SSI Ophthalmic Drugs

Tropicamide

Type: Antimuscarinic mydriatic
Receptor/Mechanism: Blocks muscarinic activity → dilates the pupil and relaxes the ciliary muscle
Indications: Pupil dilation for fundus examination and retinal imaging
Species: Veterinary ophthalmic use; no species-specific distinction given
Side effects/cautions: No specific adverse effect emphasized in the lecture
High-yield: Fast acting: 15–20 min with a brief duration of 3–5 hr; shorter acting than atropine

Atropine

Type: Antimuscarinic mydriatic
Receptor/Mechanism: Blocks muscarinic receptors → pupil dilation + ciliary muscle relaxation
Indications: Mydriasis
Species: No species-specific distinction given
Side effects/cautions: No specific caution emphasized in this lecture
High-yield: Effect lasts about 24 hr, making it much longer acting than tropicamide

Phenylephrine

Type: α₁-adrenergic agonist mydriatic
Receptor/Mechanism: α₁ agonist acting on the iris dilator muscle → pupil dilation
Indications: Mydriasis for ophthalmic examination/imaging
Species: No species-specific distinction given
Side effects/cautions: No specific adverse effect emphasized
High-yield: Produces mydriasis through the sympathetic α₁ pathway, unlike atropine/tropicamide.

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Pilocarpine

Type: Parasympathomimetic/cholinergic miotic
Receptor/Mechanism: Mimics acetylcholine at muscarinic receptors of the iris and ciliary body → miosis + ciliary muscle contraction → ↑ aqueous humor outflow
Indications: Glaucoma management; also increases tear production in dry-eye conditions
Species: No species-specific distinction given
Side effects/cautions: No specific adverse effect emphasized
High-yield: 1–2% solution; onset about 15 min, maximal effect around 4 hr, applied every 8–12 hr; useful for both glaucoma (improves drainage) and tear production

Phentolamine

Type: Adrenergic blocker; miotic/reversal agent
Receptor/Mechanism: Reversibly blocks α₁-adrenergic receptors on the radial iris dilator muscle → reduces pupil size
Indications: Reversal of pharmacologically induced mydriasis
Species: No species-specific distinction given
Side effects/cautions: Do NOT use with active ocular inflammation
High-yield: FDA-approved RYZUMVI®; think reverse the dilated pupil

Latanoprost

Type: Prostaglandin analog; antiglaucoma drug
Receptor/Mechanism: Increases uveoscleral aqueous outflow
Indications: Glaucoma; rapid reduction of intraocular pressure (IOP)
Species: No individual species distinction given
Side effects/cautions: Not specified in this lecture
High-yield: ↑ OUTflow → rapidly ↓ IOP

Acetazolamide + Dorzolamide

Type: Carbonic anhydrase inhibitors; antiglaucoma drugs
Receptor/Mechanism: Inhibit carbonic anhydrase → ↓ aqueous humor production
Indications: Glaucoma / lowering IOP
Species: No species-specific distinction given
Side effects/cautions: No individual differences discussed in this lecture
High-yield: ↓ aqueous humor PRODUCTION

Brimonidine tartrate

Type: α₂-adrenergic agonist; antiglaucoma drug
Receptor/Mechanism: α₂ agonist; further ocular mechanism not detailed in the lecture
Indications: Glaucoma management
Species: Not specified
Side effects/cautions: Not specified
High-yield: The lecture's α₂-agonist glaucoma drug

Timolol

Type: β-blocker; antiglaucoma drug
Receptor/Mechanism: β-adrenergic blockade → ↓ ocular fluid/aqueous production
Indications: Glaucoma; lowering IOP
Species: Not specified
Side effects/cautions: Not specified in this lecture
High-yield: β-blocker → ↓ aqueous production, whereas latanoprost works by increasing outflow

Proparacaine

Type: Topical local anesthetic
Receptor/Mechanism: Blocks voltage-gated Na⁺ channels → prevents action-potential propagation
Indications: Tonometry, corneal examination, biopsy, foreign-body removal, suturing, and minor ophthalmic procedures
Species: Dogs and cats specifically compared
Side effects/cautions: No major irritation emphasized
High-yield: Fast onset ~30 sec; short duration about 45 min in dogs vs 15 min in cats; FDA approved

Tetracaine

Type: Topical local anesthetic; procaine derivative
Receptor/Mechanism: Na⁺-channel blockade
Indications: Ophthalmic anesthesia for diagnostic/minor procedures
Species: No individual species distinction given
Side effects/cautions: Can cause eye irritation
High-yield: More potent → lower dose + longer duration of action; causes more irritation than oxybuprocaine

Oxybuprocaine

Type: Topical local anesthetic
Receptor/Mechanism: Na⁺-channel blockade
Indications: Tonometry, corneal examination, biopsy, foreign-body removal, suturing
Species: Not specifically differentiated
Side effects/cautions: Causes less conjunctival irritation than tetracaine
High-yield: Faster onset + less irritation than tetracaine

Lidocaine

Type: Local anesthetic
Receptor/Mechanism: Blocks Na⁺ channels → prevents nerve depolarization/action potentials
Indications: Ocular anesthesia; surgery and ophthalmic procedures
Species: No individual species distinction given
Formulations/routes: 2% subconjunctival injection, 2% topical drops, topical gel; 3.5% Akten® gel
Side effects/cautions: No unique toxicity emphasized here
High-yield: Multiple ophthalmic formulations; Akten® 3.5% is FDA-approved and preservative-free; gel used in cataract surgery. Can be used with fluorecein.

Prednisone

Type: Systemic corticosteroid
Receptor/Mechanism: Corticosteroid anti-inflammatory
Indications: Intraocular inflammation
Species: General veterinary use in this lecture
Route: Systemic; lecture dose 1–2 mg/kg
Side effects/cautions: Not specifically discussed
High-yield: Systemic corticosteroid used with topical corticosteroids

Prednisolone acetate + Dexamethasone alcohol

Type: Topical ophthalmic corticosteroids
Receptor/Mechanism: Corticosteroid anti-inflammatory drugs
Indications: Control of intraocular inflammation
Species: General ophthalmic use
Formulation: Prednisolone acetate 0.5% or 1%; dexamethasone alcohol 0.1%, generally every 6–8 hr
Side effects/cautions: No individual differences supplied in this lecture
High-yield: Grouped because both are presented as topical corticosteroids for intraocular inflammation

Flunixin meglumine

Type: Systemic NSAID
Receptor/Mechanism: Anti-inflammatory NSAID
Indications: Equine uveitis / intraocular inflammation
Species: Horses
Route: IV or PO; lecture dose 0.25–1 mg/kg every 12 hr
Side effects/cautions: Not specifically discussed here
High-yield: Used with topical and/or subconjunctival corticosteroids for equine intraocular inflammation

Ketorolac + Diclofenac + Flurbiprofen

Type: Topical ophthalmic NSAIDs
Receptor/Mechanism: NSAID anti-inflammatory drugs; individual mechanisms not differentiated in the lecture
Indications: Itchy eyes caused by allergies; swelling/redness after cataract surgery
Species: No individual species distinction given
Side effects/cautions: No individual differences stated
High-yield: Grouped because all are used for ocular inflammation, allergic itching, and post-cataract inflammation

Cyclosporine

Type: Ophthalmic calcineurin inhibitor; immunosuppressant
Receptor/Mechanism: Immunosuppression; molecular target not further detailed in the lecture
Indications: Immune-related eye disease, especially keratoconjunctivitis sicca (KCS); decreases inflammation and increases tear production
Species: Especially dogs with KCS
Formulation: Eye drops or ointment
Side effects/cautions: Temporary pain, burning, stinging, or itching; avoid touching the dropper tip to the eye or other surfaces due to contamination risk
High-yield: Immune-mediated KCS → cyclosporine → immunosuppression + ↑ tears

Chloramphenicol + Gentamicin + Levofloxacin + Polymyxin B/Trimethoprim + Tobramycin

Type: Ophthalmic antimicrobial/antibiotic drops
Receptor/Mechanism: Individual antimicrobial mechanisms are not differentiated in this lecture
Indications: Bacterial eye infections and conjunctivitis
Species: Veterinary ophthalmic use; no individual species distinctions given
Side effects/cautions: Not individually discussed
High-yield: Grouped because the lecture presents them as ophthalmic antibiotics for bacterial infection/conjunctivitis

Hyaluronic acid (BioHAnce®)

Type: Ocular lubricant / tear substitute
Receptor/Mechanism: Provides a protective hydrating coating over the ocular surface; BioHAnce is crosslinked hyaluronic acid
Indications: Eye irritation, lubrication, hydration, swollen or irritated eyes
Species: Veterinary ocular use; no species distinction given
Side effects/cautions: None specifically stated
High-yield: Coats and hydrates the ocular surface with every blink; this is a tear substitute/lacrimomimetic, not a drug that stimulates lacrimal gland tear production. Eye Drops.