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Author: Admin | 2025-04-28
Adds. “Everyone gets comfortable with certain medications in certain conditions with changes based on things like pregnancy, allergies and side effect profiles. If they can do it, so can you.”Other tips to help you get comfortable prescribing oral medications include:Remember you have the knowledge, education and training to provide these services safely and effectively.Take advantage of available educational resources, including CEs, mentors and other learning opportunities.Ask for help. Don’t hesitate to get a second opinion from a fellow care provider.Be patient and integrate new services thoughtfully and strategically. You don’t have to do everything at once.Dosing Common Oral MedsGiven the number of available drugs, prescribing oral medications may feel overwhelming at first; however, for most eyecare issues, Dr. Autry notes there are standard medications that can be used. “As long as you check for allergies, pregnancy and severe hepatic and renal disease, you can usually prescribe the same five to seven oral medications,” she says. “For most lid infections, I use amoxicillin (Moxatag) 875mg BID for adults, and for suspension in children, I use 20mg to 40mg/kg/day.”Augmentin (amoxicillin and clavulanate) 875mg can also be prescribed to adults or children with bacterial infections using the same dosing strategy as for amoxicillin; however, she notes that this isn’t needed as much today since most individuals are vaccinated against Haemophilus influenzae.If a patient is allergic to penicillin, Dr. Autry opts for doxycycline (Monodox) 100mg (contraindicated for children or nursing/pregnant patients) BID PO or Septra DS (sulfamethoxazole-trimethoprim) BID. The latter should not be used in patients allergic to sulfa or those who are nursing or pregnant, but there is a suspension for children, she notes.“I know a lot of ODs like Keflex (cefalexin) or Z-Pak (Zithromax, azithromycin), but these don’t always fix severe infections, and Keflex resistance is increasing,” she says. “Oral ciprofloxacin (Cetraxal) has almost no gram-positive coverage anymore, so I avoid it in cases of lid disease. Levaquin is an option but has its own possible side effects and is expensive.” When considering pain medications, Dr. Autry typically recommends ibuprofen and/or acetaminophen. Together, the two have shown to be equivalent to Tylenol #3, she notes. “I tell patients to take 400mg ibuprofen (two of the OTC 200mg tabs) and one 500mg acetaminophen (extra strength Tylenol).”ODs should be careful when using ibuprofen or other nonsteroidal anti-inflammatory drugs in patients with an aspirin allergy, cautions Dr. Autry, who adds that she prefers acetaminophen. If
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