Ophthalmic Drugs Module 9 Unit B (PDF)

Module 9 Unit B Ophthalmic Class Drug examples Indications MOA Safety considerations BBW Notes Generic/Trade contraindications...

Module 9 Unit B Ophthalmic Class Drug examples Indications MOA Safety considerations BBW Notes Generic/Trade contraindications D2D QT Antibiotics Bacitracin- Ophthalmic Neomycin is SE/Adverse effects - None -Pregnancy/ (topical) polymyxin B 0.1% Ointment is bactericidal for many - Itching, swelling, and noted lactation: Not enough polypeptide ophthalmic drops indicated for the gram-positive and conjunctival erythema; data, do not use antibiotic topical treatment of gram-negative More serious superficial organisms. It is an hypersensitivity reactions, infections of the aminoglycoside including anaphylaxis, external eye and its antibiotic which have been reported adnexa caused by inhibits protein rarely. Local irritation on susceptible bacteria synthesis by binding instillation has also been with ribosomal RNA and causing reported. misreading of the Contraindications: bacterial genetic - In individuals who have code. shown hypersensitivity to any of its components. Polymyxin B is bactericidal for a Caution: variety of gram- - With prolonged use negative organisms. It D2D interactions increases the - None reported permeability of the QT prolongation/Risk of TdP bacterial cell - None membrane by interacting with the  phospholipid components of the membrane. Bacitracin is bactericidal for a variety of gram- positive and gram- negative organisms. It interferes with bacterial cell wall synthesis by inhibition of the regeneration of phospholipid receptors involved in peptidoglycan synthesis. Antibiotics Erythromycin This class is Control the SE/Adverse effects: -None Pregnancy/lactation: Not (topical) 0.5% active against most development or - Minor ocular irritations, noted enough data, use with macrolide Gr+, and some Gr -. reproduction of redness, and caution. For the treatment of bacteria and inhibit hypersensitivity reactions superficial ocular protein synthesis. infections involving Control the Contraindications: the conjunctiva development or - In patients with a history and/or cornea reproduction of of hypersensitivity to caused by organisms bacteria and inhibit erythromycin susceptible to protein synthesis. erythromycin. Caution: - Watch for overgrowth or superinfection.  - Pregnancy/lactation D2D interactions: - Erythromycin can increase plasma levels and half-lives of several drugs, thereby posing a risk for toxicity: theophylline, carbamazepine, warfarin. - It prevents binding of chloramphenicol and clindamycin to bacterial ribosomes, thereby antagonizing their antibacterial effects. - Should not be combined with Verapamil, diltiazem, HIV protease inhibitors, and azole antifungals (as they inhibit erythromycin metabolism). QT prolongation/Risk of TdP: - Known risk Antibiotics Ofloxacin 0.3% Bacterial Act by interfering SE/Adverse effects: -- None -Pregnancy/lactation: (topical) ophthalmic drops conjunctivitis and with DNA gyrase - Transient ocular burning noted Not enough data Fluoroquinolone Corneal ulcers which is the enzyme or discomfort. Other Ciprofloxacin responsible for the reported reactions 0.3% stranding of bacterial include stinging, redness, DNA synthesis, as itching, chemical well as bacterial growth and conjunctivitis/keratitis, replication. They are ocular/periocular/facial bactericidal. edema, foreign body sensation, photophobia, blurred vision, tearing, dryness, and eye pain. Rare reports of dizziness and nausea have been received Contraindications: - In patients with a history of hypersensitivity to ofloxacin, to other quinolones, or to any of the components in this medication. Caution: - Pregnancy - Lactation - With patients taking glucocorticoids - In underlying CNS pathology and renal impairment. - In the elderly due to the increased risk of aortic aneurysm. D2D interactions:  - None noted when taken topically. QT prolongation/Risk of TdP: - Ciprofloxacin: known risk - Ofloxacin: possible risk Antibiotics Sulfacetamide Treatment of Inhibition of folate SE/Adverse effects: -None -Pregnancy/lactation: (topical) (Bleph-10) conjunctivitis and metabolism. - Bacterial and fungal noted Sulfonamide other superficial corneal ulcers have ocular infections developed during due to susceptible treatment with microorganisms, sulfonamide ophthalmic and as an adjunctive preparations in systemic - Local irritation, stinging sulfonamide therapy and burning. Less of trachoma: Escherichi commonly reported a coli, Staphylococcus reactions include non- aureus, Streptococcus specific conjunctivitis, pneumoniae, conjunctival hyperemia, Streptococcus (viridan secondary infections and s allergic reactions. group), Haemophilus - Fatalities have occurred, influenzae, although rarely, due to Klebsiella species, severe reactions to and Enterobacter spe sulfonamides including cies. Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant hepatic  necrosis, agranulocytosis, aplastic anemia, and other blood dyscrasias Contraindications: - Known Sulfa allergy Caution: - Prolonged use and superinfeciton D2D interactions: - Sulfacetamide preparations are incompatible with silver preparations. QT prolongation/Risk of TdP: - None Topical Beta- Timolol (timoptic) Glaucoma Lower IOP by SE/Adverse effects: Pregnancy/lactation: Blockers decreasing the - Transient ocular stinging Refer to a specialist production of - Conjunctivitis, blurred Betaxolol aqueous humor vision, photophobia, and (Betoptic) dry eyes. - Bradycardia, atrioventricular heart block, bronchospasm, heightened brown pigmentation of the iris and eyelid Contraindications:  - In those with: AV heart block, sinus bradycardia, cardiogenic shock Caution: - In those with heart failure - On Systemic beta blockers D2D interactions: - Systemic beta blockers QT prolongation/Risk of TdP: - None Resources: Textbook, Lexicomp, LactMed, CredibleMeds