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111 Cards in this Set
- Front
- Back
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Cortisol
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Corticosteriod. also called hydrocortisone. Poor penetration. short half life. Standard of corticosteroids.
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Alcohol/Acetate corticosteriod
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suspensions, best penetration, better effectiveness. alcohol metabolized more quickly than acetate
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Prednisolone
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corticosteriod. used in eye. prodrug. very effective. intermediate halflife. Good for external ocular inflammation
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phosphate corticosteriod
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solutions, less effectivness, less irritation. better compliance
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Dexamethasone
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corticosteriod. long halflife.
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Fluorometholone
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corticosteriod. fast intraocular metabolism. good for external ocular inflammation
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Loteprednol
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corticosteriod. site specific, metabolized in eye.
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Difluprednate
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corticosteriod. metabolized to active product so longer DoA.
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disadvantages of ocular administration of corticosteriods
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occasional adrenal suppresion, aggravate dendritic ulcer, conj infections, epithelial keratopathy
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Other names and strengths of Prednisolone acetate
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.125%: Pred Mild, Econopred
1.0%: AK-Tate, Pred Forte, Econopred Plus, I-Pred Best ability to penetrate cornea suspension, steriod |
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Other names and strengths of Prednisolone sodium phosophate
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.125%: AK-Pred, Inflamase Mild
.5%: Metreton 1.0%: AK-Pred, Inflamase Forte steriod solution |
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Other name of Dexamethasone
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Maxidex
steroid suspension |
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Other names of Dexamethasone sodium phosphate
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AK-Dex, Baldex, Decadron, I-Methasone, Dexotic
steroid solution |
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Other names and strengths of Fluorometholone
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.1%: FML, Fluor-Op
.25%: FML Forte steroid suspension |
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Other name of Fluorometholone acetate
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Flarex
steroid suspension |
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Other name of Rimexolone
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Vexol
steroid suspension |
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Other names and strengths of Loteprednol Etabonate
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.5%: Lotemax
.2% Alrex steroid suspension |
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Other name of Difluprednate
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Durezol
steroid emulsion |
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Other name of Dexamethasone Sodium Phosphate
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Decadron, Maxidex
Steroid Ointment |
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Periocular Disadvantages Steroids
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Adrenal Suppresion, Subconj adhesions, Allergy, Ulceration of Conj, Exopthalmos, Papilledema
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Uses of Steroids Ocularlly
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Active Inflammation, injurty to eye, allergic conditions, uveitis, acidic chemical burns
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Dosing for Steroids
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Severe Topical: q2h - 2 days, taper
Mild Topical: q4d, taper Severe oral: 60mg Prednisone/day Mild Oral: 30mg Prednisone/day Remember to taper! |
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Non-responsive conditions to Steroids
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Degenerative diseases, Congenital macular degeneration (not any congenital), Fuch's cyclitis, Traumatic hyphema, Alkali burns, infectious diseases
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Local Manifestations of Steroid Use
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Glaucoma, Increased IOP, Cataracts, increased susceptibility to infections, decreased wound healing, uveitis, mydraisis, decreased ACTH release, activation of infections.
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Systemic Manifestations of Steroid Use
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cushings, stunt growth, adrenal insufficency, peptic ulcer, osteoporosis, hypertension, muscle atrophy, diabetes, mood changes, cataracts, increased iop, decreased wound healing
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Contraindications of Steroids
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peptic ulcers, osteoporosis, psychosis
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Aspirin
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NSAID. inhibit COX (part of prost. synthase enzyeme system)
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Flurbiprofen
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Ocufen. NSAID
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Diclofenac
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Voltaren. NSAID
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Ketorolac
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Acular/Acular PF, LS. NSAID
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Bromfenac
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Bomday. NSAID
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Nepafenac
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Nevanac. NSAID suspension
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Uses of NSAID
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treat CME, inflammation, prevention of intraoperative miosis, control pain and relieving symptoms of allergic eye disease
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Toxicities of topical NSAID
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burning, stinging, irritation, hyperemia of conj. allergies. prolong bleeding. corneal epithelilial breakdown, corneal thinning, corneal melting.
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DMARDs
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Disease Modifying Anti-rheumatic drugs. Can increase risk of lympoplastic cancer.
Methotrexate and TNF inhibitors |
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Leukotriene Antagonist + Name 2
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Binds to receptor, blocks leukotrienes from acting. prophylactic treatment of asthma (not acute).
Tox: HA, dizziness, ab pain, GI upset, cough, nasal congestion, fatigue Singulair Accolate |
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5 Lipoxygenase Inhibitors + Name 1
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block leukotriene synthesis. treat asthmatics.
Tox: Ab pain, upset stomach. nausea. anaphylaxis, liver disease, neutropenia also seen Zileuton |
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Mast Cell Stabalizers
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Prevent Degranulation of Mast Cell. blocks CA++ influx. stops activation of other inflamm cells.
vernal keratoconjunctivits, allergic conjuctivitis, giant papillary conjunctivitis. Tox: stinging, H/A, nasal congestion. acute chemotic reactions. |
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Cromolyn Sodium
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Crolom (mast cell stabalizer). also available as inhaled for asthma
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Lodoxamide
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Alomide (mast cell stabalizer)
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Nedrocromil
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Alocril (mast cell stabalizer). also available as inhaled for asthma
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Pemirolast
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Alamast (mast cell stabalizer)
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Azelastine
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Optivar (Anti-histamine + Mast cell stabalizer)
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Epinastine
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Elestat (Anti-histamine + Mast cell stabalizer)
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Ketotifen
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Zatidor, Alaway. (Anti-histamine + Mast cell stabalizer)
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Olopatadine
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Patanol, Pataday (Anti-histamine + Mast cell stabalizer)
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Bepotastine
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Bepreve. (Anti-histamine + Mast cell stabalizer)
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MOA of Antihistamines
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antagonize histamine at histamine 1 type receptor. competative block. older has antimuscarinic effects (good for motion sickness, dry up secretions from cold)
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Emedastine Opthalmic
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antihistamine. selective for H1, potent.
tox: blurred vision, burning, corneal infiltrates, corneal staining, dry eyes, FB, hyperemia, keratitis, tearing, HA, wierd dreams, pruitus, rhinitis, sinusitis, asthenia, bad taste, |
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older antihistamine/decongestant combos
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Naphcon-A, Opcon-A, AK-Con-A
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Oral Antihistamines (older)
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Benadryl, Dimetane, Chlor-Trimeton, Dramamine (for antinausea)
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Oral Antihistamines (newer)
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moClaratin, Zyrtec, Allegra, Clarinex, Xyzal
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Tox of Oral Anti-hist
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Sedation, dizziness, tinnitus, weariness, blurred vision, dry mouth, loss of appetite, palpitation, GI. poisoning can cause paradoxical excitement...
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Ocular Tox of Oral Anti-hist
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Decreased vision, mydriasis, lower reaction to light, decreased tolerance to CL's, diplopia, photosensitivity (Dimetane), visual hallucinations (Chlor-Trimeton).
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Cyclosporin A
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Restasis Immunomodulators. KCS with inflammation. increase goblet cells.
Tox: burning. conj hyperemia, discharge, epiphoria, eye pain, FB sensation, pruritus, stinging, blurring. |
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Pegaptanib
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Macugen: VEGF inhibitor. prevents binding of VEGF to receptor. intravitreal.
Tox: floaters, intraocular inflammation, blur, eye pain, endopthalmitis. |
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Avastin
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(monoclonal Ab for VEGF) antiangio. intravitreal
Tox: conj hemorrhage, eye pain, floaters, increased IOP, VD, HTN, intraocular inflmmation, cataracts |
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Lucentis
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monoclonal Ab for VEGF, antiangio. intravitreal
Tox: conj hemorrhage, eye pain, floaters, increased IOP, VD, HTN, intraocular inflmmation, cataracts |
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Visudyne
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Photodynamic therapy (light generates energy, activates oxygen, damage vessel) accumulates with high LDL receptors. good for classic AMD.
Tox: loss of vision, photosensitivity, back pain, allergies |
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Antipsychotics
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Phenothiazines, Chlorpomazine. Prochlorperazine, Thioridazine.
block dopamine and alpha adrenergic receptors. Tox: decreased VA, paralysis of Accom. pigment deposits on cornea, lens, retina (thioridazine). stellate cataracts. oculogyral crisis (EOM tonic contract, lids shutter) |
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Clozapine
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atypical antipsychotic. antimuscarnic effects. caution with narrow angle glaucoma
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Risperidone
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atypical antipsychotic.
Tox: abnormal vision, abnormal accom, xeropthalmia |
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Olazapine
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atypical antipsychotic
Tox: conjunctivitis, amblyopia, abnormal vision |
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Name Antianxiety agents
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Diazepam, Alprazolam, Zolpidem, Clonazepam, Busperione, Lorazepam, Temazepam
TOX: decreased tearing. paralysis of EOM, diplopia, nystagmus, decreased corneal reflex, allergies |
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Ethanol
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Tox: EOM
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Phenytoin
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anticonvulsant.
Tox: nystagmus, dipolia, decreased accom/convergence, mydriasis, allergic, birth defects |
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Carbamazepine
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anticonvulsant.
Tox: frequent side effects, diplopia, blurred vision, heaviness in eye, conjucvitivies. |
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Valproic Acid
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anticonvulsant.
Tox: rare, diplopia, vertical nystagmus, vestibular abnormalities |
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Barbiturates
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depress CNS, can cause ptosis and blepharoclonus
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Nortriptyline
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TCA antidepressant
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Amitriptyline + TOx
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TCA antidepressant. increases NE at synapse.
TOx: cycloplegia, mydraisis, dry eye, photosensitation |
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Prozac
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SSRI
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Zoloft
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SSRI
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Paxil + TOx
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SSRI.
tox: rare. blurred vision, mydriasis, diplopia, nystagmus, ptosis |
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Venlafaxine
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atypical antidepressant.
tox: blurred vision, mydriasis |
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Bupropion
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atypical antidepressant
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Lithium
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for Bipolar.
Tox: nystagmus |
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Anti-parkinsons drugs
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L-Dopa (diplopia, blurred vision), Benztropine (cycloplegia, mydriasis)
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Opiods
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miotic, no tolerance. reversible with Naloxone
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Lidocaine (LA)
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cranial nerve paralysis
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Isoniazid
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anti-TB.
Tox: neuropathy, optic neuritis, atrophy, decreased VA. reversed with B6 |
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Ethambutol
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Anti-TB
Tox: optic neuritis, VF changes, color abnormality, mostly reversible |
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Streoptomycin
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anti-TB.
severe cases, VIII nerve damage, optic atrophy, visual loss |
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Rifampin
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anti-TB
tox: bloody tears, changes secretion color |
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Plaquenil
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Anti-malaria
Tox: decreased VA, corneal epithelial deposits (whirl-like), bulls eye retinopathy. |
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Quinine
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anti-malaria. in tonic water
tox: decreased VA, iris atrophy, optic atrophy, VF changes |
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Tetracyclines, Doxycylcine
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Antibacterial.
Tox: pigment deposits in conjunctiva. rare: papilledema, pseudo tumor cerebri, myopia, maybe myasthenia gravis |
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Floroquinolones (Ciprofloxacin, Levofloxacin)
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antibacterial
Tox: eye pain, photosensitivity, nystagmus |
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Sulfonamides
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Antibacterial
tox: transient myopia, allergies, conjunvitivites, chemosis, lid edema |
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5-Fluorouracil
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Anti-neoplastic
Tox: increased lacrimation, cicatricial changes, lids, conj, lacrimal gland |
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Vincristine
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Anti-neoplastic.
Tox: ptosis, EOM paralysis. decreased nerve transport mechanisms |
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Tamoxifen
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Anti-neoplastic
Tox: corneal opacities, retinal changes |
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Diuretics
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diuretics
Tox: decreased vision, induce myopia, ciliary edema, allergic reactions, decreased CL tolerance, photophobia |
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Metoprolol
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Beta Blocker.
Tox: diplopia, decreased vision, allergies, decrease IOP, dry eye |
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Digitoxin, Digoxin
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Digitalis Glycosides.
TX: decrease IOP, color vision abnormalities, glare phenomenon, visual sensations |
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Amiodarone
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Anti-arrhythmic
Tox: corneal deposits. lens deposits. optic neuropathy |
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Corticosteroids
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Cortisol, Beclomethasone diproprionate, Prednisone
Tox: increased IOP (mostly with topical), posterior subcapsular cataracts, decreased wound healing, decreaesed infectious resistance |
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Oral Contraceptives/Estrogens
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Tox: retinal-vascular disorders, thrombo-emboli, decreased contact lens tolerance
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Indomethacin
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NSAID.
TOx: decreased vision, diplopia, color vision, corneal deposits, allergic reaction, hemorrhages |
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Ibuprofen
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NSAID.
rare reactions |
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Allopurinol
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anti-arthritis
Tox: decreased VA, possible cataracts, allergic reaction |
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Gold Compounds
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Anti-arthritis.
Tox: deposits on mucous membranes, not serious, allergies |
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Auro-thio-glucose
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Anti-arthritis
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Tox of Oxygen
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Retrolental Fibroplasia
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Tox of Ergot Alkaloids
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Vasoconstriction
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Tox of Excess Vit. A
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enlarged blind spot, retinal hemorrhage, pseudotumor cerebri
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Isotretinoin Tox
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Vit a analog for acne
Tox: corneal opacities, keratitis, corneal neo, dry eye, blepharoconjunctivitis |
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Viagra + Cialis
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PDE5 inhibitors.
Tox: mild transient color vision impairment. loss of vision from NAION |
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Flomax
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for benign prostatic hypertrophy. alpha 1 adrenerginc blocker. relaxes smooth muscle and improves urine flow
Tox: intraoperative floppy iris syndrome |
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Tox of stimulates, ampheatmine, cocaine
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Mydriasis, Increased IOP, hallucinations, decreased vision
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Tox of Weed
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conjunctivitis, decreased visual coordination, decreased IOP, color flashes
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