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Ординатура / Офтальмология / Английские материалы / Clinical Ocular Toxicology Drug-Induced Ocular Side Effects_Fraunfelder, Chambers _2008.pdf
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Campochiaro PA, Lim JI. The Aminoglycoside Toxicity Study Group. Aminoglycoside toxicity in the treatment of endophthalmitis. Arch Ophthalmol 112: 48–53, 1994.

D’Amico DJ, Caspers-Velu L, et al. Comparative toxicity of intravitreal aminoglycoside antibiotics. Am J Ophthalmol 100: 264–275, 1985.

Doft BH, Barza M. Ceftazidime or amikacin: choice of intravitreal antimicrobials in the treatment of postoperative endophthalmitis. Arch Ophthalmol 112: 17–18, 1994.

Doft BH, Barza M. Macular infarction after intravitreal amikacin. Br J Ophthalmol 88: 850, 2004.

Galloway G, Ramsay A, Jordan K. Macular infarction after intravitreal amikacin: mounting evidence against amikacin. Br J Ophthalmol 86: 359–360, 2002.

Galloway G, Ramsay A, Jordan K, Vivian A. Macular infarction after intravitreal amikacin: authors’ reply. Br J Ophthalmol 88: 1228, 2004.

Jackson TL, Williamson TH. Amikacin retinal toxicity. Br J Ophthalmol 83: 1199–1200, 1999.

Piguet B, Chobaz C, Grounauer PA. Toxic retinopathy caused by intravitreal injection of amikacin and vancomycin. Klinische Monatsblatter fur Augenheilkunde 208: 358–359, 1996.

Seawright AA, Bourke RD, Cooling RJ. Macula toxicity after intravitreal amikacin. Austral New Zealand J Ophth 24: 143–146, 1996.

Verma L, Arora R, Sachdev MS. Macular infarction after intravitreal injection of amikacin. Can J Ophthalmol 28: 241–243, 1993.

Local ophthalmic use or exposure – topical application or subconjunctival injection

Certain

1. Irritation – primarily with subconjunctival injection

a.Hyperemia

b.Ocular pain

c.Edema

2. Eyelids or conjunctiva

a.Allergic reactions

b.Angioedema

3. Overgrowth of non-susceptible organisms

4. Conjunctival necrosis (nafcillin) – subconjunctival injection

Clinical significance

Surprisingly few ocular side effects other than dermatologicor hematologic-related conditions have been reported with the semisynthetic penicillins. The incidence of allergic skin reactions due to ampicillin, however, may be high. Ampicillin and other semisynthetic penicillins may unmask or aggravate ocular signs of myasthenia gravis. Nafcillin has been reported to cause conjunctival necrosis with subconjunctival injections. Many, and maybe all, of these agents can be found in the tears in therapeutic levels and can cause local reactions if the patients are sensitive to the drug.

Generic names: 1. Amoxicillin; 2. ampicillin; 3. nafcillin sodium; 4. piperacillin; 5. ticarcillin monosodium.

Proprietary names: 1. Amoxil, Augmentin, DisperMox, Trimox; 2. Principen, Unasyn; 3. Nafcil; 4. Pipracil, Zosyn; 5. Timentin.

Primary use

Semisynthetic penicillins are primarily effective against staphylococci, streptococci, pneumococci and various other Gram-positive and Gram-negative bacteria.

References and Further Reading

Argov Z, et al. Ampicillin may aggravate clinical and experimental myasthenia gravis. Arch Neurol 43: 255, 1986.

Brick DC, West C, Ostler HB. Ocular toxicity of subconjunctival nafcillin. Invest Ophthalmol Vis Sci 18(Suppl): 132, 1979.

Drug Evaluations, 6th edn, American Medical Association, Chicago, pp 1312–1328, 1986.

Ellis PP. Handbook of Ocular Therapeutics and Pharmacology. 6th edn. Mosby, St Louis, CV, 1981pp 42–45, 165–169, 1981.

Kaeser HE. Drug-induced myasthenic syndromes. Acta Neurol Scand 70(Suppl 100): 39, 1984.

Johnson AP, Scoper SV, Woo FL, et al. Azlocillin levels in human tears and aqueous humor. Am J Ophthalmol 99: 469–472, 1985.

Ocular side effects

Systemic administration

Generic names: 1. Azithromycin; 2. clarithromycin;

Certain

3. clindamycin; 4. erythromycin.

1. Eyelids or conjunctiva

Proprietary names: 1. Zithromax; 2. Biaxin; 3. Cleocin,

a.

Allergic reactions

b.

Blepharoconjunctivitis

Cleocin T, Clindagel, ClindaMax, Clindets; 4. AkneMycin,

c.

Edema

ATS, Del-mycin, E-Base, E-Mycin, EES, Emgal, Eramycin,

d.

Photosensitivity

Ery-Ped, Ery-Tab, Eryc, Erycette, Eryderm, Erygel, Erymax,

e.

Angioedema

Erythrocin, Ilosone, Ilotycin, PCE, Robimycin Robitabs,

f.

Urticaria

Staticin, T-Stat.

Probable

Primary use

1. Myasthenia gravis (aggravates)

Azithromycin, clarithromycin and erythromycin are macrolides,

a.

Diplopia

while clindamycin is an antibiotic with similar properties. These

b.

Ptosis

bactericidal antibiotics are effective against Gram-positive or

c.

Paresis of extraocular muscles

Gram-negative organisms.

Possible

Ocular side effects

1. Eyelids or conjunctiva

Systemic administration

a.

Erythema multiforme

b.

Stevens-Johnson syndrome

Certain

c.

Exfoliative dermatitis

1. Problems with color vision – color vision defect, blue

d.

Lyell’s syndrome

yellow defect (erythromycin)

nfectivesi -Anti ectiS • 1on

51

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