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OPT 2 00 D DRUGS WITH CORRECT ANSWERS 100 % VERIFIED!!
Xalatan - ANSWER Prostaglandin Analog Latanoprost 0.005% solution, 1 gtt q.h.s. available as generic
Lumigan - ANSWER Prostaglandin Analog Bimatoprost 0.01% solution, 1 gtt q.h.s
Travatan Z - ANSWER Prostaglandin Analog Travoprost 0.004% solution, 1 gtt q.h.s
Azopt - ANSWER CAI Brinzolamide 1% suspension, 1 gtt b.i.d.(adjunct) or t.i.d. (alone) have to shake b/c suspension
Trusopt - ANSWER CAI Dorzolamide 2% solution, 1 gtt b.i.d. (adjunct) or t.i.d. (alone) more irritating
Timolol - ANSWER Beta Blocker
0.25% solution, 1 gtt q.d.
Alphagan - ANSWER alpha agonist Brimonidine 0.2% or 0.15%, solution 1 gtt bid (adjunct) or TID (alone)
Alphagan P - ANSWER alpha agonist Brimonidine 0.15% or 0.1% solution, 1 gtt bid (adjunct) or tid (alone) preservative Purite is less allergenic
Crolom, alomide, Alamast, Alocril - ANSWER Mast cell stabilizer
**- Requires longer treatment to be effective
- Approximately 4 weeks** » Appropriate for seasonal allergies - Some symptomatic relief after 3 days » Not good choice by itself for acute allergic conjunctivitis
Opcon A, NaphconA, Visine A - ANSWER Decongestant/ Antihistamine
Alaway or Zaditor - ANSWER Antihistamine/ Mast cell stabilizer (OTC) Ketotifen 0.025% solution, b.i.d.
Pataday - ANSWER Antihistamine/Mast Cell Stabilizer (Rx) olopatadine 0.2% solution, 1 gtt qd
Pred mild - ANSWER Mild Steroid Prednisolone acetate 0.12% suspension
Alrex - ANSWER Mild Steroid
Ibuprofen - ANSWER NSAID Up to 200 to 800 mg by mouth q.i.d.
Acular LS - ANSWER NSAID Ketorolac 0.4% solution, 1 gtt q.i.d.
Atropine - ANSWER Pain Management & control inflammation (b/c constrict pupil) 1% solution 1 gtt b.i.d. or t.i.d.
Tobradex (ST) - ANSWER Combination Antibiotic/Steroid Tobramycin 0.3% & dexamethasone 0.1% suspension, ointment
- ST = improved suspension technology
Zylet - ANSWER Combination Antibiotic/Steroid Tobramycin 0.3% and loteprednol 0.5% suspension
Keflex - ANSWER Oral Antibiotics - Preseptal
- Cephalexin (250 or 500 mg)
- Preseptal: one 500 mg tablet by mouth q.i.d. x 7 days caution if allergic to PCN
Augmentin - ANSWER Oral Antibiotics - Preseptal
- PCN (250, 500, or 875 mg) + clavulanate (125 mg) - Preseptal: one 500mg cappsule by mouth b.i.d. x 10 days
Zithromax - ANSWER Oral Antibiotics - Preseptal
**- Azythromycin (250, 500, 600 mg)
- Two 250 mg capsules by mouth x 1 day, one 250 mg capsule x 4 days** Z-pack
Doxycycline - ANSWER Oral Antibiotics - Blepharitis
**- 25, 50, 75, 100, 150 mg
- Blepharitis: one 100mg capsule by mouth b.i.d. x 6 weeks** » Not to be used with milk or antacids » Not to be used < 8 year old **- Affects bone and teeth formation
- Caution with birth control pills**
Tetracycline - ANSWER Oral Antibiotics - Blepharitis Same class as doxycycline
Antibiotic -- Topicals - ANSWER • AzaSite
**- Zymar/ Zymaxid/ Vigamox/ Moxeza/ Besivance
- Safe to use > 2 -month olds - Typical eye infections: 1 -2 gtts q4 hours x 7-10 days - Severe eye infections/ulcers: 2gtts q1 hour until improvement, then q.i.d.
Polytrim Ophthalmic Solution - ANSWER • Trimethoprim + polymyxin B
**- Good choice for bacterial conjunctivitis
- Broad spectrum: Gram positive and gram negative -** Awesome against MRSA [Methicillin-resistant Staphylococcus aureus] - Sig: 1 gtt, q3 -4 hour, in affected eye x 7-10 day **- Infants (>2mo) ~ elderly
- $50 for 10mL bottle**
Trimethoprim - ANSWER • Inhibits bacterial DNA synthesis
**- Prevents production of Thymidine triphosphate
Polymixin B - ANSWER • Gram negative only
**- Binds to cell membranes
- Increases permeability
- Resulting water uptake... cell death
- Inactivates endotoxins
- Lipopolysaccharides released... toxic to other cells**
4th Generation Fluoroquinolones - ANSWER • Powerful antibiotic
- inhibits two different enzymes: Bacterial topoisomerase IV & Topoisomerase II (DNA gyrase) - Bacterial resistance less likely but already documented
no vitreous penetration similar antibiosis in anterior chamber
**- Gram negative efficacy: besifloxacin > gatifloxacin > moxifloxacin
- Gram positive efficacy: besifloxacin > gatifloxacin > or < moxifloxacin**
Gatifloxacin - ANSWER 4th Generation Fluoroquinolones 0.5% ophthalmic solution
- Zymaxid [q2 hour x 1 day, b.i.d.-q.i.d. x 6 day] » Zymar (0.3%) ... discontinued preserved with BAK
Moxifloxacin - ANSWER 4th Generation Fluoroquinolones
**- Vigamox [t.i.d.]
- Moxeza [b.i.d. because more viscous]** 0.5% ophthalmic solution not preserved but not shown to be less irritating
Besifloxacin - ANSWER 4th Generation Fluoroquinolones
- Besivance 0.6% ophthalmic suspension, t.i.d. [shake well] Preserved with BAK best gram positive and negative efficacy
Thimerosal - ANSWER -Preservative but not used because of high allergy rate (25-50%) -mercury
BAK - ANSWER • Detergent
» Wetting agents trapped and protected acanthamoeba » Uptake by contact lens reduced fungicidal activity
Aldox - ANSWER • Myristamidopropyl dimethylamine preservative
**- Strong biocide
- Effective against acanthamoeba & fungi
- Mechanism unknown**
Hydrogen Peroxide - ANSWER • Needs a catalyst to neutralize
- Two types: Neutralize as disinfects & Neutralize after disinfection - Very effective cleaning and disinfection - Problems can arise during storage
Second generation Fluoroquinolones - ANSWER • Inhibit DNA gyrase •Was first touted as the best thing ever
- lot of gram positive resistance but can prescribe with gram + selective
Ciprofloxacin - ANSWER 2nd generation Fluoroquinolones Ciloxan 0.3% solution or ointment, 1-2 gtts q1-4 hour
Ofloxacin - ANSWER 2nd Generation Fluoroquinolones Ocuflox, 0.3% ophthalmic solution, 1-2 gtts q1-4 hour
Third Generation Fluoroquinolone - ANSWER •not as good as 4th generation for gram positive selection
•Better than 2nd generation for gram positive
- Good ocular penetration
Levofloxacin - ANSWER 3rd generation fluoroquinolones 1.5% or 0.5% ophthalmic solution ○ Lquix (1.5%), 1-2 gtts q1 hour to q4 hour
○Quixin (0.5%) or generic (0.5%), 1-2 gtts q.i.d. x 7-10 days
Components of a Prescription - ANSWER • Name of medicine: Trade name or generic with concentration; Form (sol, susp, ung, tab, cap)
**- Amount of med to be dispensed: Size of bottle, number of capsules
- Instructions: How many drops, Frequency of instillation, Which eye, route of** administration (po), Duration of treatment **- Refills
- Other instructions: Shake well -** Generic substitutions?: Pred Forte for uveitis should not be substituted.
Cosopt - ANSWER Combo GLC med (beta blocker and CAI) » Timolol 0.5% solution + dorzolamide 2% solution » Less effective than separate components (in studies) » But compliance better (in practice)
Combigan - ANSWER Combo glaucoma medication (beta blocker and alpha agonist) » Timolol 0.5% solution + brimonidine 0.2% solution » Allergy to brimonidine less
Writing a Prescription - ANSWER Medicine / strength or concentration / Form Quantity (if don't know available bottle size say "largest/smallest"
- Caution in diabetes, bradycardia
Alpha agonists Side Effects and Contraindication - ANSWER • Side Effects: Tends to cause allergic reaction; Depression
- Contraindication: MAOI
Erthyromycin - ANSWER 0.05% Ophthalmic ointment
**- Macrolide •broad spectrum Gram positive selective
- Cheap
- Bacteriostatic: Inhibits cell grows & Interferes with protein synthesis
- 1 g or 3.5 tube
- Apply 1/2 " ribbon to lower fornix, QHS or q.i.d. (you specify) 7 days** ○ Vision becomes blurry with ointment so it is difficult for them to be compliant if you prescribe too often
