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2015 neuro > Conjunctivitis drugs > Flashcards

Conjunctivitis drugs Flashcards

(46 cards)

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1
Q

Infection of the Eye lid

A

blepharitis

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2
Q

infection of the cornea

A

keratitis

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3
Q

endophthalmitis

A

aqueous and vitreous humor infection

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4
Q

defense mechanisms of eye

A

Sclera and cornea act as physical barrier
tears contain sIgA and lysozyme and provide lubrication
blinking inhibits microbial attachment

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5
Q

Common symptoms with bacterial conjunctivitis

A

Bilateral eyes - usually
Discharge - mucopurulent in young children
Redness- common in older children but not infants

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6
Q

common symptoms with viral conjunctivitis

A

not usually bilateral
watery discharge
usually red

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7
Q

common symptoms with allergic conjunctivitis

A

usually bilateral
no discharge
usually red

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8
Q

Treatment of allergic conjunctivitis

A

antihistamines

but no glucocorticoids - can lead to glaucoma, cataract and 2ndary infections

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9
Q

most common causes of viral conjunctivitis

A

Neonatal = HSV

post natal = Adenovirus

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10
Q

Describe the adenovirus

A

non-enveloped, double stranded DNA virus, Lytic in epithelial cells and latent in lymphoid
spreads through fomites

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11
Q

most common cause of acute bacterial conjunctivitis

A

Children - Staph aureus, strep pneumo and haemo influ

Adults - staph aureus

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12
Q

Empiric treatments of conjunctivitis

A

Trimethoprim and polymyxin (combined in drops) called polytrim
or
Moxifloxacin (more expensive)

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13
Q

Mechanism of moxifloxacin

A

topo II and IV inhibitor

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14
Q

Mechanism of trimethoprim

A

inhibits bacterial dihydrofolate reductase.

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15
Q

Mechanism of polymyxin B

A

Binds to LPS creating holes in membrane,

Used on Gram - multi-drug resistant bacteria

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16
Q

Hyperacute bacterial conjunctivitis cause

A

neisseria

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17
Q

Signs of neisseria conjunctivitis

A

Copious yellow green discharge
gram stain reveals gram negative intracellular diplococci
grows on chocolate agar

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18
Q

Treatment of hyperacute bacterial conjunctivitis

A

System ceftriaxone promptly

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19
Q

What is opthalmia neonatorum

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A

conjunctivitis occurring within the first four weeks of birth

20
Q

Treatment of ophthalmia neonatorum

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A

Prophaylaxis - erythromycin ointment

Treat - appropriate antimicrobial (usually erythromycin)

21
Q

Mechanism of erythromycin and azithromycin

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A

inhibit translation by binding 23S rRNA of 50S subunit

22
Q

spectrum of macrolides

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A

broad coverage of respiratory pathogens and chlamydia

23
Q

Resistance of macrolides

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A

Methylation of binding site and increase efflux

24
Q

Adverse effects of macrolides

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A

GI upset and hepatic failure

inhibitors of P450 enzymes

25
Different serotypes of Chlamydia trachomatis
inclusion conjunctivitis = serotypes D-K Trachoma = serotypes A-C Trachoma is the leading cause of blindness worldwide due to multiple infections b/c no long lasting immunity
26
Diagnosis of chlamydia trachomatis
direct fluorescent antibody
27
treatment of chlamydia trachomatis
systemic azithromycin and improve hygiene | treat sexual partners and prophylaxis is being used to eliminate trachoma by 2020
28
describe life cycle of chlamydia trachomatis
Elementary body (rigid outer membrane) enters epithelial cells -> converts to reticulate body -> replicates using binary fission
29
Signs and symptoms of HSV keratoconjunctivitis
similar to adenovirus but lesions can be painful especially if scarring of the cornea occurs often and only one eye
30
treatment of HSV keratoconjunctivitis
avoid corticosteroids treat w/ topical trifluridine and systemic acyclovir consider prophylactic treatment with erythromycin to prevent bacterial infection
31
Mechanism of trifluridine
pyrimidine analog effective against acyclovir resistant virus because it can be phosphorylated by host kinases making it more toxic and should only be used topically
32
signs and symptoms of keratitis
vision defects, photophobia, pain and foreign body sensation
33
Causes of keratitis
Viral - HSV-1 usually but adenovirus and vzv too Bacterial - staph, pseudomonas and bacillus cereus Fungal can be seen in warm humid climate acanthamoeba
34
treatment of keratitis
bacterial - moxifloxacin eye drops | viral (HSV) - trifluridine and acyclovir
35
Describe pseudomonas aeroginsoa
Gram -, aerobic rod w/ flagella can use 75 different compounds for growth usually opportunistic infection naturally resistant to many antibiotics and disinfectants due to its ability to form biofilms
36
what is pyocyanin and what does it do?
a blue pigment that inhibits mitochondrial enzymes which disrupts ciliary beating in pseudomonas keratitis
37
Mechanism of keratitis
Bacterial cell surface adherence factors and secreted toxins like elastase and alkaline protease destroy corneal epithelium The host response damages the cornea leading to scarring and loss of visual acuity
38
Describe acanthamoeba
Single cell, eukaryote | can cause keratitis or granulomathous amebic encephalitis
39
treatment of acanthamoeba
Azoles
40
Mechanism of azoles
bind p-450 enzyme and block production of ergosterol Can be very toxic
41
describe uveitis
inflammation of uveal tract that can lead to blurred vision and permanent vision loss
42
iritis
(also called anterior uveitis) often not infectious but has photophobia, pain and decreased visual acuity caused by Treponema pallidum, herpes simplex and vzv
43
Chorioretinitis
most common type of uveitis has floaters and no pain blurred vision and visual field defects
44
Causes of chorioretinitis
usually manifestation of a systemic disease most common causes are Toxoplamosis and CMV (looks like brushfire from periphery) esp in neonates and HIV positive individuals Parasitic worms can also cause this (river blindness)
45
describe toxoplama
Most common parasitic disease, late term congenital infections are more likely to lead to blindness diagnose with IgM serology treat with pyrimethamine and sulfadiazine
46
Describe endophthalmitis
infection of vitreous and/or aqueous humors Rare Pain, redness and decreased vision can be bacterial or fungal Exogenous = recent intraocular surgery Endogenous = spread from the blood Treat w/ fluoroquinolone or vancomycin injected into the eye

2015 neuro (14 decks)

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