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100 Cards in this Set
- Front
- Back
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Natural Penicillins |
Pen G Pen V |
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Amino Penicillins |
Amoxicillin Amphocillin *Augmentin* |
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Methicillins |
Oxicillin Cloxicillin Dicloxicillin Nafcillin |
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Antipsuedomonal Penicillins |
Pipericillin Carbenicillin Mezlocillin Ticarcillin |
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1st generation Cephalosporins |
Cafazolin Cephalexin (G+) |
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2nd Generation Cephalosporins |
Cefalcor Cefuroxime *HENPEK* less G+ coverage |
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Salagine (pilocarpine 5mg) |
Tc for fry eye (off label) Dose= 5mg TID-QID |
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What is the dose for Salagine? |
5mg TID-QID |
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Civimeline |
Tx for dry mouth and off label for dry eye. dosing 30mg po TID |
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What is the dosing for Salagine and Civimeline? |
Salagine is 5mg Tid-qid Civimeline is 30 mg po TID |
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What are the systemic effects of Choline agonists? |
Sludge B Salivation Lacrimation Urination Defication Gastric motility Brochconstriction |
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Salagine and Cevimeline are treatments for what and what are the dosing? |
Salagine and Civimeline are tx for dry mouth and sjogrens and are off label treatmetns for dry eye dosing Salagine= 5mg TID=QID Civimeline= 30 mg po TID |
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Cycloplegics are what? |
Anti cholinergic drugs they cause mydriasis and relax the cilliary body these can INCREASE IOP unlike cholinergics which decrease IOP due to the constriction of the cilliary body causing the opening of the TM |
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Atropine |
THE MOST POTENT MYDRIATIC AND CYCLOPLEGIC AGENT can cyclo for up to 12 days VERY diluted amounts are given for the Myopia management ***THERES SIGNIFICANT PIGMENT BINDING** theres a slower onset with darker colored pigmented eyes |
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Atropine mechanics |
dialtes for 30-40 minutes and can last up to 10 days Cycloplegia begins in around 12 minutes for a maximum @ 1-3minutes lasts up to 12 days |
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What can you use atropine for? |
Cycloplegic refractions (impractical) Tx for Uveitis because it stops the spasms in the cilliary body AMBLYOPIA and MYOPIA |
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Cycloplegic refraction with atropine |
generally just used for small kid with highly spamsing accommodation. We want to calm it down WIll show Latent hyperopia and will make kids LESS ESO ** We generally want them to administer this 2-3 days before the exam *** YOU GOTTA MAKE SURE TO WASH HANDS AFTER INSTILLIN |
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How does atropine treat Anterior uveitis? |
Relieves pain by relaxing the ciliary body it prevent synechia may decrease permeability to inflamed vessels unlike pilocarpine |
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PILO VS ATROPINE |
Pilo is a cholinergic agonist that causes miosis and can INCREASE PERMEABILITY TO THE VESSELS Atropine is a cycloplegic or (anticholinergic) that relaxes the accommodation and decreases the permeability to inflamed vessels in uveitis |
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Myopia management with atropine |
atropine at LOW doses (0.05%)is shown to dramatically stop axial elongation this will also not cause very many systemic issues since its such a low dose |
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Amblyopia treatment with atropine |
You want to atropinize the GOOD eye thus letting them only use their amblyopic eye do all the near work |
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Ocular side effects of Atropine |
atropine can cause angle closure increased IOP ion angles |
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How do you use atropine in amblyopic treatment? |
You instill it in the good eye and let them, use the bad eye for all near work |
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True or false, Atropine can Decrease IOP? |
No it can increase IOP and also cause angle closure |
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Systemic effects of Atropine |
Low doses will only cause peripheral effects like Lack of Salivation or sweating with high doses it can cause CNS effects we must caution with people with lightly pigmented people, young kids and DOWNS |
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What could you do if a person overdoses on Atropine? |
Since atropine is cholinergic antagonist you need to give them a cholinergic Agonist (PHYSOSTIGMINE) |
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What are the contraindiations of Atropine? |
People with POAG and angle clopsure glaucoma kids Downs patient |
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Homatropine |
1/10th the strength of atropine and has a shorter duration 2% and 5% solutions ** Cycloplegia isnt as strong as atropine or cyclopentolate but it will last longer than cyclopentolate? |
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Will Homatropine cyclo more or less tthen cyclopentolate and will it last as Long? |
It will not cyclo as much as cyclopentolate but it will last longer |
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Scopolamine |
**stronger than atropine on a weight basis but shorter duration** it will quickly dilate but wont last long available in 0.25% solution BAD FOR ALL THE CYCLOs ONly used as a patch for motion sicnes ** A LOT OF CNS PROBLEMS** |
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will scopolamine have more or less CNS effects than atropine? |
It will have more CNS efffects than atropine and can also cross the BBB>>> It dilates quickly but doesnt last as long |
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Can scopolamine patches effect the eye? |
yes, it can effect the eye when it has systemic absorption as well as hand to eye contact |
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Cyclopentolate |
Comes in 0.5% 1% and 2% solution will cause mydriasis in about 20-30 minutes and 30-60mins in black patients youll get maximum cyclo in about an hour and will last 24 hours |
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What % does cyclopentolate come in and generally how long does it take to reach full cyclo? |
Cyclopentolat will come in 0.5% 1% and 2% and will reach its maximum cyclo in 30-60s and will last up to a day **** people with light colored eyes can reach max in about 10 minutes |
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Uses of cyclopentolate |
DOX in cycloplegic refractions becasue itll have as good of an effect as atropine and will last way less You can also treat uveitis pt with this if they are sensitive to atropine |
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SE of Cyclopentolate |
Can cause all the same issues as atropine but really doesnt happen because it needs to be taken for an extended amount time. generally More common with children when given 2% |
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All choline antagonists will cause what? |
INCREASED IOP all choline antagonists will cause increase in IOPP all choline antagonists will cause increase in IOP |
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Tropicamide |
Super fast onset and shorter duration than all the other choline antagonists it has excellent corneal penetration |
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Tropicamide |
Can cause max mydriasis in 25-30 min THIS IS NOT DOSE RELATED cycloplegia max in 30 min THIS IS DOSE DEPENDANT ***this has better MYDRIASIS THAN ALL THE OTHER CYCLOS |
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which cycloplegic has the best mydriasis? |
Tropicamide it will cause the most dialation but not as much cycloplegia as the other the Dilation is not dose dependent while the cycloplegia IS dose related |
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True or false Tropicamide's cycloplegic characteristics can increase with the amount of dosingn? |
yes cycloplegia is dose dependant but the dilation aspect of tropicamide is not dose dependant |
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if you increase the amount of tropicamide that someone get5s, what will happen |
when you increase the dose of tropicamide it will increase thwe amount of cycloplegia effects but will not effect the amount of dilation that occurs |
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risks of tropicamide? |
tropicamide is not used for uveitis becasue the effects just arent long lasting the only risks of Tropicamide is angle closure |
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Sympathetic innnervation to the eye |
Central fibers start in the hypothalamus and decend to the mediolateral collumns in the cervical cord Preganglionic fibers exit through the root of the spinal cord and travel over the apex of trhe long and synapse in the cervical ganglion Post ganglionic fiber follow the coratid plexus toward the cav Sinus where they join the ophthalmic division of CN V from the cav sinus they travel along the cilliary nerver and synapse in the iris dilator muscle at A1 receptors and the muscles of mueler in the upper eyelid |
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what are the effects of sympathetics in the eye? |
Dilation widening of the palpebral fissure vasoconstriction decrease in IOP inhibit accommodation by a small amount |
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which one of these effects will not happen in the eye? Dilation, Narrowing of the palpebral fissure, decrease in IOP or inhibition of accomm |
sympathetics will cause dilation WIDENING OF THE PALP FISSURE due to exciting the mueller muscle it causes vasoconstriction it will DECREASE IOP and it will inhibit accomm |
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what happens when sympahetics react in the eye? |
Dilation raising of the upper lid stop accom vasoconstriction decrease iop |
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Phenylephrine |
s |
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Third Generation Cephalosporins |
Ceftazidime Ceftriaxone Cefixime G+ coverage |
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Ocular uses of 3rd generation cephalosporins |
IV Ceftriaxone for orbital cellulitis |
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Ocular indications for 2nd gen Cephalosporins |
Oral cefaclor- Dacryocystitis - MSSA Pre septal Parenteral Cefuroxime- Severe Dacryocystitis and pediatric Preseptal cellulitis
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1st generation Cephalosporin Ocular indications |
Cafazolin- drug of first choice for bacterial corneal ulcers when using Broad spectrum Cephalexin- Dacryocystitis, preseptal cellulitis in MSSA |
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What kind of deficiency would you get if you take long term cephalosporins? |
VIT K deficiency due to not letting cells reabsorb vit K |
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How is amino glycosides most commonly inactivated |
Through enzymatic Activity |
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NEOMYCIN |
We use neomycin for contact dermatitis |
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What drug do we use for contact dermatitis? |
Neomycin |
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Which drug class would you use to treat psuedotumor cerebri? |
Aminoglycosides |
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Tetracycline is the DOC for what? |
ODDBALL Cx Lyme disease and chlamydia |
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Doxycycline |
Tx AIC- 100mg BID 1-3weeks Acne rosacea- 250mg qid then 250 qid for 6 months |
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When do we use Doxycycline? |
IN NON INFECTIOUS MEIBOMIAN GLAND and AIC |
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Doxycycline |
Tx rosacea, non infectious Meibo and AIC |
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SE of tetracyclines |
Photosensitivity GI disturbance Depressed bone growth in fetus Psuedotumor cerebri |
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Which one of these is not a SE of Tetracyclines? |
A. Bone depression in Fetus B. Photosensitivity C. GI disturbance D. Psuedotumor cerebri? E. NONE |
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Bacitracin |
Inhib polysaccharide chain in cell wall synthesis G+ plus neisseria ONLY AVAILABLE IN OINTMENT |
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Clarithromycin |
These have a very long half life so you only give theses drugs BID dosing DO NOT GIVE to PREGO |
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What is the topical version of Azithromycin? |
Azasite- (for Bacterial conjunctivitis) Dosing Day 1 and 2= 2 gtt qd Day 3-7 1 gtt qd |
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What topical version of Azithromycin could you use? And what would be the dosing? |
Azasite- 1-2days 1gtt BID 3-7 1 gtt qd |
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Trimethoprim effects what |
Bacterial metabolism |
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Sulfonamides |
Completely inhibit conversion of PABA Broad spectrum |
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What do Anesthetics and pus due to PABA? |
It greatly increases PABA so Sulfonamides wont work as well Pus basically gives the bacteria other nutrients to use |
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TOXOplasmosis is tx with what e |
Sulfonamides And Clindamycin |
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SE of Sulfonamides |
CAN CAUSE SEVERE STEVEN JOHNSONS SYNDROME |
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SEVERE STEVEN JOHNSONS SYNDROME can be caused by what medication? |
Sulfonamides (remember sulfa drugs can cause bad rashes) THATS WHY WE ALWAYS HAVE TO KNOW ALL CONTRAINDICATIONS |
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TRIMETHOPRIM |
Inhibits the reduction of dihydrofolic acid Synergizes with sulfonamides |
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How does Bacitracin come? |
Only comes in an ointment |
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POLYTRIM |
Solid Antibiotic for conjunctivitis |
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TMP/SMX |
Dosing- Single= 80/400 Double= 160/800 Typical adult dose 1DS tab BID |
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So does pus cause any complications with POLYTRIM? |
No it will cause issues with increased PABA but it doesn’t matter with POLYTRIM since it doesn’t share that characteristic as trimethoprim |
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What drugs affect DNA synthesis? |
Quinolones and Metroniazole |
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What is a solid use for metroniazole? |
Rosacea |
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Quinolones |
Inhibit DNA gyrase and topoiso Resistant to psuedomonas |
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What is the major fluoroquinolones? |
Ciprofloaxin for Corneal ulcers ONLY 1 AVAILABLE IN OINTMENT |
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What is the major black box warning for fluoroquinolones |
Risk of tendon ruptures Peripheral neuropathy |
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Fluoroquinolones compared |
Broader spectrum than Bacitracin, erythromycin, and the Aminoglycosides and is LESS TOXIC than Aminoglycosides |
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True or false, is fluoroquinolones more toxic than Aminoglycosides? |
False, they are less toxic and have a broader spectrum that erythromycin and the Aminoglycosides |
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What drugs do you use to treat Internal Hordeolumns? |
MSSA- dicloxacin MRSA- TPX/SMX- 1 DS tablet BID MRSA- Linezolid |
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Uses for fluoroquinolones |
CONJUNCTIVITIS (any of them will do) Keratitis( Cipro, oflox) - moxi gait besi are all off label treatments |
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What are the 2 FDA approved fluoroquinolones that treat Corneal keratitis? |
Ciprofloaxin and oxifloxacin
All other quinolones are off label ( Mox, gait ad basi) |
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True or false, Moxi, Besi and gatifloaxin Are all FDA approved to treat Corneal Keratitis? |
False only oxifloaxin and cipro are FDA approved to tx corneal keratitis |
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SE of Fluoroquinolones |
Burning and bitter taste and possible conjunctival hypermedia from the burning |
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What was the outcome to the Ocular trust data? |
Basically more and more drugs are becoming resistant to MRSA, except Tobramycin and trimethoprim |
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What is the dosing for Linezolid |
600 mg PO BID |
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True or false the dosing for Linezolid is 600mg P.O. TID? |
NO Linezolid is dosed 600mg P.O. TID |
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What is the treatment for bacterial keratitis and what is the dosing? |
Fluoroquinolones 1gtt qh |
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What is the main tx uses for Vanc? |
DOC for C Diff, TOC for penicillin resistant strep pneumoniae |
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What is the Tx of choice of Strepto Pnuemoniae? |
Vancomycin |
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Drugs affecting Cytoplasmic membranes |
POLYMyXIN B |
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What drug effects cytoplasmic membranes |
POLY MYXIN B |
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POLY TRIM |
We only use the ophthalmic prep, LARGE SPECTRUM |
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What component do most Drugs need to be able to tx g -? They need B LACTAM |
J |
