, uveitis (middle tissue layer of eye wall)

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13
Q

Brimonidine

Indication

A

Ocular hypertension, raised IOP

[Primary open-angle glaucoma]

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14
Q

Brimonidine

Mechanism of action

A

ALPHA AGONIST

Alpha 2-adrenoceptor agonist

  • Reduces aqueous production
  • Increases aqueous outflow by uveoscleral outflow
  • -> Decrease IOP
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15
Q

Brimonidine

Main side effects

A

Dry mouth
Ocular hyperaemia
Burning/stinging

–> Reversible upon discontinuation

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16
Q

Brimonidine

Contraindications/cautions

A

CI: MAOI treatment within 14 days

C: Severe CVD

C: Postural hypotension

C: Depression

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17
Q

Carbamazepine (Tegretol)

Indication

A

Trigeminal neuralgia (1st line)

[Antiepileptic]

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18
Q

Carbamazepine (Tegretol)

Mechanism of action

A

ANTIEPILEPTIC

Blocks voltage-gated Na+ channels –> prevents action
potentials –> prevents nerve activity

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19
Q

Carbamazepine (Tegretol)

Main side effects

A

CNS disturbances

  • Poor balance
  • Dizziness, drowsiness
  • Fatigue

GI effects

  • Nausea
  • Vomiting

Allergic skin reactions

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20
Q

Carbamazepine (Tegretol)

Contraindications/cautions

A

CI: AV conduction abnormalities

CI: MAOI use within 14 days

C: Potent CYP3A4 inducer –> OCs, warfarin

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21
Q

Carbomer (Poly Gel)

Indication

A

Dry eye, unstable tear film

[Meibomian gland dysfunction may be a consequence of blepharitis]

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22
Q

Carbomer (Poly Gel)

Mechanism of action

A

Thickening agent –> occlusive barrier –> reduces dryness of eyes

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23
Q

Carbomer (Poly Gel)

Main side effects

A

Irritation, blurred vision –> transient

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24
Q

Chloramphenicol (Chlorafast, Chlorsig)

Indication

A

Bacterial eye infections

[Conjunctivitis]

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25
Chloramphenicol (Chlorafast, Chlorsig) Mechanism of action
BROAD-SPECTRUM ANTIBIOTIC Prevents tRNA attachment to ribosome --> stop protein synthesis [bacteriostatic]
26
Chloramphenicol (Chlorafast, Chlorsig) Main side effects
Transient stinging
27
Choline salicylate (Bonjela) Indication
Oral & perioral lesions
28
Choline salicylate (Bonjela) Mechanism of action
ANTI-INFLAMMATORY Relieves pain/discomfort with ulcers
29
Choline salicylate (Bonjela) Main side effects
Stinging upon application
30
Choline salicylate (Bonjela) Contraindications/cautions
CI: Under 4 months old C: 30mins before reinsertion of dentures C: frequent dosing --> salicylate poisoning
31
Codeine Morphine Oxycodone Indication
Pain [Dental pain]
32
Codeine Morphine Oxycodone Mechanism of action
OPIOID AGONIST Codeine is a prodrug of morphine Bind to opiate receptors in CNS --> inhibit ascending pain pathways --> modulates pain perception & decreases response
33
Codeine Morphine Oxycodone Main side effects
Tolerance, dependence Constipation (more with codeine) Drowsiness Nausea, vomiting
34
Codeine Morphine Oxycodone Contraindications/cautions
Ci: acute head injury CI: intestinal colitis CI: under 12 yo C: asthma, COPD --> increased risk of respiratory depression C: ultra-rapid metabolisers --> increased risk of morphine toxicity
35
Dexamethasone (in Sofradex) Indication
Otitis externa
36
Dexamethasone (in Sofradex) Mechanism of action
CORTICOSTEROID Increased lipocortin production --> suppresses phospholipase --> suppresses conversion of phospholipids into arachidonic acid → no COX/LOX pathways → inflammation is suppressed
37
Dexamethasone (in Sofradex) Main side effects
Local sensitivity reactions Systemic effects: - Taste distortion - Dizziness - Headache
38
Dexamethasone (in Sofradex) Cautions
Prolonged use --> max 2 weeks Application to broken skin --> dampen inflammatory response
39
Fusidic acid (Fucithalmic) Indication
Bacterial eye infections [Conjunctivitis]
40
Fusidic acid (Fucithalmic) Mechanism of action
NARROW-SPECTRUM ANTIBIOTICS Inhibits bacterial protein synthesis
41
Fusidic acid (Fucithalmic) Main side effects
Burning, stinging --> transient
42
Fusidic acid (Fucithalmic) Contraindications
Contact lenses for duration of treatment --> scratches on lenses (also includes benzalkonium preservative)
43
Gabapentin Pregabalin Indication
Neuropathic pain [Trigeminal neuralgia]
44
Gabapentin Pregabalin Mechanism of action
ANTIEPILEPTIC Blocks voltage-gated Ca2+ channels --> reduce Ca2+ influx --> decrease release of neurotrasmitters associated with neuropathic pain
45
Gabapentin Pregabalin Main side effects
``` Dry mouth Peripheral oedema Weight gain Abnormal gait Confusion, dizziness, drowsiness ```
46
Gabapentin Pregabalin Contraindications/cautions
C: severe renal impairment --> reduce dose C: abrupt withdrawal --> taper over 1 week+ C: tolerance, dependence
47
Hypromellose (Poly-Tears) Indication
Dry eye
48
Hypromellose (Poly-Tears) Mechanism of action
ARTIFICIAL TEARS Swells & absorbs water --> expand thickness of tear film --> extended lubricant time on cornea --> reduced eye irritation due to dry eye
49
Hypromellose (Poly-Tears) Main side effects
Blurred vision Ocular discomfort/irritation
50
Hyperosmotic agents --> mannitol Indication
Angle-closure glaucoma (fast onset of action)
51
Hyperosmotic agents --> mannitol Mechanism of action
OSMOTIC DIURETIC Increases water excretion --> decreases IOP
52
Hyperosmotic agents --> mannitol Main side effects
Hypotension Fluid & electrolyte imbalance
53
Hyperosmotic agents --> mannitol Contraindications/cautions
CI: heart failure, pulmonary oedema CI: dehydration C: renal impairment
54
Levocabastine (Livostin) Indication
Allergic conjunctivitis
55
Levocabastine (Livostin) Mechanism of action
ANTIHISTAMINE Binds to H1 receptors --> decreases histamine release --> reduces inflammation associated with allergies
56
Levocabastine (Livostin) Main side effects
Stinging upon administration
57
Lignocaine Indication
Dental anaesthesia
58
Lignocaine Mechanism of action
LOCAL ANAESTHETIC Block propagation of nerve fibres --> prevent depolarisation of action potentials --> block nerve activity & pain
59
Lignocaine Main side effects
Allergic reactions (rare)
60
Lignocaine Cautions
Tongue numbness may increase risk of bite trauma
61
``` Lodoxamide (Lomide) Sodium cromoglycate (Cromo-Fresh, Rexacrom) ``` Indication
Allergic conjunctivitis, esp. seasonal
62
``` Lodoxamide (Lomide) Sodium cromoglycate (Cromo-Fresh, Rexacrom) ``` Mechanism of action
MAST CELL STABILISER Decreases mast cell activity --> less histamine released --> reduces inflammation associated with allergies
63
``` Lodoxamide (Lomide) Sodium cromoglycate (Cromo-Fresh, Rexacrom) ``` Main side effects
Burning, stinging, itching Blurred vision, tear production disturbance, ocular discomfort (more with lodoxamide)
64
``` Lodoxamide (Lomide) Sodium cromoglycate (Cromo-Fresh, Rexacrom) ``` Cautions
Adherence & up to 1 week to see effect Benzalkonium preservative --> 15 mins for contact lenses
65
Macrogol 400 & propylene glycol (Systane) Indication
Dry eye
66
Macrogol 400 & propylene glycol (Systane) Mechanism of action
Protects ocular surface & replenishes tear film lipids --> compensate for Meibomian gland dysfunction
67
Macrogol 400 & propylene glycol (Systane) Main side effects
Burning, stinging upon application
68
Olopatadine (Patanol) Indication
Allergic conjunctivitis
69
Olopatadine (Patanol) Mechanism of action
ANTIHISTAMINE & MAST CELL STABILISER Binds to histamine receptors --> no inflammation associated with allergies Stabilise mast cells --> no histamine released --> no inflammation associated with allergies
70
Olopatadine (Patanol) Main side effects
Headache Blurred vision Burning, stinging, local irritation
71
Paracetamol (Panadol) Indication
Pain [dental pain, trigeminal neuralgia]
72
Paracetamol (Panadol) Contraindications/cautions
CI/C: liver impairment C: overdose
73
Pilocarpine Indication
Glaucoma [most usually in PACG]
74
Pilocarpine Mechanism of action
Stimulate ciliary muscles --> opens trabecular meshwork --> increase aqueous outflow --> decrease IOP
75
Pilocarpine Main side effects
Excessive pupil constriction --> lead to frontal headache Blurred vision Loss of accommodation --> lou fa
76
Pilocarpine Contraindications/cautions
CI: Acute iritis CI: Retinal detachment C: GI spasm C: asthma C: CVD
77
Retinol palmitate (VitA POS) Indication
Ocular lubricant [dry eye]
78
Retinol palmitate (VitA POS) Mechanism of action
VITAMIN A [found in natural lacrimal fluid] Occlusive barrier over cornea --> stops evaporation of tears overnight
79
Retinol palmitate (VitA POS) Main side effects
Blurred vision (ointment) --> apply at night
80
Timolol Indication
Glaucoma
81
Timolol Mechanism of action
BETA BLOCKER (NONSELECTIVE) Binds beta-adrenoceptors in ciliary processes --> reduce aqueous production --> decrease IOP
82
Timolol Main side effects
Dryness, irritation Blurred vision Macular oedema
83
Timolol Contraindications/cautions
CI: bradycardia, heart block, uncontrolled heart failure CI: asthma, COPD C: diabetes
84
Tramadol (Tramal SR) Indication
Pain
85
Tramadol (Tramal SR) Mechanism of action
OPIOID AGONIST & OTHER CNS EFFECTS Bind to opiate receptors in CNS --> inhibit ascending pain pathways --> modulates pain perception & decreases response Also inhibits reuptake of noradrenaline & serotonin --> further contributes to analgesic activity
86
Tramadol (Tramal SR) Main side effects
Drowsiness Nausea Vomiting
87
Tramadol (Tramal SR) Contraindications/cautions
CI: uncontrolled epilepsy C: impaired respiratory function eg. asthma, COPD --> increased risk of respiratory depression
88
``` Chlorobutanol (Cerumol) Docusate sodium (Waxsol) ``` Indication
Removal of ear wax [otitis; especially if impacted, hard for doctor to see]
89
``` Chlorobutanol (Cerumol) Docusate sodium (Waxsol) ``` Mechanism of action
WAX SOFTENERS Increases absorption of water into ear wax --> softens & breaks it up

312 Eye/ENT/Dental/Pain (9 decks)

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