3.6 Dry Eye Therapeutics - Zagar

T or F:

symptoms of dry eye often improve with tx and the disease is usually curable

F

major RF for dry eye

old (60 yr+)

female

non-major RF for dry eye (6)

smoking

excessive computer use

immune status

RA

diabetes

rosacea

medication classes that can lead to dry eye (7)

Glaucoma meds containing BAK

Antihistamines

Antidepressants

Antianxiety medications

Hormone replacement therapy (estrogen use alone)

Oral corticosteroids

Botox

treatment of moderate dry eye syndrome includes adding therapies to...

the mild treatment options

what agents (class) is added to mild dry eye tx for the tx of moderate dry eye?

anti-inflammatory

name the 4 anti-inflammatory agents used for moderate dry eye tx

topical cyclosporine

topical lifitegrast

topical corticosteroids

cholinergic agonist nasal spray

which anti-inflammatory agent for moderate dry eye is the best in terms of efficacy?

none fam they all have same efficacy

Restasis generic

cyclosporine

cyclosporine emulsion brand name

Restasis

Restasis counseling points:

before using pts should

invert vial few times to obtain uniform, white, opaque emulsion

Restasis counseling points:

dosing

place one drop in each eye BID

Restasis counseling points:

vials are ___ use

one time

all preservative free products:

what to do with left over drug in vial

throw that shit away

Restasis counseling points:

can you use it with artificial tears? if so how?

yeah

allow 15 min interval bt administration

Restasis counseling points:

dont use if...

active eye infection

wearing contacts

Restasis counseling points:

if pt wears contacts, when can they put them in?

15-30 mins after administration

Restasis counseling points:

how long for effects?

6-12 weeks

restasis ADE

temporary burning, red eyes, watery eyes, discharge, eye pain, itching, stinging, burning

Cequa generic

cyclosporine

cequa:

administration rules

one drop in each eye BID

cequa:

similar ADE to...

Restasis

T or F

all dry eye products are preservative free

t

Restasis Multi dose counseling:

dosing instructions

one drop in each eye BID

Restasis Multi dose:

defining characteristics

unidirectional valve and air filter technology

has hella steps to prime the bottle

Vevye:

generic

cyclosporine

Vevye:

dosing instructions

one drop in each eye BID

Vevye counseling:

does it need to be primed

no

Vevye counseling:

delivery mechanism

different than restasis and cequa

improved bioavailability

Vevye counseling:

ade

mild or no discomfort

Xiidra generic

lifitegrast

lifitegrast brand name for dry eye

Xiidra

Xiidra counseling:

color

clear to yellow/brown

which product for dry eye can be yellow-brown?

Xiidra

Xiidra counseling:

dosing instructions

one drop in each eye BID

T or F:

all cyclosporine options for dry eye are dosed TID

F

(its BID)

Xiidra counseling:

vials are ____ use and must be discarded after ____

one time

used

Xiidra counseling:

when can you use eye drops or put in contacts

15 mins after administration

Xiidra counseling:

can be used with restasis? or no? and why?

yeah! different MOAs

Xiidra counseling:

onset

6-12 weeks

Xiidra counseling:

common ADE

stinging

dysgeusia

which dry eye tx is associated with causing dysgeusia?

Xiidra

which two products for dry eyes are emulsions?

restasis multidose

restasis

Varenicline brand for dry eye therapy

Tyrvaya

Tyrvaya generic

varenicline

Tyrvaya:

dosing

one spray in each nostril BID

Tyrvaya

ADE

sneezing

coughing

throat and nose irritation

which dry eye therapy option causes sneezing?

Tyrvaya

Perfluorohexyloctane brand name

Miebo

Miebo generic

Perfluorohexyloctane (long P word)

Miebo:

dosing instructions

1 drop into affected eyes qid

Miebo:

improves...

signs and symptoms of dry eye syndrome secondary to meibomian gland dysfunction

Miebo:

ADE

blurry vision

red eyes

Miebo:

when can contacts be put in

30 mins after administration

Loteprednol class

corticosteroid

Loteprednol:

dosing instructions

1-2 drops qid

Loteprednol:

ADE

increased IOP

might cause cataracts

Loteprednol:

duration of tx

short term

2 weeks

when are corticosteroids like loteprednol use for dry eyes?

severe cases and exacerbations