NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

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Which drug causes intraoperative floppy iris syndrome (IFIS)?

Digoxin
Voriconazole
Alpha-blockers
Amiodarone

The correct answer is: Alpha-blockers

Alpha-blockers such as tamsulosin are known to cause intraoperative floppy iris syndrome (IFIS). IFIS is a condition characterized by a triad of intraoperative signs including billowing of the iris stroma, progressive intraoperative pupil constriction, and propensity for iris prolapse through surgical incisions. Alpha-blockers like tamsulosin are commonly prescribed for benign prostatic hyperplasia (BPH) and can lead to this complication during cataract surgery. Digoxin is a cardiac glycoside used in the treatment of heart failure and arrhythmias. Voriconazole is an antifungal agent used to treat invasive fungal infections. Amiodarone is an antiarrhythmic medication used for various types of cardiac arrhythmias. None of these medications are associated with causing intraoperative floppy iris syndrome (IFIS) during cataract surgery.