Eye Drugs

Question 1

antiallergic ophthalmic drugs

Answer 1

• works by BLOCKING HISTAMINE RECEPTORS to block histamine release from mast cells
• decreases EYE IRRITATION & ITCHING

Question 2

antiallergic ophthalmic - indications

Answer 2

• allergic conjunctivitis
• keratitis

Question 3

antiallergic ophthalmic - adverse effects

Answer 3

• BURNING & TEARING of eye
• pancytopenia (deficiency in blood cells) *CROMOLYN
• corneal ulcers/ocular edema *LODOXAMIDE

Question 4

anesthetics

Answer 4

• works by anesthetizing the cornea
• important for application of measurement of IOP, removing any foreign bodies, or scraping of conjunctiva or cornea
• prevents IRRITATION and TRANSMISSION of NERVE IMPULSES

Question 5

Anesthetics - what are they?

Answer 5

• proparacaine
• tetracaine
  (end in caine)

Question 6

anesthetics - adv effects

Answer 6

• eye pain
• redness
• contact dermatitis
• (rare) seizures or CNS depression

Question 7

anti-infectives - MOA

Answer 7

• can be either BACTERIOSTATIC/CIDAL *bacteria
• binds to cell membrane STEROLS and increases permeability *antifungal
• or inhibits DNA synthesis *antiviral

Question 8

anti-infectives - indications

Answer 8

• corneal ulcers
• conjunctivitis *bacterial, fungal or viral

Question 9

anti-infectives - adv effects

Answer 9

• itching
• burning
• ocular irritation
• conjunctivitis
• *SJ SYNDROME *with SULFACETAMIDE and TOBRAMYCIN

Question 10

examples of anti-infectives for fun :0

Answer 10

Azithromycin, bacitracin, ciprofloxacin, erythromycin, gentamycin, levofloxacin,
natamycin, ofloxacin, sulfacetamide, tobramycin, trifluridine, & trimethoprim-
polymyxin B

(many end in -cin)

Question 11

anti-inflammatories *STEROIDAL

Answer 11

• decreases the IMMUNE RESPONSE at the site of inflammation
• always want to assess if patient is on multiple steroids > can increase risk of CUSHINGS DZ

Question 12

what are our steroidal anti-inflammatories?

Answer 12

• dexamethasone
• fluorometholone
• loteprednol
• prednisolone

Question 13

adv effects - steroidal anti-inflammatories

Answer 13

• stinging and burning
• secondary ocular infections
• delayed corneal healing *with longer use

Question 14

non-steroidal anti-inflammatories

Answer 14

• for DECREASING INFLAMMATION and ITCHING
• helps to treat OCULAR INFLAM after surgery
• do NOT COMBINE with ENOXAPARIN > leads to increased risk of OCULAR BLEEDING

Question 15

what are our non-steroidal anti-inflammatories?

Answer 15

• diclofenac
• ketorolac
  *end in lac

Question 16

adverse effects - non-steroidal anti-inflammatories

Answer 16

• ocular irritation
• keratitis
• blurred vision

Question 17

lubricants

Answer 17

• acts as ARTIFICAL TEARS to lubricate cornea
• can act as a PROTECTANT during procedures
• helps to MOISTEN contact lens
• mainly OTC

Question 18

adverse effects - lubricants

Answer 18

• ocular irritation
• photophobia
• transient blurred vision

Question 19

what are our eye lubricants?

Answer 19

• carboxymethylcellulose (refresh)
• hydroxypropyl cellulose
• polyvinyl alcohol

Question 20

what is the difference between MYDRIATICS & CYCLOPLEGICS?

Answer 20

• MYDRIATICS: DILATES the eye
• CYCLOPLEGICS: temporarily paralyzes the EYE MUSCLE

mainly used for eye exams, procedures, or treating iris conditions

Question 21

what are our MYRDRIATICS and CYCLOPLEGICS?

Answer 21

• atropine sulfate (AS)
• cyclopentolate (CY)
• phenylephrine (PH)
• tropicamide (TRO)

Question 22

drug interactions - mydriatics & cycloplegics

Answer 22

• AS, CY, & TRO; should not be combined with CLOZAPINE *increases risk of ANTICHOLINERGIC TOXICITY
• AS & PH; decreases VALSARTAN & AMLODIPINE
• AS & PH; increases HTN w/ IBUPROFEN, CAFFEINE, & MODAFINIL
• CY & TRO; w/ CLOMIPRAMINE = increases ANTICHOL ADV EFFECTS
• PH; not good with COCAINE USERS/MAOIs *causes arrhythmias

Question 23

adverse effects - mydriatrics & cycloplegics

Answer 23

• blurry vision
• conjunctivitis
• IOP
• photophobia

severe ones;
- seizures, tachy, resp. depression w/ AS, CY, & TRO
- PH; tachy, subara. hemorrhages, or MI

Question 24

beta-adrenergic blockers

Answer 24

• prevents & controls ELEVATED IOP for acute ANGLE-CLOSURE & OPEN-ANGLE GLAUCOMA
• decreases the AQUEOUS HUMOR; blocks nerve endings to produce fluid

Question 25

what are our beta-adrenergic blockers?

Answer 25

- betaxolol - carteolol - levobunolol - timolol maleate

Question 26

drug interactions - beta-adrenergic blockers

Answer 26

do not use with CLONDINE, QUINIDINE, or VERAPAMIL *causes AV blockages or BRADYCARDIA

Question 27

adverse effects - beta-adrenegic blockers

Answer 27

- BETAXOLOL; eye discomfort, blurry vision, keratitis, HR, HB, or bronchospasms - CARTEOLOL; similar to betaxolol + PTOSIS & THYROTOXICOSIS - TIMOLOL; cardiac arrest, cerebal ischemia, or Raynaud's dz

Question 28

carbonic anhydrase inhibitors

Answer 28

- decreases aq. humor production - treats OPEN-ANGLE GLAUCOMA & OCULAR HTN

Question 29

what are our carbonic anhydrase inhibitors ?

Answer 29

- brinzolamide - dorzolamide

Question 30

drug interactions - carbonic anhydrase inhibitors

Answer 30

do NOT combine with ACETAZOLAMIDE or TOPIRAMATE

Question 31

adverse effects - carbonic anhydrase inhibitors

Answer 31

can cause DERMATITIS or BLEPHARITIS; severe SJ syndrome or TOXIC EPIDERMAL NECROLYSIS

Question 32

prostaglandin analogues

Answer 32

- decreases IOP by increasing aq. OUTFLOW - mainly is the FIRST TREATMET for OPEN-ANGLE GLAUCOMA

Question 33

what are our prostaglandin analogues?

Answer 33

- bimatoprost - latanoprost - tafluprost -tavoprost *all end in prost - think "prostaglandin"

Question 34

adverse effects - prostaglandin analoues

Answer 34

- bimato, taflu, tavo; PHOTOPHOBIA, DRY EYES, CATARACTS, and MACULAR EDEMA - latano; OCULAR BURNING, BLEPHARITIS, ANGINA, reactivation of HERPES SIMPLEX KERATITIS

Question 35

alpha-adrenergic agonists

Answer 35

- REDUCES AQ. FORMATION & INCREASES outflow by stimulation of ALPHA-adrenergic receptors - used for OPEN-ANGLE GLAUCOMA

Question 36

what are our alpha-adrenergic agonists?

Answer 36

- apraclonidine - brimonidine

Question 37

drug interactions - alpha-adrenergic agonists

Answer 37

- APRACLONDINE; contraindicated - MAOIs, LINEZOLID = HTN crisis - BRIMONIDINE; contraindicated - MIDAZOLAM, PROMETHAZINE, THALIDOMIDE & HYDROCODONE = CNS & RESP DEPRESSION

Question 38

adverse effects of alpha-adrenergics

Answer 38

apraclondine - dizziness - bradycardia - dry eyes - asthma - corneal erosion brimonidine - HTN - dizziness - conjunctivitis

Question 39

cholinergic agonists

Answer 39

- stimulates & contacts the IRIS SPINCTER MUSCLE **CONSTRICTS PUPIL > improves aq. flow - treats ANGLE-CLOSURE GLAUCOMA and prevents ELEVATED IOP postop

Question 40

what are our cholinergic agonists?

Answer 40

- carbachol - pilocarpine

Question 41

drug interactions - cholinergic agonists

Answer 41

- CARBACHOL; X BROMFEN/DICLO/KETOROLAC = increases CHOL effects - PILOCARPINE; X DICYCLOMINE = increases IOP - pyridostigmine, doxepin, and hydroxyzine decreases pilocarpine effectiveness

Question 42

adverse effects - cholinergic agonists

Answer 42

- CARBACHOL; flushing, epigas. pain, retinal detach. - PILOCARPINE; blurry vision, tearing, retinal detach., impaired dark adaptation

Question 43

rho kinase inhibitors

Answer 43

- improves AQ OUTFLOW - treats OPEN-ANGLE GLAUCOMA or OCULAR HTN

Question 44

netarsudil

Answer 44

rho kinase inhibitor med - no known drug interactions, causes ADV EFFECTS of ocular redness, corneal staining or keratitis

Question 45

osmotic agents

Answer 45

- reduces volume of VITREOUS HUMOR and DECREASES IOP by ELEVATING GFR OSMOLARITY

Question 46

what are our OSMOTIC AGENTS? *drug interactions

Answer 46

- IV only; MANNITOL has drug interactions with ACYCLOVIR, AMPHOTER., LIRAGLUTIDE, METHOTREXATE, & CYCLOSPORIN (causes either nephro/neurotoxicity)

Question 47

adverse effects - osmotic agents

Answer 47

- hypotension - dehydration - polyuria [severe - HF, seizures, CNS depression, pulm. edema]