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Ophthalmology > Lecture XIII > Flashcards

Lecture XIII Flashcards

1
Q

What are the ocular manifestations of AIDS?

A

-Cotton wool spots

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2
Q

What is the viral retinitis that can be seen with HIV pts? What are the ocular manifestations of this?

A
  • CMV retinitis

- Cotton wool spots

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3
Q

What is the leading cause of visual loss in AIDS?

A

CMV retinitis

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4
Q

What is the treatment for CMV retinitis?

A
  • Oral/IV ganciclovir

- Cidofovir

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5
Q

What determines if there is ocular involvement with systemic candidiasis?

A
  • Redness and pain

- VA changes

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6
Q

What are the infections of the eye that can occur with HSV?

A
  • Conjunctivitis
  • Keratitis
  • Uveitis
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7
Q

What is the treatment for HZO?

A
  • Acyclovir

- Ophthalmic products PRN

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8
Q

What are the three major vehicles to deliver topical medication to the eye?

A
  • Drops
  • Ointment
  • Drug-containing wafers
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9
Q

What are the three different type of injections that are used in the eye?

A
  • Subconjunctival
  • Intravitreal
  • Retrobulbar
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10
Q

What should be done with applying medications to the eye in order to avoid systemic side effects?

A

Close eye immediately, and occlude the lacrimal sac

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11
Q

What is fluorescein used for?

A

Intraocular pressure and epithelial defects

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12
Q

When is IV fluorescein used?

A

Angiography for retinal disorders

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13
Q

What are the indications for topical anesthetics agents?

A
  • Measuring IOP
  • Performing superficial eye surgery
  • Evaluating a painful eye
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14
Q

What are the three major topical anesthetic agents?

A
  • Proparacaine
  • tetracaine
  • Lidocaine
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15
Q

What is the major adverse effect of overuse of topical anesthetic agents?

A

Corneal toxicity

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16
Q

What is the effect of anticholinergics on the eye?

A

Parasympatholytic (block M3 receptors on the ciliary muscle and the sphincter muscle)

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17
Q

What is the effect of adrenergic stimulants on the eye?

A

Iris dilator (stimulates alpha 2 receptor on the dilator muscle)

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18
Q

What are the two major parasympatholytic agents?

A
  • Tropicamide

- Cyclopentolate

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19
Q

What are the systemic toxic effects of parasympatholytics?

A
  • N/v
  • Flushing of the skin
  • Tachycardia
  • Diaphoresis
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20
Q

What muscle do sympathomimetic agent stimulate?

A

Iris dilator

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21
Q

What is the effect on accommodation with sympathomimetic agents?

A

No effect

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22
Q

What is the major sympathomimetic agent used in the eye? Major side effects?

A
  • Phenylephrine

- HTN

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23
Q

What is the treatment for allergic conjunctivitis?

A
  • Tear substitutes

- Decongestants

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24
Q

What is the MOA of cromolyn?

A

Mast cell stabilizer

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25
Q

What is the MOA of pemirolast?

A

Mast cell stabilizer

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26
Q

What is the MOA of nedocromil?

A

Mast cell stabilizer

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27
Q

What is the major ocular adverse effect of sympathomimetics?

A

Close angle glaucoma

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28
Q

What is the MOA of levocabastine?

A

Antihistamine

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29
Q

What is the MOA of ketotifen?

A

Antihistamine/mast cell stabilizer

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30
Q

What is the MOA of ketorolac?

A

NSAID

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31
Q

What is the MOA of epinastine?

A

NSAID

32
Q

What are the corticosteroids that are often used in eye disorders? (3)

A
  • Prednisolone
  • Dexamethasone
  • Fluorometholone
33
Q

What are the abx that are used to treat bacterial conjunctivitis?

A

Aminoglycosides (neomycin or tobramycin)

34
Q

What is the role of fluoroquinolones and macrolides in treating bacterial conjunctivitis?

A

Alternative to aminoglycosides

35
Q

What is the symptomatic treatment for viral conjunctivitis (drug + home care)?

A
  • Antihistamines

- Cool compresses

36
Q

What are the three major reasons to avoid topical steroids?

A
  • exacerbate herpes keratitis
  • Elevate IOP
  • Cause cataracts
37
Q

How is uveitis treated by ophthalmologists?

A

Topical steroids

38
Q

What is the role of treatment for open angle glaucoma?

A

Treatment may prevent blindness

39
Q

What are the drugs that used to treat open angle glaucoma?

A
  • Prostaglandin analogs
  • Beta blockers
  • Cholinergic agents
40
Q

What are the diuretics that can be used to treat glaucoma?

A

CAIs

41
Q

What is the most efficacious agents used to treat glaucoma?

A

Prostaglandin analogs

42
Q

What is the suffix for the prostaglandin analogs that are used in the treatment of open angle glaucoma?

A

-“prost”

43
Q

How do prostaglandins treat glaucoma?

A

Increases uveoscleral outflow

44
Q

What are the side effects of prostaglandin analogs? (2)

A
  • Increased iris pigmentation

- Hypertrichosis

45
Q

What is the MOA of beta blockers in treating glaucoma?

A

Decreased aqueous production (beta 1 and beta 2 blocker on ciliary body)

46
Q

What are the beta blockers that are used in glaucoma? (2)

A
  • Timolol

- Levobunolol

47
Q

What are the non-obvious side effects of beta blockers? (2)

A
  • Depression

- ED

48
Q

Who should not be on beta blockers?

A
  • Heart block
  • Bronchospasm or COPD
  • Hypotension
49
Q

How do cholinergic agonists work to treat glaucoma?

A

Increases aqueous outflow through trabecular meshwork, by contracting the ciliary muscle

50
Q

What is the classic cholinergic agonist used to treat glaucoma?

A

Pilocarpine

51
Q

What are the side effects of cholinergic agonists?

A
  • Decreased vision
  • Wet picture
  • Nearsightedness
52
Q

What are the adrenergic agonists that are used to treat glaucoma?

A

“-idine” or epi

53
Q

How do adrenergic agonists work to treat glaucoma?

A

Increases aqueous outflow

54
Q

What are the side effects of adrenergic agonists?

A
  • Chronic red eye
  • Dilate pupils
  • Tachycardia and PVCs
55
Q

Brimonidine side effect in children under 2 years = ?

A

Apnea

56
Q

What is the suffix for CAIs?

A

-“lamide”

57
Q

What are the side effects of CAIs? (4)

A
  • Electrolyte imbalances
  • Altered taste
  • Renal stones
  • Sulfa allergy
58
Q

What are the irreversible side effect at recommended doses of: alpha-1 adrenoceptor blockers

A

Floppy iris syndrome

59
Q

What are the irreversible side effect at recommended doses of: tamoxifen?

A

Optic neuropathy

60
Q

What are the irreversible side effect at recommended doses of: ethambutol

A

Dose related optic neuropathy

61
Q

What are the irreversible side effect at recommended doses of: corticosteroids

A

Cataracts and glaucoma

62
Q

What are the irreversible side effect at recommended doses of: chloroquine/hydroxychloroquine

A

Maculopathy

63
Q

What are the irreversible side effect at recommended doses of: amiodarone?

A

nonarteritic ischemic optic neuropathy

64
Q

What are the irreversible side effect at recommended doses of: topiramate?

A

May induce angle-closure glaucoma

65
Q

What drug can cause a weird closed angle glaucoma, that you NEED to tell the ophthalmologist about?

A

Topiramate

66
Q

Bulls-eye maculopathy = ?

A

Hydroxychloroquine

67
Q

What is the antipsychotic drugs that can cause significant ocular side effects?

A

Thioridazine

68
Q

What is the breast cancer drug that can cause significant ocular side effects?

A

Tamoxifen

69
Q

What are the two major antimalarial drugs that can have significant ocular side effects?

A

Chloroquine

Hydroxychloroquine

70
Q

What are the two TB abx that can cause toxic optic neuropathy?

A
  • Ethambutol

- Isoniazid

71
Q

What is the general type of abx that can cause optic neuropathy?

A

Fluoroquinolones

72
Q

True or false: antivirals are generally effective against adenovirus

A

False

73
Q

What drugs that are used in the treatment of open angle glaucoma carry a risk of retinal detachment?

A

Cholinergic agonists

74
Q

Which type of drugs cause nearsightedness and decreased vision?

A

anticholinergics

75
Q

What is the safest glaucoma medication for pregnant women?

A

Brimonidine

76
Q

Which causes near accomodation: the muscarinic or adrenergic receptor on the ciliary muscle?

A

Muscarinic

Ophthalmology (14 decks)

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