Boards Toxicology

Front 1

Which drug(s) cause: Whorl Keratopathy

Back 1

Chloroquine

Hydroxychloroquine

Amiodarone

Tamoxifen

Indomethacin

Front 2

Which disorder causes: Whorl Keratopathy

Back 2

Fabry's Dz - a lysosomal storage dz

Front 3

Which drug(s) cause: SPK

Back 3

Isotretionoin (Accutane)

Topical Aminoglycosides - Tobramycin and

Gentamicin

Front 4

Which drug(s) cause: Endothelial/Descemet's Pigmentation

Back 4

Chlorpromazine

Thioridazine

(Both are anti-psychotics)

Front 5

Which drug(s) cause: Stromal Gold Deposits

Back 5

Gold salts - visually asymptomatic yellow-brown deposits located on the posterior stroma and Descemet's membrane

Referred to as ocular chrysiasis

Front 6

Which drug(s) cause: Delayed corneal healing

Back 6

Corticosteroids

Front 7

Amiodarone is an antiarrhythmic drug with the following note worthy ocular s/e

Back 7

1. "Whorl keratopathy" - visually insignificant toxicity of the epi; can cause glare and photophobia

2. Anterior subscapular lens deposits

3. NAION (1-2% of cases)

Front 8

Which drug(s) cause: Anterior Subscapular Effects

Back 8

Miotics (vacuoles)

Thioridazine - antipsychotics

Amiodarone (deposits)

Chlorpromazine - antipsychotics

May Trigger Anterior Cataracts

Front 9

Which drug(s) cause: Posterior Subscapular

Cataracts

Back 9

Corticosteroids

PSC cataract formation from steroids is dose dependent and irreversible

Hispanics appear to be at the highest risk

Front 10

What affects does this drug cause to the

Conjunctivia and Lids: Isotretinoin (Accutane)

Back 10

Blepharoconjunctivitis

Dryness

Lid Edema

Front 11

What affects does this drug cause to the

Conjunctivia and Lids: NSAIDs

Back 11

Subconjunctival Heme

Retinal Heme

Front 12

What affects does this drug cause to the

Conjunctivia and Lids: Sulfonamides

Back 12

Ocular findings rare, but includes Stevens - Johnson Syndrome and Lid edema

Front 13

What affects does this drug cause to the

Conjunctivia and Lids: Tetracyclines

Back 13

Pigmented cysts on the conjunctivia

Front 14

What affects does this drug cause to the

Conjunctivia and Lids: Sildenafil (Viagra)

Back 14

Sunconjuntival Heme

Conjunctival Hyperemia

NAION

Front 15

What affects does this drug cause to the

Conjunctivia and Lids: Prostaglandin Analogs

Back 15

Conjunctival hyperemia

Increased growth and pigmentation of the eyelashes

Increased pigmentation of the periorbital skin

Front 16

What affects does this drug cause to the

Conjunctivia and Lids: Tamiflu

Back 16

Conjunctivitis in 1%

Front 17

Drugs that affect the autonomic nervous system can alter _____________________

Back 17

Tear Production

Front 18

Which drugs have Anticholinergic Effects and cause a decrease in Tear secretion?

Back 18

Anticholinergics - Atropine, Scopolamine

Tricyclic Antidepressants (TCAs) - Amitriptyline (Elavil), Imipramine (Tofranil)

Antihistamines - Chlorpheniramine (Chlor-

Trimeton), Bropheniramine (Dimetane), Diphenydramine (Benadryl) Promethazine (Phenergan)

Phenothiazines - Chlorpromazine (Thorazine), Thiordazine (Mellaril)

Front 19

Which drugs cause a decrease in Tear secretion?

Not drugs with anti-cholinergic effects

Back 19

Isotretinoin (Accutane)

Beta-Blockers - Most commonly caused by Timolol, Atenolol, Propranolol

Hormone Therapies - Oral contraceptives, hormone replacement drugs

ADHD Medications - Methylphenidate (Ritalin), Dextroamphetamine (Dexedrine)

Diuretics - Hydrochlorothiazide (Hydrodiuril)

Front 20

Which drugs have Anticholinergic Effects and cause Mydriasis?

Back 20

Anticholinergics - Atropine, Scopolamine

Tricyclic Antidepressants (TCAs) - Amitriptyline (Elavil), Imipramine (Tofranil)

Antihistamines - Chlorpheniramine (Chlor-

Trimeton), Bropheniramine (Dimetane), Diphenydramine (Benadryl) Promethazine (Phenergan)

Phenothiazines - Chlorpromazine (Thorazine), Thiordazine (Mellaril)

Benzodiazepine (Anxiolytic)- Diazepam (Valium)

Front 21

What other class of drugs cause Mydiasis (besides drugs with anticholinergic effects)?

Back 21

Dopamine agonists - methylphenidate (Ritaline), Dextroamphetamine (Dexedrine), Amantadine (Symmetrol), Bromocriptine (Parlodel)

Front 22

Drugs with mydriasis S/e can contribute to an ________________________

Back 22

Angle-close event [in pts with narrow angles]

Front 23

What drugs cause Miosis?

Back 23

Opiates - Morphine, Heroine, Codeine

Acetylcholinesterase Inhibitors

Front 24

Which drug(s) cause: Nystagmus

Back 24

Phenytoin (Dilantin) - [funny eye movements; funny gums]

Phenobarbital (Luminal)

Salicylates (NSAIDs)

[Diazepam (Valium)]

Front 25

Which drug(s) cause: Diplopia

Back 25

Antidepressants

Antianxiety agents

Phenytoin (Dilantin)

Front 26

What is an Oculogyric crisis and which drug(s) can cause it?

Back 26

Occurs when the EOMs undergo spastic, abnormal muscle contractions that leave the eye abnormally positioned (typically elevated)

Occurs most commonly with Phenothiazine toxicity, but can also occur with Cetrizine (Zyrtec)

Front 27

Which drug(s) cause: Intraoperative Floppy Iris Syndrome

Back 27

Tamsulosin (Flomax) - Alpha-1 Blockers

Front 28

Which drug(s) cause: Blue Sclera

Back 28

Corticosteroids

Minocycline

Front 29

What effect(s) does the following drug have on the Optic Nerve: Digoxin

Back 29

Retrobulbar Optic Neuritis

B/Y color defects

Entopic Phenomena ("snowy" vision, dimming vision, flickering lights)

Front 30

What effect(s) does the following drug have on the Optic Nerve: Ethambutol

Back 30

Optic neuritis - typically retrobulbar and bilateral

Front 31

Which drugs are typically responsible for causing an optic neuritis?

Back 31

Digoxin

Ethambutol

Chloramphenicol

Streptomycin

Sulfonamides

Isoniazd/Methotrexate

Oral Contraceptives

Front 32

What effect(s) does the following drug have on the Optic Nerve: Isoniazid/Methotrxate

Back 32

Unlikely culprits of optic neuritis

Front 33

Which drug(s) cause: NAION

Back 33

Sildenafil (Viagra)

Sumatriptan (Imitrex)

Amiodarone (Cordarone)

Front 34

What effect(s) does the following drug have on the Optic Nerve: Oral Contraceptives

Back 34

Effects are rare but may include optic neuritis, papilledema, and pseudotumor cerebri

Front 35

What effect(s) does the following drug have on the Retina: Chloroquine

Back 35

Bull's Eye maculopathy (much more common than with Hydroxychloroquine)

Front 36

What effect(s) does the following drug have on the Retina: Epinephrine

Back 36

Cystoid macular edema (topical epinephrine in aphakic eyes)

Front 37

What effect(s) does the following drug have on the Retina: Tamoxifen

Back 37

White or yellow crystalline deposits (commonly in the macula) with or without macular edema

Front 38

What effect(s) does the following drug have on the Retina: Thioridazine/Chlorpromazine

Back 38

Pigmentary retinopathy that can have an appearance similar to Bull's eye maculopathy

Front 39

What effect(s) does the following drug have on the Retina: Indomethacin

Back 39

Retinal hemorrhage

Pigmentary changes (especially in the macula)

Front 40

What effect(s) does the following drug have on the Retina: Talc

Back 40

Retinopathy (white, shiny emboli within arterioles)

Front 41

What effect(s) does the following drug have on the Retina: Isotretinoin (Accutane)

Back 41

Color vision loss

Nyctalopia (night blindness)

Front 42

What effect(s) does the following drug have on the Retina: NSAIDs

Back 42

Retinal Hemes

Front 43

What effect(s) does the following drug have on the Retina: Oral Contraceptives

Back 43

Vasculopathy including arterial and vein occlusions

Retinal Hemes

Front 44

Which drugs can cause Intracrainal HTN

Back 44

CANT

Contraceptives

Accutane - Isotretinoin

Nolidixic Acid

Tetracycline

Also Levothyroxine in Kids

Front 45

What drug(s) cause: a decrease in IOP

Back 45

Systemic Beta-Blockers

Cardiac GLycosides (Digoxin)

Alcohol

Cannabinoids - marijuana [max effect on IOP is 60-90 mins after inhalation and lats 4 hrs]

Front 46

What drug(s) cause: an increase in IOP

Back 46

Corticosteroids

Anticholinergic Activity:

Antropine and Scoplamine

Antihistamines - Bropheniramine (Dimetane), Diphenhydramine (Benedryl)

Tricyclic Antidepressants (TCAs) - Amitriptyline (Elavil), Imipramine (Tofranil)

Antipsychotics - Phenothiazines

Front 47

Why do Corticosteroids cause an increase in IOP?

Back 47

By decreasing aqueous humor outflow. Several mechanisms are believed to occur, including: decreased ability for TM cells to replace matrix and phagocytose debris and a thickening of trabecular fibrils and juxtacanalicular tissue