Transcript Oral Medications with ocular side effects

ORAL MEDICATIONS WITH
OCULAR SIDE EFFECTS
ASHLEY S. REDDELL, OD, FCOVD
HOACLS 2015
ABOUT ME
• FROM HAYSVILLE, KS
• GRADUATED FROM KU…..ROCK CHALK!
• WORKED AS A VISION THERAPIST DURING UNDERGRAD
• GRADUATED FROM SOUTHERN COLLEGE OF OPTOMETRY
• COMPLETED PEDIATRIC RESIDENCY AT SCO
• JOINED A PRIVATE PRACTICE IN LEAVENWORTH IN 2010
• NOW HAVE 3 LOCATIONS, 5 ODS, AND ~28 STAFF
HOUSEKEEPING
• I HAVE NO FINANCIAL INTERESTS IN ANY OF THE
PRODUCTS I MAY MENTION DURING THIS PRESENTATION.
• IF YOU HAVE QUESTIONS PLEASE EMAIL ME….
[email protected]
WHY GIVE THIS COURSE TO
PARA-OPTOMETRICS?
• YOU HAVE ONE OF THE MOST IMPORTANT JOBS IN THE
OFFICE….GETTING PATIENT HISTORY
• MEDICATIONS ARE A VERY IMPORTANT PART OF THAT HISTORY
• MANY COMMON MEDICATIONS HAVE OCULAR SIDE EFFECTS, IT IS
IMPORTANT FOR YOU TO MAKE SURE THE DOC IS AWARE IF
PATIENT IS TAKING ANY THAT WE DISCUSS
CORNEA
• AMIODARONE
• ANTIARRHYTHMIC
• VORTEX KERATOPATHY
CORNEA
• GOLD SALTS
• RHEUMATOID ARTHRITIS
• OCULAR CHRYSIASIS
CORNEA
• HYDROXYCHLOROQUINE
• PLAQUENIL
• TX: MALARIA, RHEUMATOID
ARTHRITIS, SYSTEMIC LUPUS
ERYTHEMATOSUS
• VERTICILLE KERATOPATHY
CORNEAL SYMPTOMS
• GLARE
• PHOTOPHOBIA
• HALOS AROUND LIGHTS
• NIGHT DRIVING COMPLAINTS
CONJUNCTIVA
• ANTI-COAGULANTS
• ASPIRIN
• COUMADIN
• PLAVIX
• VITAMIN E
CONJUNCTIVAL SYMPTOMS
• RED EYE
• TYPICALLY PAINLESS
• MAY BE ASSOCIATED WITH STRAINING, COUGHING, SNEEZING,
ETC.
PUPIL
MYDRIASIS – DILATED PUPIL
• EPINEPHRINE
• BRONCHODILATOR
• PRIMATENE MIST
• EPHEDRINE
• BRONCHODILATOR
• PRIMATENE TABLET
PUPIL
MYDRIASIS – DILATED PUPIL
• PSEUDOEPHEDRINE
• SUDAFED
• COLD/HAY FEVER DECONGESTANTS
• SCOPOLAMINE
• PATCH USED FOR MOTION SICKNESS
PUPIL
MIOSIS – CONSTRICTED PUPIL
• MORPHINE
• INSECTICIDES
PUPIL
• TAMSULOSIN
• FLOMAX
• IMPROVES URINATION IN MEN WITH
BENIGN PROSTRATE HYPERPLASIA
• CAUSES INTRAOPERATIVE FLOPPY IRIS
SYNDROME
• IMPERATIVE TO KNOW BEFORE CATARACT
SURGERY
PUPIL SYMPTOMS
• MUST BE AWARE OF NARROW ANGLES AND POTENTIAL FOR
MYDRIASIS
• DILATED PUPIL(S)
• LIGHT SENSITIVITY
LENS
• CORTICOSTEROIDS
• PREDNISONE
• USED TO TREAT INFLAMMATION
LENS
• PHENOTHIAZINES
• CHLORPROMAZINE
• ANTIPSYCHOTICS
• ANTERIOR STELLATE CATARACT
LENS SYMPTOMS
• GLARE/HALOS
• REDUCED VISUAL ACUITY
• GREATER WITH PSC
• COMMUNICATE WITH PROVIDERS
• WEIGH PROS AND CONS OF MEDICATION VS. SIDE EFFECTS
DRY EYE
• ANTI-HISTAMINES
• EXP: CLARITIN
• ANTI-CHOLINERGICS
• EXP: BENADRYL, SCOPOLAMINE
• ANTI-ANXIETY MEDS
• EXP: XANAX
• SELECTIVE SEROTONIN REUPTAKE INHIBITOR
• EXP: ZOLOFT, CELEXA, PROZAC
DRY EYE
• DIURETICS
• USED TO TREAT HYPERTENSION
• HORMONE REPLACEMENT THERAPY
• ESTROGEN
RETINA
• PLAQUENIL
• HYDROXYCHLOROQUINE
• TX: MALARIA, RA, SLE
• RETINOPATHY
RETINA
• TALC
• ADDITIVES TO IV DRUGS
• IMPORTANT TO ASK SOCIAL
HISTORY
RETINA
• TAMOXIFEN
• TX FOR BREAST CANCER
RETINA SYMPTOMS
• REDUCED VISION
• DIMMING OF VISION
• GLARE
• DISTORTION IN CENTRAL VISION
OPTIC NERVE
• CORTICOSTEROIDS
• TX INFLAMMATION: RA, COLITIS,
ASTHMA, BRONCHITIS
• LONG TERM USE CAN CAUSE
INCREASED IOP
OPTIC NERVE/RETINA
• SILDENAFIL
• VIAGRA
• VISUAL SIDE EFFECTS
• BLUISH-TINGED, PINK-TINGED, YELLOWISH-TINGED VISION
• CAN LAST SEVERAL MINUTES TO HOURS
• THOUGHT TO AFFECT PHOTOTRANSDUCTION
OPTIC NERVE
• TETRACYCLINES
• ANTIBIOTICS
• SOMETIMES USED TO TX ACNE IN
TEENS
• CAN CAUSE OPTIC NERVE HEAD
EDEMA
• ORAL CONTRACEPTIVES
OPTIC NERVE SYMPTOMS
• CHANGES IN COLOR VISION
• REDUCED VISION
• VISUAL FIELD CHANGES
QUESTIONS
• [email protected]