Toxicology

Question 1

SPK

Answer 1

Isotretinoin (Accutane)

Topical aminoglycosides

Question 2

Phenothiazines: Chlorpromazine, Thioridazine

Answer 2

Endo/Descemet pigmentation
Pigmentary retinopathy
Decrease tear production (lacrimal system)

Question 3

Anterior Subcapsular effects

Answer 3

Chlorpromazine
Thioridazine
Amiodarone
Miotics - Pilocarpine

Question 4

Whorl Keratopathy ( Cornea verticillata)

Answer 4

Chloroquine
Hydroxychloroquine
Indomethacin
Amiodarone
Tamoxifen 
Fabry Disease

Question 5

Isotretinoin ( Accutane )

Answer 5

Blepharoconjunctivitis
Myopic shift
Dryness of lids
Lid edema 
SPK
Color vision loss
Nyctalopia ( night blindness )
Pseudotumor cerebri
Abnormal dark adaptation
Abnormal ERG
o	More likely in repetitive doses
o	Mostly reversible

Question 6

Oculogyric crisis

Answer 6

Phenothiazine

Cetrizine (Zyrtec)- oral antihistamines 2nd generation

Question 7

Floppy iris syndrome

Answer 7

Tamsulosin ( Flomax)

Question 8

Blue sclera

Answer 8

Steroids

Minocycline

Question 9

Indomethacin

Answer 9

Retinal hemorrhage
Pigmentary changes in retina
Whorl Keratopathy

Question 10

Nystagmus

Answer 10

Phenytoin ( Dialantin)
Phenobarbital ( Luminal)
Salicylate ( NSAIDs )

Question 11

Amiodarone

Answer 11

• Anterior subcapsular lens deposits
• Whorl keratopathy,yellow/brown or white powdery corneal epithelial deposits located inferocentrally that appear to swirl outward while sparing the limbus. discontinuation of amiodarone will allow for complete resolution of the deposits.
• NAION

Question 12

Sulfonamides

Answer 12

Steven Johnson syndrome

Lid Edema

Question 13

Tetracycline

Answer 13

-Pigmented cysts on the conjunctiva

Question 14

NAION

Answer 14

• Sildenafil (Viagra)
• Sumatriptan ( Imitrex)
• Amiodarone ( Cordarone)

Question 15

Tamoxifen

Answer 15

White or yellow crystalline deposits

-whorl keratopathy

Question 16

Pseudo tumor ceribri

Intracranial hypertension

Answer 16

Tetracyclines
Isotretinoin (Accutane)
Oral contraceptive

Question 17

Drugs containing BAK

Answer 17

Azitromycin
Gancyclovir (zirgan)
Bromfenec (Xibrom)

Question 18

Digoxin ( Digitalis)

Answer 18

Retrobulbar optic neuritis
Decrease IOP
B/Y color defect
Entoptic phenomena 
Blurred vision
Causes cone dysfunction
Peri-central scotomas
Defective color vision
-Xanthopsia (“yellow vision”)

Question 19

Decrease IOP

Answer 19

Systemic beta blocker
Digoxin
Alcohol
Cannabinoid

Question 20

Increase IOP

Answer 20

Atropine
Scopolamine 
Antihistamines
Tricyclic antidepressant
Antipsychotics
beta 2 agonists-short acting
Sudafed
corticosteroids (after 2-8 weeks of use)

Question 21

Thimerosal

Answer 21

Trifliridine ( viroptic) -antiherpes

Flubiprofen ( Ocufen)

Question 22

Oral steroids side effects

Answer 22

Long term use causes Diabetic

CSR

Question 23

Myopic shift

Answer 23

NSC
Diamox
Topomax

Question 24

Isoniazid

Answer 24

Combat active tuberculosis

Rarely causes optic neuritis and atrophy

Question 25

Atropine

Answer 25

``` Increase blood pressure Mental confusion Increased pulse Dryness of mouth and throat Loss of neuromuscular coordination ```

Question 26

NSAID

Answer 26

Subconjunctival hemorrhage | Retinal hemorrhage

Question 27

Blood thinners

Answer 27

Subconjunctival hemorrhage

Question 28

Sildenafil (Viagra)

Answer 28

Subconjunctival hemorrhage | Conjunctival Hyperemia

Question 29

Prostoglandin analog

Answer 29

Conjunctival Hyperemia growth of eyelashes pigmentation of lashes

Question 30

Anticholinergics drugs - Anticholinergics - TCAs - Antihistamines - Phenothiazines

Answer 30

Decrease tear production | Mydriasis

Question 31

Beta-Blockers

Answer 31

Decrease tear production

Question 32

Decrease tear production

Answer 32

``` Hormone Therapies ADHD meds Diuretics Accutane Beta-blockers Anticholinergics ```

Question 33

Mydriasis

Answer 33

- Anticholinergics - TCAs - Antihistamines - Phenothiazines - SSRIs - SNRIs - Benzodiazepine - Dopamin agonists

Question 34

Topiramate (Topamax)

Answer 34

secondary angle-closure glaucoma by causing choroidal swelling

Question 35

Miosis

Answer 35

Opiates | Acetylcholinesterase inhibitors

Question 36

Diplopia

Answer 36

Antidepressants anti-anxiety phenytoin (Dilantin)

Question 37

Alpha-1 blockers

Answer 37

toxicity on sclera and uvea

Question 38

Minocycline

Answer 38

``` Blue sclera Phototoxicity teeth discoloration bone growth depression Gastric irritation blood dyscrasias skin and mucus memb pigmentation depression ```

Question 39

Optic neuritis

Answer 39

``` Ethambutol-retrobulbar Chloramphenicol streptomycin sulfonamides oral contraceptives Isoniazid (unlikely) Mehotrexate (unlikely) ```

Question 40

Epinephrine

Answer 40

CME

Question 41

Macular Edema

Answer 41

Zidovusine (Retrovir) | Fingolimod( Gilenya)

Question 42

Penicillins

Answer 42

Hypersensitivity reaction - uticaria - Anaphylaxis - Contact dermititis

Question 43

Aminoglycosides

Answer 43

``` SPK Delayed corneal epithelization Nephrotoxicity Ototoxicity neuromuscular blockade ```

Question 44

Cephalosporin

Answer 44

Hypersensitivity reaction destroy intestinal microflora alter absorption of vit k

Question 45

Anterior Uveitis

Answer 45

Rifabutin Sulfonamides-systemic Cidofovir

Question 46

Topamax®

Answer 46

- Uveal effusion and swelling of the ciliary body, potentially causing pupillary block and angle closure. - Myopic shift