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Pharm I - Eye > Eye > Flashcards

Eye Flashcards

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1
Q

T/F topical drugs for eye can be used for systemic absorption like on the skin.

A

False; local absorption only

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2
Q

How should the dose of topical eye medications be increased?

A

increased concentration (not volume)

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3
Q

what are the two mediums eye medications come in?

A

ointment and drops

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4
Q

what are the disadvantages of drops?

A
  • hard to hold eye open
  • less duration of effect
  • need to use more frequently
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5
Q

what are the advantages and disadvantages of ointments?

A

Advantages:

  • better adherence to eye
  • better exposure to drug
  • less leakage down nasolacrimal duct
  • less frequent application

Disadvantage:
- blurry vision for longer time

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6
Q

when should ointments for the eye be applied?

A

night

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7
Q

You have prescribed drops and an ointment. What order should they be applied in?

A

drops than ointment

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8
Q

What is the most common dosage form for eyes?

A

Liquid eye drops

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9
Q

How many drops should you prescribe?

A

1 is all that is needed, 2 are prescribed incase some rolls out of eye

more than 2 increases toxicity and cost without benefit

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10
Q

what is 1 drop equivalent to?

A

1 drop = 1 ggt = 1/20 cc = 0.05 cc

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11
Q

How do you put eye drops in?

A
  • wash hands
  • shake if suspension
  • hold lower lid down to hold pouch between eyelid and ball
  • brace hand against cheek or nose
  • look at sky
  • apply drops into pouch (or apply 1/2 in. of ointment here)
  • don’t touch tip of applicator on anything
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12
Q

What is the mechanism of absorption of the eye?

A

local effect of drug on the eye is by diffusion into the eye

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13
Q

where does systemic absorption of eye medications occur? what do they cause?

A

nasolacrimal duct

S/E

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14
Q

how can you prevent systemic absorption?

A

nasolacrimal occlusion

  • put drops in the eye, close the eye, apply gentle pressure on the inner cants for 1-2 minutes
  • this decreases the exposure to the nasolacrimal apparatus & systemic absorption
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15
Q

what are ocular inserts?

A
  • patient applies
  • prolonged exposure
  • often only need to apply weekly
  • CL with drug implanted for LT drug use
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16
Q

What are the 6 major groups of drugs used in the eye?

A
  • glaucoma medications
  • lubricants
  • vasoconstrictors (decongestants)
  • antihistamines
  • ocular corticosteroids
  • ocular antibiotics
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17
Q

What is glaucoma?

A

elevated IOP due to increased aqueous humor and decreased drainage that kills optic nerve causing blindness

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18
Q

Compare and contrast open-angle glaucoma and closed/narrow-angle glaucoma.

A

open:

  • slow
  • chronic loss of vision
  • topically tx fairly easily

closed:

  • rapid loss of vision
  • surgery required
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19
Q

How do glaucoma drugs work (2 ways)?

A
  • decreased production of fluid

- change anatomy of eye so more fluid is drained

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20
Q

First line drugs for glaucoma?

A
  • prostaglandin analogs
  • beta blockers
  • alpha agonists
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21
Q

second line drugs for glaucoma?

A
  • carbonic anhydrase inhibitors

- cholinomimetics

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22
Q

MOA of prostaglandin analogs?

A

increase drainage of aqueous humor; most effective groups

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23
Q

S/E of prostaglandin analogs?

A
  • hyperemia (redness)
  • punctate erosions
  • blurred vision
  • change the color of iris permanently
  • hypertrichosis (increased hair)
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24
Q

What are the different types of prostaglandin analogs available?

A
  • latanoprost
  • bimatoprost
  • travoprost
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25
what is the MOA of beta blockers?
decreased secretions of aqueous humor
26
S/E of beta blockers?
Local: - stinging - blepharitis - blurred vision Systemic: - hypotension - low HR - heart failure - worsening asthma
27
What are the beta blockers used in glaucoma?
- timolol - carteolol - levobunolol
28
what is the MOA of alpha agonists?
1. decrease production | 2. increases outflow of aqueous humor
29
What are the S/E of alpha agonists?
Local: - allergic rxn Systemic: - dizziness - fatigue - sleepy - dry mouth - decreased BP
30
What are the alpha agonists used for glaucoma?
- apraclonidine | - brimonidine
31
What is the MOA of carbonic anhydrase inhibitors?
reduce the production of aqueous humor
32
S/E of carbonic anhydrase inhibitors?
Local: - stinging - tearing - blurred vision
33
What are the two types of carbonic anhydrase inhibitors available?
``` Topical - dorzolamide - brinzolamide Oral - acetazolamide ```
34
MOA of cholinomimetics for glaucoma?
stimulate contraction of ciliary muscle which pulls open the trabecular meshwork and relieves IOP (increases drainage of humor)
35
S/E of cholinomimetics?
Local: - miosis (decreased night vision) - HA - periorbital pain
36
Examples of cholinomimetics for glaucoma?
pilocarpine; has to be used several times a day (2nd line)
37
What is used to treat dry eyes?
lubricants
38
what are the 3 types of lubricants available?
- artificial tears - lubricating ointments - restasis
39
MOA of artificial tears?
- stimulate tears | - decrease evaporation of tears
40
S/E of artificial tears?
irritation if preservative present in preparation
41
Disadvantages of artificial tears?
- short duration of action | - need to be used a lot
42
Tx with artificial tears?
2x/day and increase can use every hour if needed OTC available in single dose (preservative free) or multi dose with preservative
43
MOA of lubricating ointments?
- stimulate tears | - decrease evaporation of tears
44
Advantages and disadvantages of ointments?
- more occlusive | - blurry vision
45
cyclosporine (restasis) MOA?
immunosuppressant used topically for chronic dry eye it working suggests chronic inflammatory process in dry eyes
46
S/E of cyclosporine?
Local: - stinging - increased infections
47
Disadvantages to cyclosporine?
- takes a long time to work - need to keep using to get effect - expensive - only Rx for dry eyes
48
Vasoconstrictor MOA?
alpha agonist that decreases redness by temporarily constricting blood vessels (eye decongestant)
49
S/E of vasoconstrictors?
Local: - rebound - increased IOP - local irritation Systemic: - adrenergic agonist effects
50
Vasoconstrictors on the market for the eye?
- naphazoline - tetrahydrozoline - oxymetazoline
51
MOA of ocular antihistamines?
inhibit release of histamine from mast cells
52
examples of anthistamines?
- alcaftadine - azelastine - bepotastine - olopatadine - emedastine - epinastine - ketotifen
53
MOA of ocular antibiotics?
kill bacteria
54
uses for ocular antibiotics?
- conjunctivitis - blepharitis - keratitis - styes - prophylactically - pre/post op
55
examples of ocular antibiotics?
- besifloxaxin - moxifloxacin - gatifloxacin - erthromycin - gentamycin - suflacetamide - tobramycin
56
MOA of ocular corticosteroids?
decreases inflammation in inflammatory eye conditions
57
S/E of ocular steroids?
``` Local: - increases IOP - infections - cataracts - scleral thinning - corneal melting Systemic: - the usual ```
58
Examples of ocular corticosteroids?
- prednisolone - dexamethasone - difluprednate - fluoromethalone - loteprednol
59
What drugs are given systemically that cause adverse affects to eye?
- hydroxychloroquine - chloroquine - sildenafil - corticosteroids
60
How does hydroxychloroquine and chloroquine affect the eye?
immunomodulator that deposits pigment in back of eye, can cause blindness with LT use used for malaria
61
How does sildenafil (viagra) affect the eye?
a phosphodiesterase inhibitor may rarely cause blindness, more commonly can see color changes with its use
62
how do corticosteroids affect the eye?
increase IOP and cause cataracts
63
what drugs increase the risk of glaucoma?
- corticosteroids (eye or oral) | - anticholinergics (topical)
64
what drugs increase the risk of closed-angle glaucoma?
- anticholinergics (topical or oral) - sympathomimetics (topical) - anti-histamines - anti-depressants - topiramate - phenothiazines

Pharm I - Eye (5 decks)

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