COMMON OPHTHALMIC DRUGS Summarized from Ophthalmic Drug Facts, 2001 edition Dyes

Fluorescein used to detect loss of corneal epithelium/for Seidels test Rose Bengal stains dead corneal epithelial cells (indicator of herpes keratitis) Indocyanine Green (ICG) used to stain lens capsule during cataract surgery

Topical Anesthetics
Proparacaine anesthesia begins in 15 seconds, last for 15-20 minutes

Mydriatics/Cycloplegics
Mydriatics Phenylephrine recovery after 6 hours (10% soln.) Cycloplegic Mydriatics (Anticholinergics) Atropine recovery after 7-10 days Tropicamide recovery after 5-6 hours

Anti-Inflammatories
Corticosteroids Dexamethasone 0.1% solution or suspension (equivalent of 1% prednisolone) Prednisolone 0.125% and 1% solution or suspension Triamcinolone suspension given sub-conjunctivally lasts for days NSAIDS Flurbiprofen post-surgical inflammation/prevention of intraoperative miosis Suprofen

Artificial Tears and Lubricants

Carboxymethylcellulose/Hydroxypropyl Methylcellulose (Celluvisc/Goniosol) White Petrolatum/Mineral Oil/Lanolin (Puralube)

Anti-Infectives
Antibiotics
Small Guns (general, broad spectrum -- prophylactic, erosions, conjunctivitis)

Neomycin Neo in triple antibiotic Polymyxin B Poly in triple antibiotic Bacitracin Bac in triple antibiotic ointment

Gramicidin Gramin triple antibiotic drops Gentamicin Oyxtetracycline (Terramycin) commonly used in feline conjunctivitis
Big Guns (use usually indicated by culture stromal loss, infected or melting ulcers)

Ciprofloxacin (Ciloxan) Ofloxacin (Ocuflox) Tobramycin Cefazolin Chloramphenicol Antifungal Miconazole ointment Itraconazole given in DMSO Antiviral Trifluridine (Viroptic) solution Vidarabine (Vira-A) ointment

Glaucoma
Epinephrines reduce IOP through increased aqueous outflow Epinephrine Dipivefrin (Propine) prodrug of epinephrine Beta Blockers reduce the rate of aqueous production Timolol combined with dorzolamide in Cosopt Betaxolol (Betoptic) Direct Acting Miotics reduce resistance to aqueous outflow Pilocarpine Carbachol (Miostat) used intraocularly during cataract surgery Cholinesterase Inhibitor Miotics reduce resistance to aqueous outflow Physostigmine Demecarium (Humorsol) Carbonic Anhydrase Inhibitors reduce the rate of aqueous production Methazolamide (Neptazane) oral Dorzolamide (Trusopt) topical/combined with timolol in Cosopt Brinzolamide (Azopt) topical Prostaglandins increase aqueous outflow Latanoprost (Xalatan)

Hyperosmotic Agents
Topical Hypertonic Sodium Chloride (Muro 128) topical/temporary relief of corneal edema Intravenous Mannitol reduction of IOP in acute glaucoma

Surgical Adjuncts
Intraocular Irrigation BSS (Balanced Salt Solution) Povidone Iodine Betadine 5% solution used for surgical prep Viscoelastic Agents Sodium Hyaluronate (Hylartin) maintains the anterior chamber during intraocular surgery