Therapeutic drugs used in Opthalmology
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| Topical Anesthetics | Proparacaine, Alcaine, Fluracaine (Short Acting)
Tetracaine (Long acting)
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| NSAIDS | Diclofenac Sodium sol'n (Voltaren) - TX of post-op inflammation, relief of photophobia
Ketorlac tromethamine sol'n (Acular) - relief of ocular itching d/t allergies
Flurbiprofen sodium sol'n (Ocufen, Allergan) - Prevention of intraoperative miosis
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| Corticosteroids | Prednisolone acetate sol'n (Pred Forte)
Prednisolone sodium phosphate
Dexamethasone/Tobramycin oint/susp. (Alcon)
Dexamethsone 0.05%, 0.1% oint/soln
Fluorometholone 0.1% soln (Flarex)
Fluorometholone 0.25% susp. (FML-Forte)
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| Decongestants | Naphazoline (Visine A, Clear Eyes, Vasoclear)
Tetrahydrolozine (Murine)
Patients with narrow anterior chamber angles or narrow-angle glaucoma should not use these products.
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| Antihistamines | Levocabastine HCL 0.05% soln (Livostin)
Emedastine difumarate 0.05% soln (Emadine)
Azelastin (Optilast)
Pheniramine maleate (Naphcon A, Opcon A) - OTC
Olopatadine HCL (Patanol) -mast cells
Cromolyn Sodium (Crolom) - mast cells
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| Antibiotics - Sulfonamides | MOA: Inhibits formation of folic acid
Used for: Lid infections, conjunctivitis, corneal abrasion/ulcer, prevention of infection
Sulfacetamide (Bleth 10)
Sulfisoxazole (Cetamide)
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| Antibiotics - Fluoroquinolones | Used especially in prevention/tx of pseudomonas infection
- Ciprofloxacin (Ciloxan) sol'n or ointment
- Ofloxacin (Ocuflox) sol'n
- Levofloxacin (Quixin)
- Gatifloxacin (Zymar)
- Moxifloxacin (Vigamox)
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| Antibiotics - Aminoglycosides | MOA: bind to ribosome and prevent tRNA synthesis
Used for: same as the sulfonamides
- Gentamycin (Garamycin) sol'n or ointment
- Tobramycin (Tobrex) sol'n
- Neomycin (Not used often because of high incidence of allergies)
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| Antibiotics - Other | - Erythromycin sol'n or ointment (used for prevention of gonorrhea transmission in childbirth)
- Bacitracin ointment (inhibits cell wall synthesis)
- Trimethoprim Sulfate - Polymyxin B Sulfate (Polytrim)
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| Antivirals | Trifuridine (Viroptic)
Vidarabine (Vira-a)
Idoxuridine (Herplex)
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| Cycloplegics | MOA: paralyzes the ciliary muscle, inducing pupil dilation
-Atropine (Isopto Atropine)
- Scopolamine (Isopto Hyoscine)
- Cyclopentolate (Cyclogyl)
- Mydriacyl (Tropicamide)
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| Agents for the TX of Glaucoma - Beta Blockers | * Decrease aqueous humor formation*
- Betaxolol (Betoptic) *The best one for asthmatics*
- Timolol maleate (Timoptic)
- Levobunolol (Betagan, AKBeta)
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| Agents for the TX of Glaucoma -Sympathomimetic (Alpha Adrenergic agonists) | * Reduce intraocular pressure (IOP) by increasing outflow and reducing production of aqueous humor*
- Brimonidine (Alphagan)
- Apraclonidine (Iopidine) 0.5%, 1%
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| Agents for the TX of Glaucoma - Miotics (parasympathomimetics) | * increased outflow of the aqueous fluid*
- Pilocarpine (Pilocar, Pilagan)
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| Agents for the TX of Glaucoma - Prostaglandin Analogs | * Increase uveoscleral outflow of the aqueous *
- Latanoprost (Xalatan)
- Travapost (Travoprost)
- Bimatoprost (Lumigan)
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| Agents for the TX of Glaucoma - Carbonic Anhydrous Inhibitors | * Reduce secretion of aqueous humor by inhibiting carbonic anhydrase in ciliary body *
- Dorzolamide HCl (Trusopt) 2%
- Brinzolamide (Azopt) 1%
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| Acetazolamide (Diamox) | Carbonic Anhydrase Inhibitor - Glaucoma
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| Dorzolamide HCl (Trusopt) 2% | Carbonic Anhydrase inhibitor - Glaucoma
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| How do Carbonic Anhydrase Inhibitors treat Glaucoma? | They reduce secretion of aqueous humor by inhibiting carbonic anhydrase in the ciliary body
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| Brinzolamide (Azopt) 1% | Carbonic Anhydrase Inhibitor - Glaucoma
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| How do Prostaglandin analogs treat Glaucoma? | They increase the uveoscleral outflow of the aqueous
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| Latanoprost (Xalatan) | Prostaglandin analog - Glaucoma
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| Travaprost (Travoprost) | Prostaglandin analog - Glaucoma
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| Bimatoprost (Lumigan) | Prostaglandin analog - Glaucoma
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| How do Miotics (parasympathomimetics) treat Glaucoma? | They increase the outflow of the aqueous fluid
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| Pilocarpine (Pilocar, Pilagan) | Miotic (parasympathomimetic) - Glaucoma
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| How do Sympathomimetics (alpha adrenergic agonists) treat glaucoma? | They reduce IOP by increasing outflow and reducing production of aqueous humor
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| Brimonidine (Alphagan) | Sympathomimetic (alpha adrenergic agonist) - glaucoma
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| Apraclonidine (Iopidine) | Sympathomimetic (alpha adrenergic agonist) - glaucoma
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| How do Beta Blockers treat Glaucoma? | They decrease aqueous humor formation
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| Betaxolol (Betoptic) | Beta Blocker - Glaucoma *Best one for asthmatics*
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| Timolol maleate (Timoptic) | Beta blocker - Glaucoma
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| Levobunolol (Betagan, AKBeta) | Beta Blocker - Glaucoma
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| What do cycloplegics do? | They paralyze the ciliary muscle, inducing pupil dilation
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| Atropine (Isopto Atropine) | Cycloplegic
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| Scopolamine (Isopto Hyoscine) | Cycloplegic
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| Cyclopentolate (Cyclogyl) | Cycloplegic
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| Mydriacyl (Tropicamide) | Cycloplegic
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| Trifuridine (Viroptic) | Antiviral
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| Vidarabine (Vira-a) | Antiviral
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| Idoxuridine (Herplex) | Antiviral
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| Erythromycin sol’n or ointment | Antibiotics - other
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| Bacitracin ointment | Antibiotics - other *inhibits cell wall synthesis*
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| Trimetoprim Sulfate | Antibiotics - other
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| Polymyxin B Sulfate (Polytrim) | Antibiotics - other
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| How do Aminglycoside antibiotics treat eye infections? | They bind to the ribosome and prevent tRNA synthesis
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| Gentamycin (Garamycin) | Aminoglycoside antibiotic
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| Tobramycin (Tobrex) | Aminoglycoside antibiotic
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| Which aminoglycoside antibiotic is not used often because of its high incidence of allergic reactions? | Neomycin
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| Neomycin | Aminoglycoside antibiotic
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| When is the use of fluoroquinolones strong encouraged? | For infections involving contact lens wearers (pseudomonas)
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| Ciprofloxacin (Ciloxan) | Fluoroquinolone
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| Ofloxacin (Ocuflox) | Fluoroquinolone
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| Levofloxacin (Quixin) | Fluorquinolone
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| Gatifloxacin (Zymar) | Fluoroquinolone
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| Moxifloxacin (Vigamox) | Fluoroquinolone
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| How do the sulfonamides treat eye infections? | They inhibit the formation of folic acid
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| What are the sulfonamides used to treat? | Lid infections, conjunctivitis, corneal abrasions/ulcers and prevention of infections
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| Sulfacetamide (Bleth 10) | Sulfonamide
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| Sulfoxazole (Cetamide) | Sulfonamide
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| In what patient is the use of ocular antihistamines contraindicated? | Contact lens wearers
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| Levocabastine HCL (Livostin) | Antihistamine
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| Emedastine difumarate (Emadine) | Antihistamine
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| Azelastin (Optilast) | Antihistamine
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| Pheniramine maleate (Naphcone A, Opcon A) | Antihistamine OTC
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| Olopatadine HCL (Patanol) | Antihistamine - mast cell stabilizer
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| Cromolyn Sodium (Crolom) | Antihistamine - mast cell stabilizer
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| In what patient is the use of ocular decongestants contraindicated? | Patients with narrow-angle glaucoma
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| Naphazoline (Visine A, Clear Eyes, Vasoclear) | Decongestant
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| Tetrahydrolize (Murine) | Decongestant
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| Prednisolone acetate (Pred Forte) | Corticosteroids
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| Prednisolone sodium phosphate | Corticosteroid
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| Dexamethasone/Tobramycin oint/susp (Alcon) | Corticosteroid
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| Dexamethasone oint/susp | Corticosteroid
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| Fluorometholone (Flarex) | Corticosteroid
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| Fluorometholone 0.25% susp. (FML - forte) | Corticosteroid
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| Diclofenac sodium (Voltaren) | NSAID (used for TX of post-op inflammation, relief of photophobia)
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| Ketorlac tromethamine sol’n (Acular) | NSAID (used for relief of ocular itching due to allergies)
🗑
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| Flurbiprofen sodium (Ocufen, Allergan) | NSAID (used for prevention of intraoperative miosis)
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| Proparacaine | Topical anesthetic - short acting
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| Alcaine | Topical Anesthetic - short acting
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| Fluracaine | Topical anesthetic - short acting
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| Tetracaine | Topical Anesthetic - Long Acting
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