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Flashcards in Eye Deck (50):
1

Meds are put into the eye for ____ effects only

local

(no systemic absorption necessary with eye)

2

How would you increase the dose of drug delivered to the eye?

increase the CONCENTRATION, not the volume

3

How are toxicities delivered with eye drugs?

-local toxicities are common
-systemic often limit drugs and doses that can be used topically in the eye (not very common)

4

Ointment info
-benefits
-downsides

-ointments better adherence to eye
-more drug exposure of eye to drug
-less leakage down nasolacrimal duct
-less frequent application
-causes blurry vision (often use ointments at bedtime because of this)

5

How should you apply meds if you are prescribed both drops and ointment

drops first, then ointment

6

Prostaglandin Analogs (for glaucoma) MOA

increase drainage of aqueous humor

7

ADRs of prostaglandin analogs

-well tolerated; mostly local ADRs
-hyperemia (redness)
-punctate erosions (local irritating effect)
-blurred vision
-change color of iris - permanently
-hypertrichosis (increase hair)
(recently approved to help grow eye lashes)

8

List Prostaglandin analogs available

-Latanoprost (Xalatan)
-Bimatoprost (Lumigan)
-Travoprost (Travitan Z)

9

MOA of Beta Blockers (for glaucoma)

-decrease secretion of aqueous humor
so less aqueous humor made

10

Local ADRs of beta blockers

-stinging
-blepharitis (inflammation of eye lash follicles)
-blurred vision

11

Systemic ADRs of beta blockers

*systemic effects are important
-get hypotension
-bradycardia
-heart failure
-worsening asthma

12

List beta blockers used in glaucoma

-timolol (Istolol & Timoptic)
-Carteolol (Occupress)
-Levobunolol (Betagan)

13

MOA of alpha agonist (for glaucoma)

-decreases production of aq. humor
-increases outflow of aq. humor

14

Local ADRs of alpha agonists

-allergic rxns
-so not as popular as beta blockers and prostaglandin analogues

15

Systemic ADRs of alpha agonists

*systemic effects important
-dizziness
-fatigue
-sleepy
-dry mouth
-decreased blood pressure

16

List alpha agonists used in glaucoma

-Apraclonidine (Iopidine)
-Brimonidine (Alphagan P) (also combined w/timolol as Combigan)

17

MOA of Carbonic Anhydrase Inhibitors (for glaucoma)

-reduce production of aq. humor
(like a diuretic for the eye)

18

local ADRs carbonic anhydrase inhibitors

-stinging
-tearing
-blurred vision

19

Systemic ADRs of carbonic anhydrase inhibitors

-few

20

List carbonic anhydrase inhibitors

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

21

MOA of Cholinomimetics (for Glaucoma)

-stimulate contraction of ciliary muscle
-pulls open trabecular meshwork and relieves intraocular pressure
-increases drainage of humor

22

local ADRs of cholinomimetics

-miosis
(decreases night vision)
-HA
-periorbital pain

23

Systemic ADRs of cholinomimetics

rare

24

list cholinomimetics for glaucoma

pilocarpine

25

MOA Artificial tears (for dry eye/ as lubricants)

-hydrates & lubricates eye
-stimulates tears
-decreases evaporation of tears

26

ADRs for artificial tears

irritation if preservative in preparation

27

MOA lubricating eye ointments

-similar to artificial tears
-more occlusive and work better than artificial tears

28

MOA cyclosporine (restasis)

powerful immunosupresant used topically
-helps chronic dry eye
-not sure how

29

local ADRs cyclosporine (restasis)

stinging
maybe more eye infections

30

systemic ADRs cyclosporine

-systemic absorption
-immunosuppresions
-these are concerns but haven't been seen

31

MOA of vasoconstrictors in eye (for dry eye)

alpha agonists decrease redness by temporarily constricting BVs
-eye decongestants

32

local ADRs vasoconstrictors

rebound
increase inraocular pressure
local irritation

33

systemic ADRs vasoconstrictors

-adrenergic agonist effect

34

List vasoconstrictors for eye

-Naphazoline (clear eyes)
-tetrahydrozoline (Visine)
-oxymetazoline (Visine LR)

35

List Ocular Antihistamines

-Alcaftadine (lastacaft)
-Azelastine (Optivar)
-Bepotastine (Bepreve)
-Olopatadine (Pataday/Patanol)
-Emedastine (Emadine)
-Epinastine (Elestat)
-Ketotifen (Zaditor, Claritan, Alaway)

36

MOA Ocular Abx

-kill bacteria in eye
for conjunctivitis, blepharitis, keratitis, stys, prophylactically before & after surgery

37

ADRs ocular antibiotics

depends on abx
-resistance is problem

38

List ocular antibiotics

-Besifloxaxin (Besivance)
-Moxifloxacin (Moxeza & Vigamox)
-Gatifloxacin (Zymaxid)
-Erythromycin
-Gentamycin
-Suflacetamide
-Tobramycin

39

MOA ocular corticosteroids

decrease inflammation in inflammatory eye conditions

40

Local ADRs ocular corticosteroids

-increased IOP, infections, cataracts, scleral thinning, corneal melting

41

systemic ADRs ocular corticosteroids

the usual? what!

42

List ocular corticosteroids

-Prednisolone (Pred Forte)
-Dexamethasone (Ozurdex)
-Difluprednate (Durezol)
-Fluoromethalone (FML)
-Loteprednol (lotemax)

43

Drugs given systemically with adverse effects on the eye

-Hydroxychloroquine
-Chloroquine
-Slidenafil Viagra)
-Corticosteroids

44

Hydroxychloroquine

An immunomodulator that deposits pigment in back of eye, can cause blindness if used longterm

45

Chloroquine

used for malaria, same as hydroxychloroquine

46

Sildenafil (Viagra)

phosphodiesterase inhibitor may rarely cause blindness more commonly can see color changes with its use (likely happens with all drugs in this class)

47

Corticosteroids

oral or topical can increase IOP & cause cataracts

48

Drugs that increase open-angle glaucoma risk

-corticosteroids (ophthalmic or oral)
-anticholinergics (topical)

49

Drugs that increase closed-angle glaucoma risk

-topical & systemic anticholinergics
-topical sympathomimetics
-antihistamines
-anti-depressants
-topiramate
-phenothiazines

50

A 65 year old man presents for a routine physical exam. You note on last years exam he had brown eyes. This year his irises appear to be hazel in color. Which topical eye medication might be responsible for this change?

Prostaglandin analogues