NBEO drug list/KMK/Gen Pharm Flashcards by Joanna Neel

Q

Acetazolamide (Diamox)

A

Carbonic Anhydrase Inhibitor (Diuretic) –po, inhibits CA enzyme, alkalinization of urine (increased HCO3- in urine), diuretic effect only lasts a few to several days, tx for alkalosis

decrease in H+ for exchange w/Na+ results in Na+ loss (stops Na+ reabsorption)
sulfa sensitivity!

-SE: paresthesia!

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Q

Brinzolamide (Azopt)

A

topical Carbonic anhydrase inhibitor - glaucoma drop, decreases aqueous humor production and CSF
-orange cap

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Q

Dorzolamide (Trusopt)

A

topical Carbonic anhydrase inhibitor - glaucoma drop, decreases aqueous humor production and CSF
-orange cap

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Q

Methazolamide (Neptazane)

A

Carbonic anhydrase inhibitor - po, tx glaucoma, decreases aqueous humor production and CSF

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Q

Furosemide (Lasix)

A

Loop Diuretic - blocks the Na+/K+/2Cl- transporter in the thick ascending limb of the loop of Henle, induces kidney prostaglandins (vasodilation) can be used to tx HTN

causes loss of Ca2+ and Mg2+, also Cl- and K+
tx for heart failure (edema), and pulmonary edema, tx hypercalcemia
can cause hypokalemic metabolic alkalosis, hyperuricemia, irreversible ototoxicity, NSAID interference

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Q

Hydrochlorothiazide (Esidrix)

A

Thiazide, most used diuretic, also a common DOC for HTN (C/I for DM pt!)

inhibits Na+ reabsorption at distal tubule -causes decrease of Na+, CO, decrease in blood volume and so decrease in BP
increase in ATP-dependent K+ channel opening, causes hyperpolarization (vasodilation in smooth muscle) and also decreases insulin

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Q

Chlorothiazide (Diuril)

A

Thiazide diuretic, also a common DOC for HTN (C/I for DM pt!)

inhibits Na+ reabsorption at distal tubule -causes decrease of Na+, CO, decrease in blood volume and so decrease in BP
increase in ATP-dependent K+ channel opening, causes hyperpolarization (vasodilation in smooth muscle) and also decreases insulin

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Q

C/I for thiazides

A

causes dry eye, hyperglycemia (C/I for DM pts), hyperlipidemia, lithium toxicity, digitalis toxicity, hepatic coma in cirrhotic pts, hypokalemic metabolic alkalosis, hyperuricemia! (tell pts to stop thiazide before having a surgical procedure)

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Q

Diuretic drug that can be used for patients with a sulfa allergy

A

Ethacrynic acid (Edecrin)

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Q

Triamterene (Dyrenium)

A

Potassium-sparing Diuretic
-reduces the K+ loss caused by the other diuretics, used in combination as they are weak on their own
-inhibit Na+/K+ exchange independently of aldosterone
C/I for burn patients (already hyperkalemic!)

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Q

Spironolactone (Aldactone)

A

Potassium-sparing Diuretic - competitive inhibitor of aldosterone (anti-androgen)

tx edema w/HF, hyperaldosteronism, hirsutism, PMS
SE: occasional hyperkalemia w/ACEI and ARBs
C/I: liver damage, renal insufficiency

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Q

Mannitol (Osmitrol)

A

Osmotic Diuretic
IV only, keeps water in tubules, large amount of water diuresis, keeps water flowing and protects kidney, can be used as prophylaxis of acute renal failure
-decreases IOP and ICP quickly
-SE: cellular dehydration, edema
-C/I: DON’T USE WITH HF pts!

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Q

What is the order of effectiveness for diuretic drugs?

A

Loops >> thiazides >>> K+ sparing drugs

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Q

Hydralazine

A

Antihypertensive - acts through nitric oxide to cause vasodilation - used during pregnancy for long-term tx of severe HTN in combo with other BP-lowering meds and as a last resort
-SE: Lupus!

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Q

Minoxidil (Loniten)

A

Antihypertensive - acts through opening potassium channels (hyperpolarizes membrane) to cause vasodilation
SE: Hypertrichosis

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Q

Nifedipine (Procardia)

A

Calcium Channel Blocker - Dihydropiridine type
-strong vasodilator, more vascular effects, increases HR

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Q

Amlodipine (Norvasc)

A

Calcium Channel Blocker - Dihydropiridine type

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Q

Felodipine (Plendil)

A

Calcium Channel Blocker - Dihydropiridine type

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Q

Verapamil (Calan)

A

Calcium Channel Blocker - strong cardiac effect, decreases HR

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Q

Diltiazem (Cardizem)

A

Calcium Channel Blocker - effects in between Verapamil and Dihydropiridines

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Q

Captopril (Capoten)

A

Angiotensin-Converting Enzyme Inhibitor - works on the renin-angiotensin system
-good choice of anti-HTN med for DM pts

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Q

Enalapril (Vasotec)

A

Angiotensin-Converting Enzyme Inhibitor - works on the renin-angiotensin system
-good choice of anti-HTN med for DM pts

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Q

Quinapril (Accupril)

A

Angiotensin-Converting Enzyme Inhibitor - works on the renin-angiotensin system
-good choice of anti-HTN med for DM pts

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Q

Lisinopril (Zestril)

A

Angiotensin-Converting Enzyme Inhibitor - works on the renin-angiotensin system
-good choice of anti-HTN med for DM pts

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Benazepril (Lotensin)

Angiotensin-Converting Enzyme Inhibitor - works on the renin-angiotensin system -good choice of anti-HTN med for DM pts

Losartan (Cozaar)

Angiotensin receptor blocker - anti HTN blocks AT1 receptor but not AT2 (difference from ACEIs)

Valsartan (Diovan)

Angiotensin receptor blocker - anti HTN blocks AT1 receptor but not AT2 (difference from ACEIs)

Clonidine (Catapres)

Alpha 2 agonist, sympatholytic, anti-HTN

Methyldopa (Aldomet)

Alpha 2 agonist, sympatholytic, anti-HTN -used in pregnancy

Prazosin (Minipress)

Alpha 1 adrenergic blocker, anti-HTN also good for tx BPH

Doxazosin (Cardura)

Alpha 1 adrenergic blocker, anti-HTN

Terazosin (Hytrin)

Alpha 1 adrenergic blocker, anti-HTN

Propranolol (Inderal)

nonspecific Beta-blocker, anti-HTN - reduces sympathetic vasomotor tone but doesn't cause vasodilation unless with NO - SE: bronchoconstriction, decreased insulin release, increase of lipids and atherogenesis, masks hypoglycemia - C/I: asthmatics, DM, hypercholesterolemia, heart block end stage HF

Carvedilol (Coreg)

Combined alpha and beta blocker to tx HTN

Labetalol (Trandate)

Combined alpha and beta blocker to tx HTN, used in pregnancy, HTN emergencies -SE: hepatotoxicity

Metoprolol (Lopressor)

Cardio specific or B1 blocker for treating HTN

*Nebivolol (Bystolic)*

Cardio specific or B1 blocker for treating HTN, has NO (vasodilation)

Atenolol (Tenormin)

Cardio specific or B1 blocker for treating HTN

Nitroglycerin

DOC for tx acute anginal attack

Isosorbide dinitrate (Isordil)

tx angina, decreases oxygen demand SE: headaches, tolerance

Sildenafil (Viagra)

phosphodiesterase type 5 (PDE5) inhibitor tx - ED, pulmonary HTN C/I: Nitrates CYP3A4 interactions

Vardenafil (Levitra)

phosphodiesterase type 5 (PDE5) inhibitor - faster onset than sildenafil

Tadalafil (Cialis)

phosphodiesterase type 5 (PDE5) inhibitor - longer duration

Lovastatin (Mevacor)

HMG-CoA reductase inhibitor - treats hyperlipidemia

Atorvastatin (Lipitor)

HMG-CoA reductase inhibitor - treats hyperlipidemia

Rosuvastatin (Crestor)

HMG-CoA reductase inhibitor - treats hyperlipidemia

Pravastatin (Pravachol)

HMG-CoA reductase inhibitor - treats hyperlipidemia

Simvastatin (Zocor)

HMG-CoA reductase inhibitor - treats hyperlipidemia

Fluvastatin (Lescol)

HMG-CoA reductase inhibitor - treats hyperlipidemia

Cholestyramine (Questran)

bile acid binding resins, very safe but can inhibit other drug absorption

Niacin (Nicotinic acid, Vitamin B3)

impairs synthesis of lipoproteins, effective at increasing HDL and treating hypercholesterolemia

Gemfibrozil (Lopid)

fibric acid derivative - increases catabolism of VLDL, effective at treating hypertriglyceridemia

Fenofibrate (Tricor)

fibric acid derivative - increases catabolism of VLDL, effective at treating hypertriglyceridemia

Warfarin (Coumadin)

clotting factor synthesis inhibitor - anticoagulant, prevention of emboli development -INR(2-3)

Apixaban (Eliquis)

direct inhibitor of factor Xa, anticoagulant

Aminocaproic acid (Amicar)

inhibits tPA, treatment for bleeding disorders (pro-clotting) can be used for hemophilia

Aspirin

inhibitors of prostaglandin production, antiplatelet agent -secondary prevention of CV events

Clopidogrel (Plavix)

inhibitor of ADP-induced platelet aggregation, irreversible, used for pts with aspiring allergy - interacts w/omeprazole - DOC after coronary stent sx

Ticlopidine (Ticlid)

inhibitor of ADP-induced platelet aggregation, irreversible, used for pts with aspiring allergy - interacts w/omeprazole - DOC after coronary stent sx

Dipyridamole

coronary vasodilator, combine with aspirin

Betaxolol (Betoptic)

beta 1 selective blocker, can be used topically in eye to tx glaucoma

Carteolol (Cartol)

partial agonist, beta-blocker, can be used in eye said to have intrinsic sympathetic activity

Tamsulosin (Flomax)

Alpha 1 adrenergic blocker, little effect on BP but used to tx BPH

Phenoxybenzamine (Dibenzyline)

alpha-receptor blocker, irreversible, very long acting

Leuprolide (Lupron)

GnRH agonist, suppresses LH/FSH release (long term), DOC for endometriosis, IVF, precocious puberty, etc.

Goserelin (Zoladex)

GnRH Agonist

Estradiol (Estraderm)

estrogen given in cream/patches

*Ethinyl estradiol*

estrogen used in oral contraceptives (not available individually)

*Premarin*

conjugated estrogens, used for HRT

Tamoxifen (Novaldex)

Antiestrogen - SERM (selective estrogen receptor modulator) tx. pre-menopausal breast cancer, AE: can cause crystalline retinopathy

Raloxifene (Evista)

Antiestrogen, SERM, tx: osteoporosis

Medroxyprogesterone (Provera)

progestin

Drospirenone/ethinyl estradiol (Yasmin, Yaz)

combination oral contraceptive, the only one approved to treat PMDD

*Flutamide (Eulexin)*

Anti-androgen (androgen receptor antagonist) tx: prostate cancer w/GnRH agonist

Finasteride (Propecia)

5a-reductase inhibitor (stops conversion to DHT) tx: BPH and male pattern baldness

Insulin lispro (Humalog)

Rapid-acting insulin - IV

Insulin, inhaled (Afrezza)

Rapid-acting insulin

Regular insulin (Novolin R, Humulin R)

Short-acting insulin, IV

NPH Insulin (Humulin N, Novolin N, isophane)

Intermediate-acting insulins

Insulin glargine (Lantus)

Long-acting insulins

Insulin detemir (Levemir)

Long-acting insulins

Metformin

a biguanide, oral, DOC, only used in type 2 DM, decreases glucose levels (euglycemia), does not increase weight, decreases risk of CV events C/I: renal failure AE: lactic acidosis, diarrhea

*Exenatide (Byetta)*

glucagon-like peptide-1 receptor agonist (GLP-1 RA), incretin mechanism, stimulates pancreas beta cells, causes weight loss AE/caution w/pancreatitis injected

*Sitagliptin (Januvia)*

dipeptidyl-peptidase-IV (DPP-4) inhibitor, inhibits DPP-4 so glucose gets to beta cells better, no effect on weight

Canagliflozin (Invokana)

SGLT-2 inhibitor, oral, weight loss, decrease risk of CV events AE: UTIs C/I: renal impairment

Pioglitazone (Actos)

thiazolidinedione derivative, increases insulin sensitivity AE: edema, increased heart failure risk, macular edema

* Acarbose (Precose)* * Miglitol (Glyset)*

alpha-glucosidase inhibitors, delays carb absorption, causes gas and GI issues, no effect on weight

Glyburide, Glipizide, Glimepiride, Tolbutamide, Chlorpropamide

Sulfonylureas, stimulate insulin release from pancreas beta cells. AE: weight gain, hypoglycemia C/I: sulfa allergy

*Repaglinide*

meglitinides - bind K+ channels, increases insulin release

*Pramlintide (Symlin)*

amylin-like peptide (synthetic analogue), only used as an insulin adjunct, can be used in Type 1 DM, injected, causes weight loss

*Glucagon injection*

hyperglycemic agent to treat hypoglycemia in patients with sufficient glycogen stores, increases glucose levels. produced by alpha cells (pancreas)

Acetaminophen

analgesic and antipyretic, but does NOT have anti-inflammatory properties AE: hepatotoxicity

Cyclobenzaprine (Flexeril)

tx muscle spasms, MOA - decreases somatic motor activity by inhibiting tonic activity of alpha and gamma motor neurons AE - anticholinergic effects, caution for pts w narrow angle glaucoma

Tramadol (Ultram)

analgesic, acts as an agonist at Mu opiate receptors (but not a true opiate), and inhibits serotonin and NE uptake in pain pathways AE: dry mouth, sedation, dizziness, nausea, less miosis than true opiates

Bacitracin

topical antibiotic, **CWI**, prevents the transfer of peptidoglycan into the bacterial cell wall, acts on **gram +**, tx blepharitis often used in Neosporin or Polysporin with polymyxin B (for gram -)

amoxicillin (Principen, Amoxil), ampicillin

oral extended-spectrum penicillin antibiotics, **gram + and -** , but not resistant to beta-lactamase (penicillinase), often paired with clavulanic acid to inhibit beta-lactamase activity (=Augmentin) AE - ampicillin rash!

dicloxacillin (Dynapen)

oral **penicillinase-resistant** penicillin antibiotic, **gram +** with some gram - coverage but not as much as extended-spectrum, tx - hordeloa, preseptal cellulitis, etc. DOC - MSSA

*oxacillin, nafcillin, cloxacillin, methicillin*

oral **penicillinase-resistant** penicillin antibiotics, **gram +** with some gram - coverage but not as much as extended-spectrum DOC - MSSA

MSSA

methicillin-sensitive Staphylococcus aureus

MRSA

methicillin-resistant Staphylococcus aureus

*piperacillin, ticarcillin*

antipseudomonal penicillins

*penicillin G, penicillin V*

penicillin antibiotics, CWI, highest activity of the penicillins against **gram +** bacteria, but is susceptible to beta-lactamase/penicillinase

cephalexin (Keflex)

oral 1st gen cephalosporin, **high G+ activity**, some G-, inhibits transpeptidase, tx - skin infections, dacryoadenitis/cystitis, preseptal cellulitis

ceftriaxone (Rocephin)

IV/IM, 3rd gen cephalosporin, **both gram + and -** , inhibits transpeptidase, penetrates CNS, tx - gonorrhea, orbital cellulitis C/I - neonates (bilirubin displacement), warfarin (excessive blood thinning)

*cefazolin (Ancef)*

IV/IM 1st gen cephalosporin, **high G+ activity**, some G-, inhibits transpeptidase, DOC for sx prophylaxis

*cefaclor (Ceclor)*

oral 2nd gen cephalosporin, **G+ activity**, some G-, inhibits transpeptidase

cefuroxime (Zinacef)

IV/IM, 2nd gen cephalosporin, **G+ activity**, some G-, inhibits transpeptidase

cefepime (Maxipime)

IV, 4th gen cephalosporin, antipseudomonal activity, broadest coverage, **gram + and -** , inhibits transpeptidase

side effects for cephalosporins

GI - anorexia, nausea, diarrhea superinfections, disulfiram-like reaction after alcohol consumption, allergy cross-reactivity, synergistic nephrotoxicity with aminoglycosides

ceftazidime (Fortaz)

IV/IM, 3rd gen cephalosporin, **both gram + and -** , inhibits transpeptidase

vancomycin

IM or po, exclusively **gram +**, prevents transpeptidation of peptidoglycan chains (not PBPs), DOC - MRSA, and C. diff superinfections AE - Red man syndrome, oto- and nephrotoxicity

gentamycin (Garamycin)

aminoglycoside, binds to **30S** subunit, inhibits protein synthesis, effective against gram + and -, mostly **aerobic G-** , including Pseudomonas , bactericidal

tobramycin (Tobrex)

aminoglycoside, binds to **30S** subunit, inhibits protein synthesis, effective against gram + and -, mostly **aerobic G-** , including Pseudomonas , bactericidal

*streptomycin,* amikacin, *neomycin*

aminoglycoside, binds to 30S subunit, inhibits protein synthesis, effective against gram + and -, mostly **aerobic G-** , bactericidal

TobraDex

tobramycin 0.3% and dexamethasone 0.1% tx - inflammatory ocular conditions w assoc bacterial infection such as marginal keratitis, corneal infiltrates

side effects for aminoglycosides

oto- and nephrotoxicity, weakness, GI, allergy caution with loop diuretics, cephalosporins, vancomycin, cidofovir, for doubling risk ocular - SPK, delayed corneal re-epithelialization

tetracycline

tetracycline antibiotic, inhibit protein synthesis, bacteriostatic, bind 30S subunit, broad spectrum

doxycycline

tetracycline antibiotic, inhibit protein synthesis, bacteriostatic, bind 30S subunit, broad spectrum

minocycline

tetracycline antibiotic, inhibit protein synthesis, bacteriostatic, bind 30S subunit, broad spectrum

side effects of tetracyclines

C/I in pregnancy and children \<8yo! AE - pseudotumor cerebri, inhibited bone growth, discolouring of teeth, minocycline may cause blue sclera or pigmented cysts on the conjunctiva

chloramphenicol (Chloromycetin, Chloroptic)

bacteriostatic, inhibits protein synthesis, binds **50S** subunit, broad spectrum G+/-, aerobic and anaerobic, reaches CNS, restricted to life-threatening conditions due to “grey baby” syndrome and fatal aplastic anemia

erythromycin

macrolide antibiotic, bacteriostatic, inhibits protein synthesis by binding to the 50S subunit, mostly gram + coverage AE - drug interactions (CYP3A4), diarrhea/GI, QT prolongation (more azithro), ototoxicity

azithromycin

macrolide antibiotic, bacteriostatic, inhibits protein synthesis by binding to the 50S subunit, mostly gram + coverage AE - diarrhea/GI, QT prolongation, ototoxicity

clarithromycin

macrolide antibiotic, bacteriostatic, inhibits protein synthesis by binding to the 50S subunit, mostly gram + coverage AE - drug interactions (CYP3A4), diarrhea/GI, QT prolongation (mostly azithro), ototoxicity

clindamycin (Cleocin)

anaerobic G+/- and aerobic G+, inhibits protein synthesis, binds 50S subunit, tx - osteomyelitis, MRSA toxicity - C. diff! immediately stop and switch to vancomycin

*linezolid (Zyvox)*

bacteriostatic antibiotic, aerobic G+, reversible nonselective inhibitor of MAO similar AE to MAOIs, drug interactions with antidepressants and risk for serotonin syndrome

Bactrim

sulfamethoxazole and trimethoprim

sulfisoxazole

bacteriostatic sulfonamide antibiotic, inhibits dihydropteroate synthase which converts PABA to dihydrofolic acid (1st step in folic acid synthesis), **gram + and -** , used to treat blepharitis or conjunctivitis but not as much anymore

sulfacetamide

bacteriostatic sulfonamide antibiotic, inhibits dihydropteroate synthase which converts PABA to dihydrofolic acid (1st step in folic acid synthesis), **gram + and -** , used to treat blepharitis or conjunctivitis but not as much anymore (Blephamide)

sulfamethoxazole

bacteriostatic sulfonamide antibiotic, inhibits dihydropteroate synthase which converts PABA to dihydrofolic acid (1st step in folic acid synthesis), **gram + and -** , with trimethoprim in Bactrim

sulfadiazine

bacteriostatic sulfonamide antibiotic, inhibits dihydropteroate synthase which converts PABA to dihydrofolic acid (1st step in folic acid synthesis), **gram + and -** , rx with pyrimethamine to tx toxoplasmosis

side effects of sulfonamides

kernicterus in infants due to bilirubin accumulation (C/I during pregnancy), myopic shift, Stevens-Johnson syndrome

trimethoprim

antibiotic, inhibits dihydrofolate reductase (2nd step in folic acid synthesis), gram + and - but not against Pseudomonas, makes up Polytrim with polymyxin B, and Bactrim with sulfamethoxazole

pyrimethamine

antibiotic, inhibits dihydrofolate reductase (2nd step in folic acid synthesis), gram + and - but not against Pseudomonas, given orally for toxoplasmosis

most potent ophthalmic antibiotics against MRSA

trimethoprim, tobramycin, then besifloxacin and vancomycin

ciprofloxacin (Ciloxan, Cipro)

2nd gen fluoroquinolone, aerobic G+/- , inhibits DNA gyrase and topoisomerase IV, tx CL-related corneal ulcers, abrasions, bacterial conjunctivitis, etc. also gram - urinary infections AE - tendinitis, C/I in pregnancy and children \<18yo, inhibition of bone growth

ofloxacin (Ocuflox)

2nd gen fluoroquinolone, aerobic G+/- , inhibits DNA gyrase and topoisomerase IV, tx CL-related corneal ulcers, abrasions, bacterial conjunctivitis, etc. AE - tendinitis, C/I in pregnancy and children \<18yo, inhibition of bone growth

levofloxacin (Quixin)

3rd gen fluoroquinolone, aerobic G+/- , inhibits DNA gyrase and topoisomerase IV, tx CL-related corneal ulcers, abrasions, bacterial conjunctivitis, etc. AE - tendinitis, C/I in pregnancy and children \<18yo, inhibition of bone growth

gatifloxacin (Zymar)

4th gen fluoroquinolone, anaerobic G+/- , inhibits DNA gyrase and topoisomerase IV, tx CL-related corneal ulcers, abrasions, bacterial conjunctivitis, etc. AE - tendinitis, C/I in pregnancy and children \<18yo, inhibition of bone growth

moxifloxacin (Vigamox, Avelox)

4th gen fluoroquinolone, anaerobic G+/- , inhibits DNA gyrase and topoisomerase IV, tx CL-related corneal ulcers, abrasions, bacterial conjunctivitis, etc. AE - tendinitis, C/I in pregnancy and children \<18yo, inhibition of bone growth

besifloxacin (Besivance)

4th gen fluoroquinolone, anaerobic G+/- , inhibits DNA gyrase and topoisomerase IV, tx CL-related corneal ulcers, abrasions, bacterial conjunctivitis, etc. AE - tendinitis, C/I in pregnancy and children \<18yo, inhibition of bone growth

TB medications

rifampin, isoniazid, pyrazinamide, ethambutol

rifampin (Rifadin)

tx TB, inhibits mRNA synthesis by binding DNA-dependent RNA polymerase (rpoB subunit) AE - hepatotoxicity, orange-pink secretions, drug interactions

isoniazid (Nydrazid)

tx TB, CWI, inhibits mycolic acid synthesis AE - hepatotoxicity, vitamin b6 deficiency - peripheral neuropathy, optic neuritis/atrophy

Ethambutol (Myambutol)

tx TB, CWI inhibits arabinosyl transferase AE - **optic neuritis** (pts on med should have periodic assessments of VA and R/G colour discrimination)

oseltamivir (Tamiflu)

antiviral, tx influenza, inhibits viral neuraminidase and prevents spread of virus, needs to be given within 72 hours before viral load is too high

zidovudine (Retrovir, AZT)

HIV therapy, is a nucleoside analogue of thymidine that acts as a potent inhibitor of viral RNA-dependent DNA polymerase (reverse transcriptase) AE - bone marrow suppression, lactic acidosis, muscle breakdown

ribavirin (Copegus, Rebetol, Virazole)

Hep C therapy (with interferon), inhibits viral RNA polymerase AE - conjunctivitis common, can have retinopathy, teratogenic RIBAViriN = RD, Ischemia (cws), Bleeding (hemes), Arterial and Venous occlusions, and optic Neuritis

trifluridine (Viroptic)

topical antiviral, inhibits DNA polymerase, tx HSV-1 keratitis

acyclovir (Zovirax)

systemic DNA polymerase inhibitors, tx HSV, VSV AE - decrease dose in pts with kidney disease

valacyclovir (Valtrex)

systemic DNA polymerase inhibitors, tx HSV, VSV AE - decrease dose in pts with kidney disease

famciclovir (Famvir)

systemic DNA polymerase inhibitors, tx HSV, VSV AE - decrease dose in pts with kidney disease

Ganciclovir (Zirgan)

ophthalmic gel, inhibits DNA polymerase, reduced corneal toxicity compared to trifluridine, tx HSV keratitis, also as an intraocular sustained-release tx in CMV retinitis

foscarnet (Foscavir)

IV antiviral, DNA polymerase inhibitor, tx CMV retinitis

amphotericin B

broad-spectrum antifungal, binds to ergosterol (fungus version of cholesterol), and forms pores causing cellular components to leak out and cause cell death, tx fungal keratitis AE - nephrotoxicity in IV tx

natamycin

antifungal, binds to ergosterol (fungus version of cholesterol), and forms pores causing cellular components to leak out and cause cell death, tx fungal blepharitis, conjunctivitis, keratitis

nystatin

antifungal, binds to ergosterol (fungus version of cholesterol), and forms pores causing cellular components to leak out and cause cell death, not in ophthalmic use but for oral thursh and yeast infections

norfloxacin

1st gen fluoroquinolone, aerobic G+/- , inhibits DNA gyrase and topoisomerase IV, tx UTIs AE - tendinitis, C/I in pregnancy and children \<18yo, inhibition of bone growth

metronidazole

bactericidal antibiotic, G+/- , metronidazole metabolites are taken up into bacterial DNA and form unstable molecules, needs ferredoxin to work (only in anaerobes) 2nd choice for tx C. diff after vancomycin

ketoconazole

antifungal, inhibits ergosterol synthesis, tx severe fungal corneal ulcers, systemic fungal infections, acanthamoeba

fluconazole

antifungal, inhibits ergosterol synthesis, tx severe fungal corneal ulcers, systemic fungal infections, acanthamoeba increasing resistance :(

miconazole

antifungal, inhibits ergosterol synthesis

griseofulvin (Grifulvin)

oral agent that inhibits fungal mitosis by interfering with microtubule formation during cell wall synthesis, tx - fungal skin or scalp infections

chloroquine (Aralen)

MOA - causes a build-up of heme that is toxic to Plasmodium parasite that causes malaria. also inhibits phospholipase A to decrease inflammation AE - bull's eye maculopathy (first sign is RPE mottling at macula), whorl keratopathy

risk of bullseye maculopathy increases with:

- a dosage \>3mg/kg of ideal body weight or 2.3 mg/kg of real body weight - tx duration \>5yrs, abnormal renal function, high body fat %, age \>60yo, liver disease, concomitant retinal disease

lindane (Kwell)

tx lice and scabies, lipophilic structure that gets absorbed through exoskeleton of insects and causes death, causes conjunctivitis if used on lashes

hydroxychloroquine

like chloroquine, inhibits phospholipase A2 and causes a build-up of heme, tx rheumatoid arthritis, lupus, malaria AE - whorl keratopathy, bullseye maculopathy

hydrocortisone

anti-inflammatory, tx adrenal insufficiency

triamcinolone (Kenalog)

steroid injection, can be used for mac edemas, Graves', posterior uveitis, chalazia, etc. AE - elevated IOP, depigmentation if injecting eyelid

fluticasone

intranasal corticosteroid, tx allergic rhinitis

aspirin

NSAID, salicylate that inhibits Cox1 and Cox2 and so prostaglandins and thromboxanes, used as a fever and pain reliever, also reduces risk of recurrent heart attacks in pts with known heart disease AE - GI effects, bleeding, Reye's syndrome in peds

indomethacin

NSAID, reversible Cox1 and Cox2 inhibitor,

acetylcysteine (Mucomyst)

mucolytic agent that breaks disulfide bonds in proteins of mucus in order to reduce its viscosity. can be rx'd topically for filamentary keratitis, dry eye, or corneal burns

pilocarpine

direct cholinergic agonist, opens corneal scleral pathway increasing aqueous outflow. SE: RD, AAC, ASC, miosis, headache/brow ache

direct cholinergic agonists

pilocarpine, acetylcholine, bethanechol, carbachol “PABC”

indirect cholinergic agonists

donepezil, echothiophate, edrophonium, pyridostigmine, isofluorophate, neostigmine “DEEP IN”

phenylephrine

a1 agonist, dilates and vasoconstriction (C/I in heart arrhythmia/HTN, Graves, people on MAOI or TCAs), blanches episcleritis, dx Horners, 10% breaks synechiae

NE does not act on

beta 2

brimonidine

a2 agonist (which is inhibitory) so decrease in aqueous production, and increase in uveoscleral outflow, neuroprotective

apraclonidine

a2 agonist mostly but some a1 (weak but can be used to dx Horners), effect does not last long enough to be used chronically for glaucoma

polysporin

bacitracin + polymixin b antibiotic ointment

polytrim

polymixin b + trimethoprim

neosporin

neomycin + polysporin