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NBEO Part 1 > Ocular Pharm > Flashcards

Ocular Pharm Flashcards

1
Q

How much of drops are lost to evaporation

A

25%

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2
Q

Bioavability

A

The percent of unchanged drug that gets to the desired site.

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3
Q

Tear layer characterisitics

A

Lipid=lipid soluble. Aqeuous=water mucus=both

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4
Q

Corneal layer characteritis

A

End and epi=lipid. Stroma=water

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5
Q

What type of drugs with penetrate best

A

small, uncharged, lipid soluble molecules. Most formulated as weak bases.

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6
Q

What route has the best bioavaliblity

A

IV

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7
Q

Where are parasympathetic cell bodies located

A

Cranial sacral. PCS.

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8
Q

Where are sympathetic cell bodies located

A

Thoracic-lumbar.

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9
Q

NT for preganglionin in Para

A

Acetylcholine

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10
Q

NT for pre ganglion in symp

A

Acetylcholine

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11
Q

Which autonomic pathway has longer post ganlgionic

A

sympathetic

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12
Q

NT for post ganglion Para

A

acetylcholine

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13
Q

NT for post ganglion sympathetic

A

norepinerphein and epinerphine.

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14
Q

Functions of para

A

SLUDGE

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15
Q

Dilator of iris sympathetic function and receptor

A

alpha 1. Dilates

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16
Q

CB vasculature SNS function and receptor

A

Alpha 2. Decreaes aqeuosu

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17
Q

CM vascualrture SNS function and recptor

A

B2. relaxes

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18
Q

TM SNS function and recetpro

A

B2. Increases outflow

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19
Q

NPCE SNS function and receptor

A

B1 and B2. Increases outflow.

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20
Q

What structures in the eye receive Parasympathetic innervation?

A

Iris, CB, and lacrimal gland.

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21
Q

Pilocarpine

A

Direct acting cholinergic agonist. First every glaucoma drug. Stimulates the longitudinal fibers of the CB which pulls on the scleral spur and opens up the TM.

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22
Q

What pilio do you use with Aidies

A

0.125%

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23
Q

SE of pilocarpine

A

brow ache, HA, myopic shift, can cause angle closure or RD or cataracts.

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24
Q

Edrophonium (Enlon)

A

Used to diagnose MG. If ptosis improves know it is MG.

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25
Q

Neostigmine (prostigmin)

A

Treatment for MG or limb strength evaluation.

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26
Q

Echothiophate (phospholine)

A

Irreversible ACHE inhibitors. Can be used to diagnose or treat accommodative esotropia.

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27
Q

Pyridostigmine (mestinon)

A

Used to treat MG.

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28
Q

Pralidoxime

A

Used for overdose of indirect cholinergic agonists. Only works with irreversible (echothiphate)

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29
Q

Scopalamine

A

Cholinergic antagonist. Used for motion sickness. High incidence of crossing BBB.

30
Q

Which cholinergic antagonist has the fastest onset and shortest duration?

A

tropic amide

31
Q

Atropine

A

Most potent.

32
Q

Who should you dilate with caution?

A

THINK. Thyroid. Iris fixed IOL. Narrow angle. Kids (DS)

33
Q

which drug do you use for anterior uvieits?

A

homatropine. It dilates the iris, reduces pain, and stabilizes the blood aqueous barrier.

34
Q

How long does Atropin work

A

7-10 days

35
Q

How long does scopolamine work

A

3-7 days

36
Q

How long does homatropine work

A

1-3 days

37
Q

How long does cycloplegia work

A

24 hours

38
Q

How long does tropic amide work

A

4-6 hours.

39
Q

Botox

A

Anticholingeric and NMJ.

40
Q

Norephinerphein vs. Epinerphine

A

Norepinephrine does not work on B2 receptors.

41
Q

Phenylephrine

A

Sympathetic agonist. 2.5% routinely used for dilation. Acts on alpha 1 receptor with no affect on B. Allows dilation without any SE.

42
Q

Which is the weird on in sympathetic NS

A

Alpha 2

43
Q

When to give BB

A

In the morning

44
Q

Who should you be cautions with BB

A

diabetic (hid hypo signs), lungs, Heart, hyperthyroidism, MG.

45
Q

Short term escape

A

lowers initially and then raises

46
Q

Long term drift

A

IOP starts to gradually rise

47
Q

Do you get short term escape and long term drift with BB

A

YES.

48
Q

Cosopt

A

Timolol and dorzolamide

49
Q

Combigan

A

Timolol and briminoladine

50
Q

Alpha 2 agonist action

A

Act to decrease production and increase outflow

51
Q

SE of CAI

A

Aplastic anemia, thrombocytopenia, agranuloctyopenia, metallic taste, metabolic acidosis.

52
Q

CI for CAI

A

SULFA BASED

53
Q

Prostaglandin Analogs

A

Acts on FP receptors (PGF2alpha) on the ciliary muscle which causes reduction of neighboring collage (using MMP), decreasing resistance with the uveoscleral meshwork. Also acton on skin receptors and hair follicles.

54
Q

When to dose prostaglandins

A

bedtime

55
Q

SE of prostaglandins

A

Iris herterochromia, darker lashes, dark pigment around the eyes.

56
Q

Reduction in IOP of glaucoma drugs

A

Apraclondine (30-40), prost (33), Pilo (30). BB (25), biminodine and dorzolamid (18).

57
Q

How do topical ocular anesthetics work

A

Block nerve conduction and change membrane potential by stopping the influx of Na.

58
Q

Amides

A

Go inside. Injectable. Liver.

59
Q

Esters

A

topical. Metabolized locally.

60
Q

Proparacaine

A

Ester anistehtic. Lasts 10-20 minutes.

61
Q

Fluoress

A

Fluorescent and benoxinate (another topical anesthetic)

62
Q

How do antihistamines work

A

block the cell receptors the histamines act upon

63
Q

Emedastine

A

H1 antihistamine. Use with moderate allergic conj.

64
Q

Mast cell stabilizers

A

Not good for acute but use chronically. Stops mast cells from becoming degranulated by stopping CA influx.

65
Q

SE of corticosteroids

A

Risk of secondary infection, Cataract, ocular HTN (junk not cleared out and decreased outflow)

66
Q

What do corticosteroids do?

A

Stop phosophilapase A2.

67
Q

Soft Steroids

A

FML and Loteprednol.

68
Q

NSAIDS

A

COX blockers so stop Leukotriens, thrombin,

69
Q

Where is FA dye injected

A

Brachial vein

70
Q

How long from injection to eyes

A

10-20 seconds

71
Q

Who is glycine CI in?

A

Diabetics. Use isosorbide instead.

72
Q

Methylcellulose

A

used to increase viscosity of AT and allow more contact time with cornea

NBEO Part 1 (17 decks)

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