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NBEO Pharm Flashcards

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1
Q

Sulfacetamide (Sulamyd)

A

sulfonamide antibiotic (inhibits folic acid synthesis)

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2
Q

Amiodarone (Cordarone)

A

Anti-arryhythmic medication

  • blocks K+ channels (some Na and Ca channels)
  • ADRS
    • NIAION
    • whorl keratopathy
    • anterior subcapsular deposits
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3
Q

Valacyclovir (Valtrex)

A

Anti-viral

oral

Tx: HSV 1 and 2, Shingles, herpes zoster ophthalmicus, HSV keratitis

Systemic DNA polymerase inhibitor

ADRs- HAs, GI effects

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4
Q

Cetirizine (Zyrtec)

A

H1 blocker - second generation

Tx- allergic rhinitis and chronic urticaria

ADRs:

  • abnormal EOM contractions (oculogyric crisis)
  • less CNS/anticholinergic effects vs first generation
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5
Q

Celecoxib (Celebrex)

A

NSAID- selective COX 2 inhibitor

  • protects gastric mucosa and limits GI bleeding

ADRs

  • conjunctivitis
  • blurry vision
  • Stevens Johnson sydrome
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6
Q

Pralidoxime (Protopam)

A

Reverse effects of irreversible AchE inhibitors

allows breakdown of ACh - reverse effects of pesticide poisoning

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7
Q

Chloroquine (Aralen)

A

Anti-parasitic drug

build up of heme= toxic to plasmodium parasite (responsible for malaria)

also inhibits phospholipase A - decrease inflammation (Tx of RA/lupus)

ADRs - whorl keratopathy (reversible) - bull’s eye maculopathy (initial stage- RPE mottling)

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8
Q

Phenobarbital (Luminal)

A

Anti-convulsant

  • reduces glutamatergic excitatory transmissions
  • Tx- seizures and sedation
  • ADRs
    • mydrasis
    • increased IOP
    • cycloplegia
    • sedation, respiratory depression
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9
Q

Pemirolast (Alamast)

A

Mast cell stabilizer

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10
Q

Cholestyramine (Questran)

A

Antihyperlipidemic agent

Bile acid binding resin

  • binds bile acid- prevents reabsoprtion
  • ADRS
    • constipation and fatty stools
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11
Q

Lidocaine

A

Amine local anesthetic

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12
Q

Simvastatin (Zocor)

A

Antihyperlipidemic agent

  • HMG CoA reducases inhibitor (used in synthesis of cholesterol)
  • lower LDL and triglycerides
  • increases HDL
  • first line tx for high cholesterol
  • ADRs
    • hepatotoxicity
    • myopathy
    • contraindicated in pregnancy
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13
Q

Clarithromycin (Biaxin)

A

macrolide antibiotic (50S protein inhibitor)

oral - respiratory infections

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14
Q

Edrophonium (Enlon)

A

*Indirect Cholinergic Agonist* - Dx of MG (Tensilon test)

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15
Q

Amitriptyline (Elavil)

A

Anti-depressant - TCA

anti- cholinergic

  • inhibits NorE and serotonin uptake
  • ADRs
    • anticholinergic effects (anti- sluds)
    • overdose can be life threatening!!!
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16
Q

Botulina toxin (botox)

A

blocks release of Ach at NMJ - Tx of blepharospam and strabismus

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17
Q

Augmentin

A

amoxicillin + clavulonic acid (penicillinase/ beta lactamse inhibitor)

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18
Q

Cimetidine (Tagamet)

A

H2 blocker

Tx- stomach ulcers and acid reflux

ADRs:

  • Diarrhea
  • drug interactions
  • gynecomastia and loss of libido
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19
Q

Amantadine (Symmetrel)

A

Antiparkinsonian med

  • potentiates dopamine effects
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20
Q

Glycerine (Osmoglyn)

A

Hyperosmotic agent

acute angle closure attack

contraindicated in DM pts

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21
Q

Topiramate

A

anti-convulsant

ADRS

  • blurred vision
  • diplopia
  • nystagmus
  • choroidal swelling - acute secondary angle closure
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22
Q

Aggrenox

A

combo of Aspirin and Dipyridamole

anticoagulant

Tx- pts with h/o of ischemic strokes

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23
Q

Triamcinolone (Kenalog)

A

Systemic steroid

Opthalmic uses

  • DME
  • Graves
  • intermediate/ non resolving uveitis
  • Chalazia
  • recalcitrant irvine gass cystoid mac edema
  • mac edema 2^CRVO

Systemic uses

  • dermatoses, asthma, MS and arthritis

ADR

  • elevated IOP
  • depigmentation of eyelid skin in dark skinned pt
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24
Q

Neosporin

A

Bacitracin + polymyxin + neomycin

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25
Dexamethasone (Maxidex)
Potent steroid
26
Indomethacin (Indocin)
**NSAID- Reversible COX 1 and COX 2 inhibitor** Tx- scleritis and episcleritis ADRS * increase risk of bleeding complications in eye * GI bleeding * cardiovascular events (MI or stroke) (contraindicated in pts with coronary artery disease/ stroke) * pigmentary retinopthaty * whorl keratopaty
27
Nepafenac (Nevanec)
NSAID
28
Carteolol (Ocupress)
**\*Adrenergic antagonist\***- Non- selective beta blocker * intrinsic sympathomimetic activity (ISA) * less bradycardia vs other beta blockers (less side effects
29
Rosiglitazone (Avandia)
Thiazolidinedione (oral DM medication) * activate peroxisome proliferator- activated receptor gamma to increase glucose uptake in muscles and fatty tissue * used to combat insulin resistance
30
Ketorolac Tromethamine (Acular LS)
NSAID only one approved from topical tx of seasonal allergic conjunctivitis
31
Cell wall synthesis blockers
bacitracin penicillins cephalosporins
32
Neostigmine (Prostigmin)
**\*Indirect Cholinergic Agonist\*** - Treatment of MG
33
Cyclobenzaprine (Flexeril)
**Muscle relaxant** anti- cholinergic
34
Furosemide (Lasix)
Loop diuretic HTN med * inhibits Na/2Cl/K co-transporters in thick ascending loop of Henle * increases Ca * ADRS * hypokalemia * nephrotoxicity * ototoxicity * DES
35
Cromolyn sodium (Crolom)
**Mast Cell Stabilizer**
36
Acetaminophen (Tylenl)
**Non-opiate analesic** * NO anti inflam properties * can be used in infants * ADRs * hepatotoxicity
37
Phenylephrine (Neo-Synephrine)
**Adrenergic agonist (alpha 1 )** * dilation without cycloplegia * palpebral widening * differentiate scleritis from episcleritis * horner's syndrome (post lesion= dilation, pre lesion= no dilation) * 10% break posterior synechiae (but adverse cardiovascular effects) contraindicated in ppl taking MAOIs, TCA, atropine, Graves pts.
38
Chlorpromazine (Thorazine)
**Antipsychotic (Phenothiazine)** Anti- cholinergic * dopamine receptor antagonist * ADRs * parkinson like side effects * pigmentation effects (pigment on corneal endo, anterior stellate cataracts, hyperpigmentation of RPE) * anticholinergic effct- dry eye, mydriasis, increase IOP * oculogyric crisis
39
Fluorometholone (FML)
Soft steroid
40
Clopidogrel (Plavix)
**Anticoagulant** * inhibits ADP receptor on platelet cell membranes - needed for platelet aggregation and clot formation * ADRs * increased risk of bleeding, GI upset, rash * effects = irreversible
41
Prednisolone acetate
**Steroid- potent** SHAKE!
42
Rifampin (Rifadin)
Tb drug * prevents mRNA synthesis by binding to RNA polymerase * ADR- hepatoxicity, orange/pink tear and urine discoloration
43
Acylovir (Zovirax)
Anti-viral oral Tx: HSV 1 and 2, Shingles, herpes zoster ophthalmicus, HSV keratitis Systemic DNA polymerase inhibitor ADRs- HAs, GI effects
44
Fluoroquinolones (names and facts)
antibiotic- * inhibits DNA gyrase and topoisomerase IV * ciprofloxacin, ofloxacin, levofloxacin, gatifloxacin, moxifloxacin, besifloxacin * all gram - * 3rd and 4th generation have imporved gram + * uses: * CL related corneal uclers, abrasions, bacterial conjunctivits * systemic uses * cipro- gram - urinary infections * moxi- pneuomia, sinusitis, intra ab and skin infections ADRS * oral - affect bones= tendinitis. contraindicated in pregnancy, and \<18yo * topical - use in 1yo and older (except Levo)
45
Latanoprost (Xalatan)
**Prostaglandin analog** Tx of GL * 27-35% IOP reduction (increases uveoscleral outflow of AQ) * nighttime dosing * ADRS * iris heterochromia * increase pigmentation and growth of eyelashes * skin darkening around eyes * conjunctival hyperemia * itching * Contraindications - CME -Active inflammation - previous HSV keratitis
46
Sulfonamides
**antibiotic (foltate synthesis inhibitor)** * inhibits dihydropteroate synthase (converts PABA--\> dihydrofolic acid)- first step of folic acid synthesis * bacteriostatic * gram + and - * ophthalmic: blepharitis and conjunctivitis (rare use) * ADRs- stinging, burning, contact derm, local photosensitivity * system: toxoplasmosis (sulfadiazine +pyrimethamine) * ADRs- kernicterus in infants, induce myopic shift, steven johnson syndrome.
47
Famciclovir (Famvir)
Anti-viral oral Tx: HSV 1 and 2, Shingles, herpes zoster ophthalmicus, HSV keratitis Systemic DNA polymerase inhibitor ADRs- HAs, GI effects
48
Apraclonidine (Iopidine)
**Adrenergic agonist (alpha 2)** * acute angle closure attack * controls IOP spike (decrease AQ production and increase uveoscleral outflow) * 30-40% decrease - not effective as chronic therapy b/c tachyphylaxis * dx of Horner's syndrome ( Horner's dilates due to hypersensitivity of alpha 1 vs normal pupil= no dilation)
49
Trifluridine (Viroptic)
Anti-viral tx herpes simplex keratitis inhibits DNA polymerase dose 9x/day
50
Oxycodone (Roxicodone)
**Opiate analgesic** * agonist at Mu, Kappa and Delta opiate receptors * potent analgesics * addictive * ADRs * miosis * resp depression * drowsiness * sedation * nausea
51
Nifedipine (Procardia)
Calcium channel blocker HTN med * blocks L type Ca channels * decrease peripheral vascular resistance
52
Lincomycin/ Clindamycin (Cleocin)
**50S protein inhibitor antibiotic** reversible Rx- MRSA and anaerobic infections
53
Azithromycine (zithromax- oral) (azasite- topcial)
**macrolide antibiotic** (50S protein inhibitor) * oral- chlamydial infections - 1g single dose (empty stomach ) * topical- bacterial conjunictivits and blepharitis (contains BAK)
54
Dicloxacillin (Dynapen)
Penicllin gram + resistant to penicillinase drug of choice for methicillin-sensitive staph aureus (MSSA)
55
Folate synthesis inhibitors
sulfonamides trimethoprim pyrimethamine
56
Chlorpropamide (Diabinese)
Sulfonylureas (oral DM medication) * increases secretion of insulin * ADRS * hypoglycemia * sulfa allergy * with beta blockers incease risk of hypoglycemia
57
Olopatadine 0.2% (Pataday)
Mast cell stabilizer + antihistamine combo
58
Ketotifen (Zaditor)
Mast cell stabilizer + antihistamine combo
59
Brimonidine (Alphagan)
**Adrenergic agonist (alpha 2)** GL treatment * decrease AQ production and increase uveoscleral outflow * Neuroprotective * follicular conjunctivits - miosis - contraindicated with MAOIs
60
Lodoxamide (Alomide)
Mast cell stabilizer
61
Tetrazosin (Hytrin)
Alpha 1 antagonist (prevent vasocontriction) tx- BPH, HTN ADRs- floppy iris sydrome
62
Homatropine
**\*Cholinergic antagonist\*** standard tx of anterior uveitis * dilates and mobilizes iris * paralyzes ciliary and sphincter muscle (reduce pain) * stabilizes blood AQ-barrier
63
Losartan (Cozaar)
Angiotensin II receptor antagonist- HTN med * NO cough
64
Tamsulosin (Flomax)
Alpha 1 antagonist (prevent vasoconstriction) tx- BPH ADRs- floppy iris sydrome
65
Levothyroxine (Synthroid)
Synthetic T4 ADRs * hyperthyroid * pseudotumor cerebri in kids
66
Loteprednol (Lotemax)
**Soft steroid** Ester based safest steroid
67
Atropine
**\*Choninergic antagonist\*** longest duration amblyopia treatment use \>3 yo - caution in Down's syndrome, small children and elderly
68
Gentamicin (Garamycin)
**aminoglycoside antibiotic** (30s protein inhibitor)
69
Naproxen (Naprosyn)
**NSAID- Reversible COX 1 and COX 2 inhibitor** Tx- scleritis and episcleritis ADRS * increase risk of bleeding complications in eye * GI bleeding * cardiovascular events (MI or stroke) (contraindicated in pts with coronary artery disease/ stroke)
70
Cyclobenzaprine (Flexeril)
**Non-opiate analesic** * decrease motor activity by inhibiting tonic activiity of alpha and gamma motor neurons * tx- muscle spasms * ADRs * drowsiness * Loss of coordination * anticholinergic effects * caution in narrow angle GL
71
Donepezil (Aricept)
\***Indirect Cholinergic agonist\*** treatment of Alzheimer's and dementia * CNS acetylcholinesterase inhibitor * ADRs * cataracts * blurred vision * ocular irritation * lower IOP
72
Spironolactone (Aldactone)
Potassium- sparing diuretic * blocks action of aldosterone in late DCT and collecting ducts= increases excretion of sodium and water and decreases secretion of K+ * ADRs * hyperkalemia * gynecomastia * antiandrogen effects * DES
73
Metoprolol (Lopressor)
Beta blocker - beta 1 specific HTN med ADRS: * CNS- disorientation, depression, fatigue * Cardio - bradycardia, arrhythmias, syncope * Pulmonary- dyspnea, wheezing, bronchospasm * GI- nausea, vomitting, diarrhea, ab pain * Reproductive- ED
74
Methazolamide (Neptazane)
**Carbonic anhydrase inhibitor** oral * Side effects - metallic taste, tingling, metabolic acidosis - bone marrow suppression and aplastic anemia (fatal!!) - malaise, fatigue, weight loss, impotence, depression, diarrhea - myopic shift contraindicated - COPD - pregnancy - sulfa allergy
75
Trimethoprim (Primsol)
antibiotic (folate acid synthesis inhibitor) * inhibits dihydrofolate reductase (converts hydrofolic acid--\> tetrahydrofolic acid) second step of synthesis * gram + and - (not pseduomonas) * effective against MRSA * ADRs - bone marrow suppression --\> anemia, leukopenia, granulocytopenia
76
Systane
ocular lubricant
77
Bromfenac (Xibrom, Bromday)
NSAID Xibrom- contains sodium sulfite- beware with sulfa allergy
78
Antibiotics to take on empty stomach
PAT: * penicillin * azithromycin * tetracyclines (exp- doxy)
79
Brinzolamide (Azopt)
**Carbonic anhydrase inhibitor** topical - tx GL - sulfa based - ADRs- stings and metallic taste
80
Loratadine (Claritin)
**H1 blocker - second generation** Tx- allergic rhinitis and chronic urticaria ADRs: * less CNS/anticholinergic effects vs first generation
81
Amoxicillin (Principen)
Penicillin gram + and -
82
Optive
Ocular lubricant
83
Gatifloxacin (Zymar)
4nd generation fluoroquinolone
84
Theophylline (Theo Dur)
miscullaneous respiratory agent ihibits phophodiesterase --\> increased cAMP--\> increased Epi beta blockers can mitigate bronchodilatory effects
85
Diazepam (Valium)
**Anxiolytic** anti- cholinergic * benzodoazepine * opens chloride channels by binding to GABA receptors= hyperpolarization of neurons in CNS * ADRs * sedation, depression, confusion, bradycardia, dyspnea * mydrasis and nystagmus (contraindicated in narrow angle GL)
86
Besifloxacin (Besivance)
4nd generation fluoroquinolone - only topical
87
Cephalosporins (drugs + main points)
Cephalexin, ceftriaxone * inhibit transpeptidase (inhibit cell wall synthesis) * 1st generation: gram + * 2nd generation: gram + and some gram - * 3rd generation: gram + and - * ADRs * hypersensitivity rxns, * alters absorption of vit K= excessive blood thinning if taking blood thinner
88
Macrolides (drugs and facts)
erythromycin, azithromycin, clarithromycin - 50S protein inhibitors
89
Ofloxacin (Ocuflox)
2nd generation fluoroquinolone
90
Antibiotics effective for MRSA
Bactrim (trimethoprim-sulfamethoxazole) doxycycline clindamycin
91
Propranolol (Inderal)
Beta blocker - non selective HTN med ADRS: * CNS- disorientation, depression, fatigue * Cardio - bradycardia, arrhythmias, syncope * Pulmonary- dyspnea, wheezing, bronchospasm * GI- nausea, vomitting, diarrhea, ab pain * Reproductive- ED
92
Phenelzine (Nardil)
**Anti-depressant - MAOI** anti- cholinergic * inhibits MAO (respobsible for breakdown of NorE and serotonin) * ADRs * GL * nystagmus * interactions with tyramine (wine, cheese, dried meat)- causes lethal hypertensive crisis
93
Isotretinoin (Accutane)
Derm med * reduces size and degree of oil production from sebaceous glands * ADRS * **blepharoconjunctivitis** * **DES** * **pseudotumor cerebri** * lid edema * loss of color vision * nyctalopia * cataracts * teratogenic and contrindicated in pregnancy
94
Duloxetine (Cymbalta)
**Anti-depressant- selective NorE reuptake inhibitor** * inhibits serotonin and NorE reuptake * Tx- depression, anxiety, panic disorder * ADRs * mydraiassis (caution in narrow angle pt) * serotonin syndrome
95
Montelukast (Singulair)
miscullaneous respiratory agent **leukotriene receptor antagonist** tx- asthma, bronchoconstriction, allergic rhinitis
96
Captopril (Capoten)
ACE ihbitior- HTN med * prevents formation of angiotensin II and blocks metabolsim of bradykinins (= vasodilation) * ADRs * cough
97
Bactericidal antibiotics
Penicillins bacitracin aminoclycosides cephalosporins fluoroquinolones
98
Isoproterenol (Isuprel)
**beta 1 and beta 2 agonist** short acting tx- arrhythmias- IV treatment only (no longer used from asthma) GL warning (b/c increased IOP)
99
Brompheniramine (Dimetane)
**H1 blocker (first generation)** Anti- cholinergic Tx- allergic skin reactions ADRS * sedation * anticholinergic effects (mydrasis, dry eye, dry mouth, tachycardia)
100
Metformin (Glucophage)
Biguanide (oral DM medication) * decreases gluconeogenesis in liver * does not cause hyerglycemia * ADRs * diarrhea * if renal insuff or hepatic impairment- at greater risk of lactic acidosis
101
Phenytoin (Dilantin)
**anti-convulasant** * ADRs * nystagmus * diplopia * EOM palsies * ataxia * gingival hyperplasia
102
Nystatin (Mycostatin)
Anti-fungal binds ergosterol and forms pores- leaking out contents = cell death Tx - Candida oral and vaginal yeast infections (no ophthalmic use)
103
Imipramine (Tofranil)
**Anti-depressant - TCA** anti- cholinergic * inhibits NorE and serotonin uptake * ADRs * anticholinergic effects (anti- sluds) * overdose can be life threatening!!!
104
Cephalexin (Keflex)
**1st generation cephalosporin antibiotic** (inhibits cell wall syn) gram + tx * dacryoadenitis/ cystitis * preceptal cellulitis
105
Ranitidine (Zantac)
**H2 blocker** Tx- stomach ulcers and acid reflux ADRs: Diarrhea
106
Sumatriptan (Imitrex)
**Migraine tx** * serotonin subtype 1B and 1D receptor agonists * causes vasoconstriction and reduces inflammation in CNS * ADRs- released to systemic vasoconstriciton * NAION * retinal artery occlusions and venous thromboses * MI * ischemic strokes
107
Apirin
**Irreversible COX 1 and COX 2 inhibitor- NSAID** Tx- antipyresis, anti- inflam and analgesia reduces risk of heart attacts ADRS * GI effects (ulcers, bleeding) * bleeding complications in eye * Reye's sydrome (in kids)
108
Promethazine (Phenergan)
**H1 blocker (first generation)** Anti- cholinergic Tx- allergic skin reactions chemical structure similar to antipsychotic meds (phenothiazine) ADRS * sedation * anticholinergic effects (mydrasis, dry eye, dry mouth, tachycardia) * eye * corneal epithelail keratopathy * corenal endothelail pigmentation * lenticular changes * pigmentary retinopathy
109
Levalbuterol (Xopenex)
**Beta 2 agonist** ## Footnote short acting tx- rescue inhaler for asthma and COPD GL warning (b/c increased IOP)
110
Naphazoline (Naphcon)
**Adrenergic (Alpha) agonist** ocular decongestant
111
Ketoconazole (Nizoral)
Anti-fungal inhibits ergosterol synthesis tx -severe fungal corneal uclers ,systemic fungal infections, acanthamoeba ADR- hepatotoxicity
112
Cosopt
Timolol 0.5% + Dorzolamide 2%
113
Penicillins (drugs + main points)
Amoxicillin, Dicloxacillin * inhibits transpeptidase (inhibits bacterial cell wall synthesis * bacterial eyelid infections (hordeolum, preseptal celullitis) * ADRs * hypersensitivity rxns * oral contraceptives ineffective * stevens- johnson syndrome (amoxicillin)
114
Hydrochlorothiazide (Hydrodiuril)
Thiazide diuretic HTN med * inhibits NaCl reabsorption and decreases Ca excretion in DISTAL CONVOLUTED TUBULE * ADRs * acute transiet myopia and acute angle closure GL * DES
115
Natamycin (Natacyn)
Anti-fungal binds ergosterol and forms pores- leaking out contents = cell death Tx - fungal blepharitis - conjunctivitis - keratitis
116
Famotidine (Pepcid)
**H2 blocker** Tx- stomach ulcers and acid reflux ADRs: Diarrhea
117
Polytrim
Polymyxin B (strong gram -) + trimethoprim
118
Isoniazid (Nydrazid)
Tb drug * prevents cell wall synthesis by inhibiting mycolic acid synthesis * ADRs: hepatoxicity, pyridoxine (vit B6) deficiency= peripheral neuropathy, optic neuritis (rare)
119
Bepotastine (Bepreve)
Mast cell stabilizer + antihistamine combo
120
Levobunolol (Betagan)
**\*Adrenergic antagonist\***- non-selective beta blocker
121
Tamoxifen (Nolvadex)
**Estrogen Antagonist** * agonist inhibitor of estradiol * Tx- breast cancer * ADRs * _crystalline retinopathy_ * _whorl keratopathy_ * thromboembolism * fatty liver * hot flashes * increased risk of uterine cancer
122
Polysporin
Bacitracin (gram +) + polymyxin B (gram -)
123
Warfarin (Coumadin)
**Anticoagulant** * vitamin K antagonist- interferes with clotting factors (dependent on vit K for synthesis) * ADRS * d/c 96-115 hours (4 doses ) prior to catarct surgery
124
Ceftriaxone (Rocephin)
**3rd generation cephalosporin antibiotic** (inhibits cell wall syn) gram + and - * IV= tx of choice for gonococcal conjunctivitis and orbital cellulitis
125
Gemfibrozil (Lopid)
Antihyperlipidemic agent Fibric Acid * binds peroxisome proliferator activated receptor -- increases activity of lipoprotein lipase- breaks down VLDL * ADRS * GI upset * skin rash * urticaria * myositis
126
Hydrocortisone (Cortef)
**Systemic steroid** * tx of adrenal insufficiency
127
Salmeterol (serevent)
**Beta 2 agonist** long acting tx: maintence therapy for asthma and COPD (not used as rescue inhaler) does not have warning re: glaucoma pts
128
Thioridazine (Mellaril)
**Antipsychotic (Phenothiazine)** Anti- cholinergic * dopamine receptor antagonist * ADRs * parkinson like side effects * pigmentation effects (pigment on corneal endo, anterior stellate cataracts, hyperpigmentation of RPE) * anticholinergic effct- dry eye, mydriasis, increase IOP * oculogyric crisis
129
Chlorothiazide (Diuril)
Thiazide diuretic HTN med * inhibits NaCl reabsorption and decreases Ca excretion in DISTAL CONVOLUTED TUBULE * ADRs * acute transiet myopia and acute angle closure GL * DES
130
Digoxin (Lanoxin)
**CHF medication** * inhibits Na/K ATPase enzyme = increased intracellular Ca * ADRs * retrobullblar optic neuritis * B/Y color defects * entopic phenomenon
131
Azathioprine (Imuran)
**Immunosuppressive agent** * purine analog * Tx- RA, prevent kidney rejection, ocular myasthenia
132
Fluoress
Fluorescein + Benoxinate
133
Escitalopram (Lexapro)
**Anti-depressant- selective serotonin reuptake inhibitor** * ADRs * mydraiassis (caution in narrow angle pt) * serotonin syndrome
134
Metaproterenol (Alupent)
**Beta 2 agonist** short acting - no longer recommended for asthma b/c of cardio effects from beta 1 stimulation GL warning (b/c increased IOP)
135
Albuterol (Ventolin)
**Beta 2 agonist** short acting tx- rescue inhaler for asthma and COPD GL warning (b/c increased IOP)
136
Sildenafil (Viagra)
ED med * PDE-5 inhibitor (increasing blood flow and prolong effects of cGMP) * Systemic ADRs * flushing, HAs, sustained erection * **ocular ADRS** * **color changes (cyanopsia- blue tint)** * **blurred vision** * **photosensitivity**
137
Atorvastatin (Lipitor)
**Antihyperlipidemic agent** * HMG CoA reducases inhibitor (used in synthesis of cholesterol) * lower LDL and triglycerides * increases HDL * first line tx for high cholesterol * ADRs * hepatotoxicity * myopathy * contraindicated in pregnancy
138
Clonidine (Catapres)
Alpha 2 agonist
139
Aminoglycosides (drugs and main facts)
gentamicin and tobramycin * gram - \> gram + * ADRs * SPK and delayed corneal re-epithelialization
140
Levofloxacin (Quixin)
3rd generation fluoroquinolone
141
Acetazolamide (Diamox)
**Carbonic anhydrase inhibitor** Oral * Tx of acute angle attacks * Side effects - metallic taste, tingling, metabolic acidosis - bone marrow suppression and aplastic anemia (fatal!!) - malaise, fatigue, weight loss, impotence, depression, diarrhea - myopic shift contraindicated - COPD - pregnancy - sulfa allergy
142
Ranibizumab (Lucentis)
Monoclonal antibody targets VEGF - intravitreal injection tx of ARMD
143
Pyridostigmine (Mestinon)
**\*Indirect cholinergic agonist\*** - "rid" (treatment) of MG
144
Fluconazole (Diflucan)
Anti-fungal inhibits ergosterol synthesis ADR- hepatotoxicity
145
Methylphenidate (Ritalin)
**dopamine agonist** tx- ADHD, narcolepsy, depression * ADRs * adrenergic agonist effects - mydriasis and dry eye (caution in narrow angle GL)
146
Pyrimethamine (Daraprim)
antibiotic (folate acid synthesis inhibitor) * inhibits dihydrofolate reductase (converts hydrofolic acid--\> tetrahydrofolic acid) second step of synthesis * orally for ocular toxo * ADRs - bone marrow suppression --\> anemia, leukopenia, granulocytopenia
147
Fexofenadine (Allegra)
**H1 blocker - second generation** Tx- allergic rhinitis and chronic urticaria ADRs: * less CNS/anticholinergic effects vs first generation
148
Miconazole (monostat-derm)
Anti-fungal inhibits ergosterol synthesis ADR- hepatotoxicity
149
Refresh Tears
ocular lubricant
150
Enalapril (Vasotec)
ACE ihbitior- HTN med * prevents formation of angiotensin II and blocks metabolsim of bradykinins (= vasodilation) * ADRs * cough
151
Pegaptanib (Macugen)
Antieoplastic agent inhibits VEG-F - intravitreal injection tx of ARMD
152
Rimexolone (Vexol)
**Steroid-** potent
153
Ethambutol (Myambutol)
Tb drug * inhibits synthesis of mycobacterial cell wall- inhibits arabinosyl transferase * ADR- optic neurtitis (retrobulbar and bilateral)
154
Pilocarpine
**\*Direct Cholinergic agonist\*** * 30% IOP reduction (increase outflow- corneal scleral) * short half life * uses * s/p angle closure attack * 1%- to differentiate 3rd CN palsy vs sphincter tear * 0.125% dx of Adies pupil * ADRs * Brow ache, HAs, myopic shifts - Miosis - Cataracts - RD - Secondary angle closure GL
155
Bromocriptine (Parlodel)
dopamine agonist tx- hyperprolacinemia
156
Olopatadine 0.1% (Patanol)
Mast cell stabilizer + antihistamine combo
157
Erythromycin
**macrolide antibiotic** (50S protein inhibitor) * topical ung * prophylaxis opthalmia neonatorum
158
Misoprostol (Cytotec)
**Prostaglandin EI (synthetic)** - provention and treatment of NSAID induced stomach ulcers ADRS- miscarriages and premature labor
159
Diclofenac sodium (Voltaren)
NSAID corneal melting in generic form
160
Cyclopentolate
**\*Cholinergic antagonist\*** Cycloplegic effects- fastest onset and shortest duration standard cycloplegic agent
161
Hydroxychloroquine (Plaquenil)
Inhibits phospholipase A2 and causes build up of heme (similar to choloroquine) uses: * lupus, RA, malaria ADRs * whorl keratopathy * Bull's eye maculopathy * \>5mg/gk/day (or 400mg/ day ) * risk factors * tx duration \>5 years * abnormal renal functions * liver disease * age \> 60 * high body fat * concomitant retinal disease * 10-2 VF and OCT ( can also do multifocal ERG and fundus autofluorescence)
162
Mannitol (Osmitrol)
Osmotic diuretic HTN med * increases plasma osmolarity * ADR * contraindicated in pt with pulmondary edema, dehydration adn CHF * DES
163
Piroxicam (Feldene)
**NSAID- Reversible COX 1 and COX 2 inhibitor** Tx- scleritis and episcleritis ADRS * increase risk of bleeding complications in eye * GI bleeding * cardiovascular events (MI or stroke) (contraindicated in pts with coronary artery disease/ stroke)
164
Amphotericin B (Amphocin)
Anti-fungal binds ergosterol and forms pores- leaking out contents = cell death Tx - fungal keratitis (ung) IV form- systemic and intraocular fungal infections ADR- nephrotoxicity (IV form)
165
Cyclosporine (Neoral, Sandimmune, Restasis)
**immunosuppressive agent** * inhibits release and production of interleukin 2 (responsible for T cell activiation) * TX- topical- keratoconjunctivitis sicca * ADRs * opportunistic infections * malignancies * HTN * kidney dysfunction
166
Ibuprofen (Advil, Motrin)
**NSAID- Reversible COX 1 and COX 2 inhibitor** Tx- scleritis and episcleritis ADRS * increase risk of bleeding complications in eye * GI bleeding * cardiovascular events (MI or stroke) (contraindicated in pts with coronary artery disease/ stroke)
167
Tramadol (Ultram)
**Non-opiate analesic** * agonist at Mu optiate receptors and inhibits serotonin and norE uptake * ADRs * dry mouth * sedation * dizziness * nausea
168
Chlorpheniramine (Chlor-Trimeton)
**H1 blocker (first generation)** Anti- cholinergic Tx- allergic skin reactions ADRS * sedation * anticholinergic effects (mydrasis, dry eye, dry mouth, tachycardia)
169
Scopolamine
**\*Cholinergic antagonist\*** CNS toxicity!
170
Bactrim
Sulfamethoxazole + trimethoprim
171
Oseltamivir (Tamiflu)
Anti-viral inhibits influenza A and B viral neuroaminidase
172
Dipyridamole (Persantine)
**Anticoagulant** * inhibits adenosine deaminase and phosphodiesterase = accumulation of cAMP and adensosine= inhibit platelet aggregation * ADRS * increased risk of bleeding
173
Sodium Chloride (Muro 128)
Hyperosmostic agent reduces corneal edema
174
Zafirlukast (Accolate)
miscullaneous respiratory agent **leukotriene receptor antagonist** tx- asthma, bronchoconstriction
175
Chloramphenicol (chloroptic)
**50S protein synthesis inhibitor** gram + and - ADR * fatal aplastic anemia * optic neuritis
176
Venlafaxine (Effexor)
**Anti-depressant- selective NorE reuptake inhibitor** * inhibits serotonin and NorE reuptake * Tx- depression, anxiety, panic disorder * ADRs * mydraiassis (caution in narrow angle pt) * serotonin syndrome
177
Combigan
Timolol 0.5% + Brimonidine 0.2%
178
Flurbiprofen (Ocufen)
NSAID contains thimerosal
179
Amantadine (Symmetrel)
dopamine agonist tx- Parkinson's disease
180
Bacitracin
**cell wall synthesis inhibitor antibiotic** inhibits transfer of peptidoglycans into cell wall - Gram + tx: * blepharitis
181
Lacrilube
ocular ointment
182
Nedocromil (Alocril)
Mast cell stabilizer
183
Diltiazem (Cardizem)
Calcium channel blocker HTN med blocks L type Ca channels decrease peripheral vascular resistance ADR * have direct cardiac effects * negative chronotropism (decrease HR) * ionotropism (decrease contractility) contraindicated in GL pts taking timolol (b/c greater risk of bradycardia and heart failure)
184
Epinastine (Elestat)
Mast cell stabilizer + antihistamine combo
185
Metronidazole (MetroGel)
Derm med * topical agent for acne rosacea * disrupts DNA and inhibits nucleic acid synthesis * anti-inflammatory properties * ADRs * irritation of skin and eyes possible
186
Zidovudine (Retrovir) (AZT)
Antiviral HIV * tx nucleosdie analog of thymidine inhibitor of reverse transcriptase * ADRs - bone marrow suppression - lactic acidosis - muscle breakdown
187
Lovastatin (Mevacor)
**Antihyperlipidemic agent** HMG CoA reducases inhibitor (used in synthesis of cholesterol) * lower LDL and triglycerides * increases HDL * first line tx for high cholesterol * ADRs * hepatotoxicity * myopathy * contraindicated in pregnancy
188
Metipranolol (Optipranolol)
**\*Adrenergic antagonist\***- non- selective beta blocker
189
Fluticasone (Flonase)
**Systemic Steroid** = intranasal (topical) steroid tx- allergic rhinitis ADRS * cataracts * increased IOP * conjunctivitis * DES
190
Ciprofloxacin (Ciloxan, Cipro)
2nd generation fluoroquinolone
191
Tobramycin (Tobrex)
**aminoglycoside antibiotic** (30S protein inhibitor)
192
Sucralfate (Carafate)
Gastic lining protector ADRs- interfere with absorption of oral meds
193
Acetylcysteine (Mucomyst)
miscullaneous respiratory agent breaks disulfide bonds in proteins of mucus topic opthalmic form * filamentary keratitis * DES * corneal burns
194
Triamterene (Dyrenium)
Potassium- sparing diuretic directly blocks epithelial sodium channels- blocks action of aldosterone in late DCT and collecting ducts= increases excretion of sodium and water and decreases secretion of K+ (does not have antiandrogen effects vs spironolactone) ADRs * hyperkalemia * DES
195
Sulfisoxazole (Gantrisin)
sulfonamide antibiotic (inhibits folic acid synthesis)
196
Proparacaine (Opthaine)
topical local anesthetic (ester)
197
Dorzolamide (Trusopt) -
**Carbonic anhydrase inhibitor** topical - tx GL - sulfa based - ADRs- stings and metallic taste
198
Lindane (Kwell)
Anti-parasitic drug lipophilic structure absorbed through insect exoskeleton- leading to seizures and death tx lice and scabies ADRs- can cause conjunctivitis
199
Dextroamphetamine (Dexedrine)
**dopamine agonist** * tx- ADHD, narcolepsy, depression * ADRs * adrenergic agonist effects - mydriasis and dry eye (caution in narrow angle GL)
200
Restasis (Cyclosporine)
T cell inhibitor (suppresses inflammation) stops production of interleukin-2 Tx of DES
201
Methotrexate (Rheumatrex)
**immunosuppressant** * inhibits dihydrofolate reductase * TX- rheumatoid arthritis * ADRs * hepatotoxicity * myelosuppresion * increased risk of opportunistic infections
202
Azelastine (Optivar)
Mast cell stabilizer + antihistamine combo
203
Tobradex
**tobramycin + dexamethasone** * Rx inflammatory ocular condition with associated bacterial infection * eg. staph marginal keratitis, corneal infiltrates
204
Hydralazine (Apresoline)
HTN med * increases cGMP = smooth muscle relaxation * ADRS * compensatory tachycardia * fluid retention * lupus like syndrome * conjuctivitis and increased lacrimation
205
Betaxolol (Betoptic-S)
**\*Adrenergic antagonist\***- Beta 1 specific blocker - * Neuroprotective
206
Glipizide (Glucotrol)
Sulfonylureas (oral DM medication) * increases secretion of insulin * ADRS * _hypoglycemia_ * sulfa allergy * with beta blockers incease risk of hypoglycemia
207
Glyburide (Diabeta, Micronase)
Sulfonylureas (oral DM medication) * increases secretion of insulin * ADRS * hypoglycemia * sulfa allergy * with beta blockers incease risk of hypoglycemia
208
Terbutaline (Brethine)
**Beta 2 agonist** ## Footnote short acting tx- rescue inhaler for asthma and COPD GL warning (b/c increased IOP)
209
Foscarnet (Foscavir)
Anti-viral IV solution CMV retinitis (when ganciclovir fails or HSV resistant infections in AIDS pts ADR - nephrotoxicity and seizures
210
Pseudoephedrine (Sudafed)
**non specific alpha and beta agonist** Tx- cold medication ADRS * increaased SNS (tachycardia, bronchodilation, nervousness/ agitation) * diplopia, blurred vision * increased IOP
211
Moxifloxacin (Vigamox, Avelox)
4nd generation fluoroquinolone
212
Tetrahydrozoline (Visine)
**Adrenergic (alpha) agonist** ocular decongestant
213
Pioglitazone (Actos)
**Thiazolidinedione (oral DM medication)** * activate peroxisome proliferator- activated receptor gamma to increase glucose uptake in muscles and fatty tissue * used to combat insulin resistance * ADRS * **new or worsening macular edema** * peripheral tissue edema * heart failure * hypoglycemia
214
Echothiophate (Phospholine)
**\*Indirect Cholinergic Agonist\*** Dx or treatment of accommodative Esotropia (rarely for GL) IRREVERSIBLE AchE agent
215
Benoxinate
topical local anesthetic (ester)
216
Sulfamethoxazole (Gantanol)
sulfonamide antibiotic (inhibits folic acid synthesis)
217
Vardenafil (Levitra)
ED med * PDE-5 inhibitor (increasing blood flow and prolong effects of cGMP) * Systemic ADRs * flushing, HAs, sustained erection * **ocular ADRS** * **color changes (cyanopsia- blue tint)** * **blurred vision** * **photosensitivity**
218
Prazosin (Minipress)
Alpha 1 antagonist (prevent vasocontriction) tx- BPH, HTN ADRs- floppy iris sydrome
219
Benazepril (Lotensin)
ACE ihbitior- HTN med * prevents formation of angiotensin II and blocks metabolsim of bradykinins (= vasodilation) * ADRs * cough
220
Naloxone (Narcan)
**Opioid antagonist** reverse effects of opiates
221
Difluprednate (Durezol)
**Potent steroid** highest potential for steroid response
222
Labetolol (Trandate)
Beta blocker - non selective HTN med ADRS: * CNS- disorientation, depression, fatigue * Cardio - bradycardia, arrhythmias, syncope * Pulmonary- dyspnea, wheezing, bronchospasm * GI- nausea, vomitting, diarrhea, ab pain * Reproductive- ED
223
Timolol (Timoptic)
**\*Adrenergic antagonist\*** non-selective beta blocker - Tx GL * decrease AQ production * 25% IOP reduction * dose in morning * long term drift (IOP gradually rises) and short-term escape (IOP initially lowers but then returns to normal after weeks of starting tx) * use with caution - DM (masks hypoglycemia) - hypertyroidism (masks sx) - MG (exacerbates sx of weakness)
224
Tropicamide
**\*Cholinergic antagonist\*** * Mydriatic effect- fast onset and shortest duration * safe drug
225
Diphenhydramine (Benadryl)
**H1 blocker (first generation)** Anti- cholinergic Tx- allergic skin reactions ADRS * sedation * anticholinergic effects (mydrasis, dry eye, dry mouth, tachycardia)
226
Ganciclovir ophthalmic gel (Zirgan)
Antiviral HSV keratitis and CMV retinitis (intraocular capsule) inhibits DNA polymerase dose 5x/day ADRs - blurred vision and ocular irritation (reduced corneal toxicity vs Viroptic) - possible RD and vitreous hemorrhage
227
Ipratropium (Atrovent)
**Anti-cholinergic** - muscarinic block= bronchodilation caution in narrow angle GL (causes pupil dilation and anterior shift of iris)
228
Omeprazole (Prilosec)
Proton pump imhibitor Tx- GERD
229
Emadastine (Emadine )
**H1 Antihistamine** Tx of allergic conjunctivitis
230
Esomeprazole (Nexium)
Proton pump imhibitor Tx- GERD
231
Tetracyclines (drugs and main facts)
tetracycline, doxycline, minocycline * bind to 30S subunit * inhibit protein synthesis * doxy- meibomainitis and acne, chlamydial ocular infections and after RCE * mino- acne vulgaris * do not take with food (dairy, antacids and iron chealating componds) EXCEPT doxy (can take w/ food) * excreted through kidneys (except doxy- though fecal matter) * ADRs * contraindicated in pregnancy and children * pseduotumor cerebri * bone growth retardation * teeth discoloration * minocycline-- blue sclera, pigmented cysts on conj
232
Protein synthesis inhibitors antibiotics (names)
**30S inhibitors** * aminoglycosides (gentamicin, tobramycin) * tetracyclines (tetracycline, doxycycline, minocycline) **50S inhibitors** * chloramphenicol * macrolides (erythromycin, azithromycin, clarithromycin) * lincomycin * clindamycin
233
Griseofulvin (Grifulvin)
Anti-fungal inhibits fungal mitosis- interferes with microtubule formation tx -scalp and skin infections
234
Naproxen sodium (Aleve)
**NSAID- Reversible COX 1 and COX 2 inhibitor** Tx- scleritis and episcleritis ADRS * increase risk of bleeding complications in eye * GI bleeding * cardiovascular events (MI or stroke) (contraindicated in pts with coronary artery disease/ stroke)
235
Bacteriostatic antibiotics
tetracyclines trimethoprim sodium sulfacetamide erythromycin
236
Bromocriptine (Parlodel)
**Antiparkinsonian med** * dopamine agonist * tx- prolactin secreting pituitary adenoma or parkinsons
237
Celluvisc
ocular ointment
238
Fluoxetine (Prozac)
**Anti-depressant- selective serotonin reuptake inhibitor** * ADRs * mydraiassis (caution in narrow angle pt) * serotonin syndrome
239
Ribavirin (Copegus or Rebetol)
Antiviral Hep C tx * inhibits viral RNA polymerase * ADRS - conjunctivitis * (RIBAViriN:) * Retinal detachment * Ischemia (cotton wool spots) * Bleeding (retinal hemorrhages) * Arterial and venous occlusions * Optic neuritis
240
Sulfadiazine (Microsulfan)
sulfonamide antibiotic (inhibits folic acid synthesis)
241
Lisinopril (Prinivil, Zestril)
ACE ihbitior- HTN med * prevents formation of angiotensin II and blocks metabolsim of bradykinins (= vasodilation) * ADRs * cough
242
Atenolol (Tenormin)
Beta blocker - beta 1 specific HTN med ADRS: * CNS- disorientation, depression, fatigue * Cardio - bradycardia, arrhythmias, syncope * Pulmonary- dyspnea, wheezing, bronchospasm * GI- nausea, vomitting, diarrhea, ab pain * Reproductive- ED
243
Verapamil (Calan, Isoptin)
Calcium channel blocker HTN med * blocks L type Ca channels * decrease peripheral vascular resistance ADR * have direct cardiac effects * negative chronotropism (decrease HR) * ionotropism (decrease contractility) contraindicated in GL pts taking timolol (b/c greater risk of bradycardia and heart failure)
244
Clonidine (Catapres)
CNS alpha 2 agonist HTN med * decreases sympathetic outflow--\> decreased vascular resistance and decreased heart rate * ADRs * dry mouth * sedation * impotence * severe rebound HTN Parent compound of apraclonidine (cand decrease IOP)
245
Meperidine (Demerol)
**Opiate analgesic** * agonist at Mu, Kappa and Delta opiate receptors * potent analgesics * addictive * ADRs * miosis * resp depression * drowsiness * sedation * nausea build up of normeperidine - causes seizures, increased ICP and _papilledema_

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