L6

Question 1

what are the 5 cardinal signs of inflammation

Answer 1

pain
heat
redness
swelling
loss of function

Question 2

what is prostaglandin and leukotrienes

Answer 2

they are chemical mediators incharge of causing

Increase permeability of vessels: EDEMA
Increase sensitivity to PAIN caused by prostaglandins

Question 3

what are the 4 types of hypersensitivity reaction

Answer 3

1: immediate
2: cytotoxic
3: immune complex
4: delayed

Question 4

what is type 1 hypersensitivity reaction

Answer 4

Antigen is reintroduced into an individual who has been exposed to the antigen previously.

First exposure results in formation of Immunogloblin E (IgE)
IgE binds to mast cells and makes cell rupture when Antigen is reintroduced

Question 5

What is hypersensitivity

Answer 5

immune system overreacts

Question 6

what is histamine

Answer 6

it is a mediator of hypersensitivity. it is release in large quantities from mast cell in type 1 reaction.

Synthesized and stored in almost all tissues: skin, lungs, nasal mucosa etc

Ocular: lids, conjunctiva, episclera, limbus

Question 7

what are the effect of histamine

Answer 7

Vasodilation
Edema
Itching
pain

Question 8

what are the types of anti-inflammation drugs

Answer 8

-Anti-histamine
-Mast cells Stabilizer
-Vasoconstrictors (decongestants)
-NSADIS
-Corticosteroids

Question 9

what is anti-histamine

Answer 9

Blocks the actions of produced histamine
Used topically for relief of mild to moderate symptoms of allergic conjunctivitis or irritation (itching), pinguecula, pterygium

They bind to histamine receptors

Resulting in the prevention of physiologic actions of histamine

Compound of anti-histamine: pyrilamine, pheniramine, antazoline

Question 10

what are some of the example of anti-histamine drug

Answer 10

Ketotifen
Optivar
Emedine

Question 11

what is mast cell stabilizer

Answer 11

• Inhibits the degranulation of mast cells, therefore inhibits the release of histamine.
• Prophylactic treatment (preventive)
• Long term management of allergies: vernal and seasonal allergic conjunctivitis
• It has NO EFFECT on mediators that has already been released.

Question 12

what are the example of mast cell stabilizer

Answer 12

Cromolyn sodium (Opticrom 2%)

Question 13

what is vasoconstrictors

Answer 13

• Adrenergic agonists
• Usually combined with anti-histamines
• Compound of vasoconstrictors: phenylephrine, tetrahydrozoline, oxymetazoline

Question 14

what are the example of vasoconstrictors

Answer 14

Visine
Opcon-A

Question 15

what is NSAID

Answer 15

• Alternative to steroids
• Inhibit prostaglandin formation
• Conditions: Episcleritis, scleritis, uveitis, cystoid macular edema

Question 16

example of NSAID

Answer 16

Paracetamol (oral)
Aspirin (oral)
Ocufen (ocular)
indocin (ocular)
acular (ocular)

Question 17

what is corticosteroid

Answer 17

• Supress inflammation but underlying cause still remains
• Supress inflammatory responses often caused by:
  Allergy
  Infection
  Trauma

Question 18

what are the different type of steroid

Answer 18

• Short acting:
  Hydrocortisone, prednisolone
• Intermediate acting:
  Traimcinolone, Fluprednisolone
• Long acting:
  Dexamethasone, betamethasone

Question 19

indication for corticosteroid

Answer 19

• Topical
  Allergic conjunctivitis
  Uveitis
  Scleritis
  After intraocular surgeries: IOL implants
• Systemic (disease behind the crystalline lens)
  Posterior uveitis
  Optic neuritis

Question 20

what is ocular complication of steroid

Answer 20

• Lens opacities (Posterior subcapsular cataract)
• Elevated IOP
• Mask diseases
• Lower resistance to infections
• Retards corneal healing

Question 21

what is anti-infective drug

Answer 21

Anti-infectives are medicines that work to prevent or treat infections, they include antibacterials, antivirals, antifungals and antiparasitic medications.

Question 22

what are the ocular defence system

Answer 22

• Tears: Lysozyme, Immunoglobulin A, Lactoferrin, albumin, B-lysin
• Blinking: constant flow and movement of the tear film to wash away debris
• Conjunctiva: lymphoid tissue which has anti-microbial defence
• Cornea: Langerhans’ cells (antigen presenting cell) from the limbus, cytokines

Question 23

what are bacterial eye infection

Answer 23

Yellowish discharge, usually severe.
Example: blepharitis, preseptal cellulitis

Question 24

what are the anti-bacterial drugs

Answer 24

• Bacitracin
  Ointment form
  Bacteriocidal against most gram-positive bacteria
  Treatment for: Blepharitis
• Chloramphenicol
  Broad spectrum
  eye drops/solution or ointment
  Treatment for: Conjunctivitis
• Aminoglycosides: most active against gram negative bacteria
• For superficial ocular infections
  Neomycin
  Tobramycin
  Gentamycin

Question 25

what is fungal eye infection

Answer 25

Most aggressive, hard to resolve.
Example: fungal corneal ulcer

Question 26

what are the anti-fungal drug

Answer 26

Nystatin
Amphotericin
Natamycin

Question 27

what is viral eye infection

Answer 27

Watery discharge, very infectious.
Example: herpetic keratitis, Cytomegalovirus retinitis

Question 28

what are the drug available for viral eye infection

Answer 28

Topical drugs

Trifluridine
Topical Acyclovir ointment (zovirax)

Intravenous route:
Ganciclovir
Foscarnet

Oral:
Acyclovir
Famcyclovir