Ophthalmologic Drug Guide Ophthalmologic Drug Guide Douglas J. Rhee, MD Assistant Professor, Harvard Medical School, Massachusetts Eye & Ear Infi rmary, Boston, Massachusetts, USA Kathryn A. Colby, MD, PhD Assistant Professor, Harvard Medical School, Director, Joint Clinical Research Center, Massachusetts Eye & Ear Infi rmary, Boston, Massachusetts, USA Christopher J. Rapuano, MD Professor, Jefferson Medical College, Co-Director, Cornea Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA Lucia Sobrin, MD Instructor, Harvard Medical School, Massachusetts Eye & Ear Infi rmary, Boston, Massachusetts, USA Douglas J. Rhee, MD Kathryn A. Colby, MD, PhD Assistant Professor Assistant Professor Harvard Medical School Harvard Medical School Massachusetts Eye & Ear Infi rmary Director, Joint Clinical Research Center Boston, MA02114 Massachusetts Eye & Ear Infi rmary USA Boston, MA02114 USA Christopher J. Rapuano, MD Professor Lucia Sobrin, MD Jefferson Medical College Instructor Co-Director, Cornea Service Harvard Medical School Wills Eye Hospital Massachusetts Eye & Ear Infi rmary Philadelphia, PA 19107 Boston, MA02114 USA USA Library of Congress Control Number: 2006930104 ISBN-10: 0-387-33251-0 Printed on acid-free paper. ISBN-13: 978-0387-33251-2 © 2007 Springer Science+Business Media, LLC All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any formof information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. 9 8 7 6 5 4 3 2 1 springer.com To my lovely wife Tina, for your continual patience and encouragement. To my father and mother, Dennis and Serena Rhee, for your support and guidance. To Susan Rhee for your understanding, and To all my families– Rhee, Chang, Kim, and Chomakos. Douglas J. Rhee To my daughters, Amelia and Lillian, who fi ll my life with joy. Kathryn A.Colby To my wonderful wife and best friend, Sara, and To my terrifi c children, Michael, Patrick, Daniel and Megan. You keep me sane and constantly remind me of what is important in life. Christopher J. Rapuano To my husband and my parents. Lucia Sobrin Preface This pocket reference is designed to assist the eye care professional by provid- ing current information on the ever-increasing number of ocular pharmaco- therapeutics. Many different classes of medications are listed, oftentimes with pertinent facts. This book presents the usual recommended dose for the medi- cations listed. Clinical judgment should always be used, as all therapy should be tailored to the individual patient. The intent of this manual is to provide therapeutic suggestions once the diagnosis is known. We recommend its use in conjunction with an ophthalmologic reference text, such as the Massachu- setts Eye & Ear Infi rmary Illustrated Manual of Ophthalmology (Saunders) or the The Wills Eye Manual: Offi ce and Emergency Room Diagnosis and Treat- ment of Eye Disease(LippincottWilliams & Wilkins). A more complete listing of all mechanisms, side effects, and drug interactions can be found in the product insert, the Physicians’ Desk Reference, and the Physicians’ Desk Refer- ence for Ophthalmology, and these should be consulted. Douglas J.Rhee, MD Kathryn A. Colby, MD, PhD Christopher J. Rapuano, MD Lucia Sobrin, MD Contents Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii Abbreviations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi 1 Antibacterial Agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 2 Antifungal Agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 3 Antiviral Agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 4 Antiparasitic Agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 5 Antiglaucoma Agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 6 Neuro-Ophthalmology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69 7 Anti-Infl ammatory Agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 8 Mydriatics, Cycloplegics, and Reversal Agents . . . . . . . . . . . . . 81 9 Lubricants and Viscoelastics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85 10 Miscellaneous Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93 11 Anti-Angiogenesis Agents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105 12 Contact Lens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 Appendices Appendix 1: Topical Antibacterial Spectrum . . . . . . . . . . . . . . . . . . 121 Appendix 2: Preparing Fortifi ed Topical Antibiotics and Oral Acetazolamide Solution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123 Appendix 3: Antifungal Activity Spectrum . . . . . . . . . . . . . . . . . . . 124 Appendix 4: Acyclovir Dosing in Renal Failure . . . . . . . . . . . . . . . . 125 Appendix 5: Glaucoma Medication Preservatives . . . . . . . . . . . . . . 130 Appendix 6: Titrating Topical Drops for Children . . . . . . . . . . . . . . 132 Appendix 7: Dosing Protocol for Verteporfi n (VISUDYNE) . . . . . 133 Product Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135 Subject Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141 Abbreviations Abbreviation Meaning Dosing Qx Every xhours QOD Every other day QD Once per day BID Twice per day TID Three times per day QID Four times per day IV Intravenous Administration PO Take by mouth Weights and Measures mg Milligram gm Gram kg Kilogram m2 Meters mathematically squared (refers to body surface area) ml Milliliter U International unit Formulation Soln Solution Susp Suspension Oint Ointment Tab Tablet 1. Antibacterial Agents 2 es P. d steci nd st e np a n at ais a aia Notes 2FortifiedBC2FortifiedBS, except BC againstH. infl uenzae, N meningitidis,N. gono.rrhea ,C. trachomatis Has been reported to be associ with aplastic anemia. Fluoroquinolone -BC; active agand NeiPs. seAreirauginosa N. gBoSn; oarcrthieve against C. trachomatis Fluoroquinolone-BCAminoglycoside -BC; active agand N. gonAoerrruhgeinosa 2Fortified Dose Q1hr QD-QID Q1 hr Q3–6 hr QHS-Q3 hr QID-Q1/2 hr QHS-QIDQD-QID QID-Q1 hr Q1–6 hr QD-TID hr Q1 ml U/m Preparation Soln, 10,000 Oint, 500 U/gSoln, 5% Soln, 0.5% Oint, 1% Soln, 0.3% Oint, 0.3% Oint, 0.5% Soln, 0.3% Soln, 0.3% Oint, 0.3% 1.5% Soln, 1BIOTICS Trade N/A AK-Tracin Ancef Chloromycetin, Chloroptic,Ocu-Chlor Chloromycetin, Chloroptic , Ocu-ChlorCiloxan AK-mycin , Ilotycin Zymar Garamycin , Genoptic , Gentacidin , Gentak, Ocu-mycin, Garamycin , Genoptic , Gentak ,Gentacidin Ocu-mycinN/A I T N A. TOPICAL A Drug bacitracin cefazolin chloramphenicol cipro floxacin erythromycin gati floxacin gentamicin