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eye drugs Flashcards

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1
Q

what is the drug name for fluorescein dye

A

sodium fluorescien

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2
Q

why do we use fluorescein dye

A

to detect abrasions on the cornea (must remove contacts before using)

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3
Q

name two ocular anesthetics

A

proparacaine hydrochloride 0.5%

tetracaine 0.5%

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4
Q

what should you NOT do with ocular anesthetics

A

prescribe for repeated use

also do not rub eye for 10 min after use

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5
Q

what are the two types of dilating agents (mydriatics)

A
  1. cholinergic blocking

2. adrenergic stimuating

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6
Q

name 3 types of cholinergic blocking dilating agents/ mydriatics

A
  1. tropicamide 0.5% or 1%
  2. cyclopentolate hydrochloride 0.5%, 1%, 2%
  3. homatropine hydrobromide 2% or 5%
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7
Q

name one type of adrenergic stimulating dilating agents/ mydriatics

A

phenylephrine hydrochloride 2.5-10%

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8
Q

how do the cholinergic blocking dilating agents work

A

dilation by paralyzing the iris sphincter

referred to as cycloplegics –> produce paralysis of accommodation

can also be used for pain relief as it paralyzes the ciliary spasm during iritis etc

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9
Q

how do adrenergic stimulating dilating agents work

A

stimulates the pupillary dilator muscles

no effect on accommodation

dilatory effect is not as strong

mydriatic but NOT cycloplegic

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10
Q

how should you introduce drops to the eye

A

avoid dropping them directly on cornea as it is the most sensitive part of the eye

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11
Q

what do you use if maximum mydriasis is required

A

phenylephrine and tropicamide in combo

in peds, use cyclopentolate and phenylephrine

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12
Q

what drug should never be used by a primary care physician

A

topical ocular corticosteroids

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13
Q

what drug should you use to treat ophthalmic herpes SIMPLEX viral infection

A

topical trifluridine (viroptic)

use only under direction of ophtho

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14
Q

what should you never use to dilate the pupil for a fundus exam

A

atropine or scopolamine

the dilatory effects can last up to 1-2 weeks

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15
Q

what side effects are associated with regular beta blockers?

how does this differ for betaxolol?

A

regular beta blockers have pulmonary SEs and are thus contraindicated in asthma and COPD

betaxolol is cardioselective so less pulm SEs

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16
Q

what is tamsulosin

A

alpha 1a antagonist for BPH

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17
Q

what are the ocular ramifications of tamsulosin

A

can cause intraoperative floppy iris syndrome

flaccid iris–> prolapse from surgical wounds and poor pupillary dilation

higher risk of intraoperative complications for example during cataract surgery

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18
Q

what are the ocular ramifications of thioridazine

A

pigment retinopathy at high doses

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19
Q

list the types/classes of glaucoma meds

A
  1. beta blockers
  2. cholinergic stimulating
  3. alpha 2 agonists
  4. adrenergic stimulating
  5. prostaglandin inhibitors
  6. carbonic anhydrase inhibitors
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20
Q

name beta blockers used to treat glaucoma

A

topical timolol, levobunolol, metipranolol, carteolol

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21
Q

name a cholinergic stimulating drug used to treat glaucoma

A

pilocarpine

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22
Q

how does pilocarpine work

A

increases aqueous flow through the trabecular meshwork

unpleasant SEs in eye and thus unpopular–> often less systemic PNS side effects

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23
Q

name 2 alpha-2 agonist drugs used to treat glaucoma

A

brimonidine tartrate

apraclonidine

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24
Q

how does apraclonidine work

Study These Flashcards
A

decreases aqueous formation and increases outflow

used in critical situations in pressure spikes

25
what drug is used in critical situations of pressure spikes in glaucoma
apraclonidine --> used in ER for temporary control of IOP
26
who should you not give apraclonidine to
infants due to risk of severe hypotension and apnea
27
SEs of apraclonidine
orthostatic hypotension fairly high sensitivity reactions
28
name two adrenergic stimualting drugs used to treat glaucoma
epinephrine dipivefrine
29
how are prostaglandin analogues used to treat glaucoma
increase aqueous outflow through the uveoscleral pathway have no major systemic toxicities have more unique local effects like iris darkening, eyelash lengthening, inflammation/ swelling of eye
30
name two PO carbonic anhydrase inhibitors used to treat glaucoma
PO acetazolamide and methazolamide used for chronic glaucoma management, limited by side effects
31
side effects of PO carbonic anhydrase inhibitors used to treat glaucoma
paresthesia anorexia renal calculi/bone marrow
32
name two intraocular carbonic anhydrase inhibitors used to treat glaucoma
IO dorzolamide, brinzolamide
33
what is the benefit to IO carbonic anhydrase inhibitors to treat glaucoma
similar therapeutic effect but less systemic SEs altered taste is main adverse reaction
34
what ocular effect can the following drug have: amiodarone
optic neuropathy--> mildly decreased vision, visual field defects, bilateral optic disc swelling produces WHORL SHAPED pigmented deposits on the corneal epithelium
35
what should you think of if you see whorl shaped pigmented deposits on the corneal epithelium
amiodarone side effect
36
what is amiodarone
cardiac anti arrhythmic
37
what ocular effect can the following drug have: bisphosphonates
associated with conjunctivitis, scleritis, uveitis symptoms are red eye, photophobia, decreased vision, deep eye pain
38
what do bisphosphonates treat
osteoporosis
39
what ocular effect can the following drug have: chloroquine
can produce corneal deposits and retinopathy retinal damage is insidious, slowly progressive and usually irreversible BULLS EYE macular lesions when damage has already occurred all patients on chloroquine should be referred to ophtho to determine baseline and f/u intervals
40
what should you think of if you see bulls eye lesions on the macula
damage from chloroquine drug
41
what is chloroquine used to treat
rheumatoid
42
what ocular effect can the following drug have: chlorpromazine
produces punctate opacities in the corneal epithelium after long term use reversible with discontinuation
43
what ocular effect can the following drug have: corticosteroids
long term use can cause POSTERIOR SUBCAPSULAR CATARACTS also may cause central serous retinopathy and related macular edema
44
what ocular effect can the following drug have: digitalis
blurred vision abnormally coloured vision objects can appear frosted or have white halo
45
what is digitalis used for
cardiac--arrhythmias etc
46
what ocular effect can the following drug have: diphenyhydantoin
can cause dosage related cerebellar-vestibular effects (nystagmus)
47
what ocular effect can the following drug have: ethambutol
dosage related optic neuropathy
48
what is ethambutol used for
chemo of TB
49
what ocular effect can the following drug have: statins
associated with cataracts when given in excessive doses (not proven)
50
what ocular effect can the following drug have: rifabutin
uveitis
51
what is rifabutin used for
MAC infections
52
what ocular effect can the following drug have: viagra
at peak plasma levels may experience transient impairment of colour discrimination (blue colour tinge) rare at normal dose
53
what ocular effect can the following drug have: tamoxifen
high doses can cause whorl-shaped opacities, retinal crystalline deposits, macular edema, cataracts, optic neuritis rare at normal dose
54
what ocular effect can the following drug have: topiramate
shown to induce acute bilateral angle closure glaucoma
55
what is topiramate used for
treatment of seizure
56
define epiphora
chronic tearing
57
define amblyopia
loss of visual acuity not correctable by glasses in an otherwise healthy eye
58
define photopsias
flashes of light

ophtho (5 decks)

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