RT Book, Section
A1 Schwinghammer, Terry L.
A1 DiPiro, Joseph T.
A1 Ellingrod, Vicki L.
A1 DiPiro, Cecily V.
SR Print(0)
ID 1178899314
T1 Drug-Induced Ophthalmic Disorders
T2 Pharmacotherapy Handbook, 11e
YR 2021
FD 2021
PB McGraw Hill
PP New York, NY
SN 9781260116694
LK accesspharmacy.mhmedical.com/content.aspx?aid=1178899314
RD 2024/04/25
AB Table  Graphic  Jump  LocationTABLE  A9-1Common  Drug-Induced  Ophthalmic  Disorders,  Causative  Agents,  and  Treatment  RecommendationsView  Table||Download  (.pdf)TABLE  A9-1Common  Drug-Induced  Ophthalmic  Disorders,  Causative  Agents,  and  Treatment  RecommendationsReactionsCausative  AgentsTreatment  RecommendationsCataractsAlkylating  agents  (busulfan)Antiestrogens  (tamoxifen)CorticosteroidsStatinsSurgical  removal  of  cataractDry  eyeAlpha-1  antagonists  (alfuzosin,  tamsulosin,  terazosin)Alpha-2  agonists  (apraclonidine,  brimonidine)Anticholinergics  (atropine,  homatropine,  hyoscine,  ipratropium,  tolterodine)Anticonvulsants  (valproic  acid)Antihistamines  (cetirizine,  chlorpheniramine,  diphenhydramine,  doxylamine)Antimalarials  (chloroquine,  hydroxychloroquine)Antineoplastics  (busulfan,  cyclophosphamide)Antipsychotics  (thioridazine)Anxiolytics  (lorazepam)Beta  agonists  (acebutolol)Beta  blockers  (atenolol,  propranolol)Benzalkonium  chlorideBisphosphonatesCannabinoids  (dronabinol)Systemic  decongestants  (pseudoephedrine)Diuretics  (furosemide,  indapamide,  metolazone)Oral  contraceptivesRetinoids  (isotretinoin)Topical  decongestants  (naphazoline)Tricyclic  antidepressants  (amitriptyline)Nonpharmacologic  therapy:  (1)  warm  compresses,  (2)  increase  fluid  intake,  (3)  use  humidifierIncrease  tear  volume:  (1)  consider  artificial  tears  or  other  topical  lubricants,  (2)  punctal  occlusionDecrease  inflammation:  (1)  0.05%  cyclosporine  ophthalmic  drugs,  (2)  LFA-1  antagonist  ophthalmic  drops,  (3)  short-term  ophthalmic  glucocorticoidsMedication  changes:  (1)  discontinue  medication,  (2)  use  preservative-free  ophthalmic  dropsFloppy  iris  syndromeAlpha-1  antagonistsBenzodiazepinesChlorpromazineDonepezilDuloxetineFinasterideQuetiapinePreoperative  screening  for  previous  and/or  current  use  of  causative  agentsConsider  cataract  surgery  before  initiation  of  alpha-1  antagonist  therapyIntracameral  alpha-adrenergic  agonists  (epinephrine,  phenylephrine)Intraoperative  devices:  (1)  iris  retractors,  (2)  OVDs,  (3)  pupil  expandersOptic  neuropathyAmiodaroneEthambutolLinezolidPDE-5  inhibitors  (avanafil,  sildenafil,  tadalafil,  vardenafil)Discontinuation  of  causative  drug  as  medically  appropriateRegular  ophthalmic  examinationsRetinopathyAminoquinolines  (hydroxychloroquine,  chloroquine)Antiestrogens  (tamoxifen)Phenothiazines  (chlorpromazine,  thioridazine)Retinoids  (isotretinoin)Monitor  via  regular  ophthalmic  examinations,  patient-reported  signs  and  symptomsVision  loss  is  irreversibleLFA-1,  lymphocyte  function-associated  antigen  1;  OVDs,  ophthalmic  viscosurgical  devices;  PDE-5,  phosphodiesterase  5.