Lecture XIII Flashcards Preview

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Flashcards in Lecture XIII Deck (76):
1

What are the ocular manifestations of AIDS?

-Cotton wool spots

2

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

-CMV retinitis
-Cotton wool spots

3

What is the leading cause of visual loss in AIDS?

CMV retinitis

4

What is the treatment for CMV retinitis?

-Oral/IV ganciclovir
-Cidofovir

5

What determines if there is ocular involvement with systemic candidiasis?

-Redness and pain
-VA changes

6

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

-Conjunctivitis
-Keratitis
-Uveitis

7

What is the treatment for HZO?

-Acyclovir
-Ophthalmic products PRN

8

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

-Drops
-Ointment
-Drug-containing wafers

9

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

-Subconjunctival
-Intravitreal
-Retrobulbar

10

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

Close eye immediately, and occlude the lacrimal sac

11

What is fluorescein used for?

Intraocular pressure and epithelial defects

12

When is IV fluorescein used?

Angiography for retinal disorders

13

What are the indications for topical anesthetics agents?

-Measuring IOP
-Performing superficial eye surgery
-Evaluating a painful eye

14

What are the three major topical anesthetic agents?

-Proparacaine
-tetracaine
-Lidocaine

15

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

Corneal toxicity

16

What is the effect of anticholinergics on the eye?

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

17

What is the effect of adrenergic stimulants on the eye?

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

18

What are the two major parasympatholytic agents?

-Tropicamide
-Cyclopentolate

19

What are the systemic toxic effects of parasympatholytics?

-N/v
-Flushing of the skin
-Tachycardia
-Diaphoresis

20

What muscle do sympathomimetic agent stimulate?

Iris dilator

21

What is the effect on accommodation with sympathomimetic agents?

No effect

22

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

-Phenylephrine
-HTN

23

What is the treatment for allergic conjunctivitis?

-Tear substitutes
-Decongestants

24

What is the MOA of cromolyn?

Mast cell stabilizer

25

What is the MOA of pemirolast?

Mast cell stabilizer

26

What is the MOA of nedocromil?

Mast cell stabilizer

27

What is the major ocular adverse effect of sympathomimetics?

Close angle glaucoma

28

What is the MOA of levocabastine?

Antihistamine

29

What is the MOA of ketotifen?

Antihistamine/mast cell stabilizer

30

What is the MOA of ketorolac?

NSAID

31

What is the MOA of epinastine?

NSAID

32

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

-Prednisolone
-Dexamethasone
-Fluorometholone

33

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

Aminoglycosides (neomycin or tobramycin)

34

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

Alternative to aminoglycosides

35

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

-Antihistamines
-Cool compresses

36

What are the three major reasons to avoid topical steroids?

-exacerbate herpes keratitis
-Elevate IOP
-Cause cataracts

37

How is uveitis treated by ophthalmologists?

Topical steroids

38

What is the role of treatment for open angle glaucoma?

Treatment may prevent blindness

39

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

-Prostaglandin analogs
-Beta blockers
-Cholinergic agents

40

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

CAIs

41

What is the most efficacious agents used to treat glaucoma?

Prostaglandin analogs

42

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

-"prost"

43

How do prostaglandins treat glaucoma?

Increases uveoscleral outflow

44

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

-Increased iris pigmentation
-Hypertrichosis

45

What is the MOA of beta blockers in treating glaucoma?

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

46

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

-Timolol
-Levobunolol

47

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

-Depression
-ED

48

Who should not be on beta blockers?

-Heart block
-Bronchospasm or COPD
-Hypotension

49

How do cholinergic agonists work to treat glaucoma?

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

50

What is the classic cholinergic agonist used to treat glaucoma?

Pilocarpine

51

What are the side effects of cholinergic agonists?

-Decreased vision
-Wet picture
-Nearsightedness

52

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

"-idine" or epi

53

How do adrenergic agonists work to treat glaucoma?

Increases aqueous outflow

54

What are the side effects of adrenergic agonists?

-Chronic red eye
-Dilate pupils
-Tachycardia and PVCs

55

Brimonidine side effect in children under 2 years = ?

Apnea

56

What is the suffix for CAIs?

-"lamide"

57

What are the side effects of CAIs? (4)

-Electrolyte imbalances
-Altered taste
-Renal stones
-Sulfa allergy

58

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

Floppy iris syndrome

59

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

Optic neuropathy

60

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

Dose related optic neuropathy

61

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

Cataracts and glaucoma

62

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

Maculopathy

63

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

nonarteritic ischemic optic neuropathy

64

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

May induce angle-closure glaucoma

65

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

Topiramate

66

Bulls-eye maculopathy = ?

Hydroxychloroquine

67

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

Thioridazine

68

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

Tamoxifen

69

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

Chloroquine
Hydroxychloroquine

70

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

-Ethambutol
-Isoniazid

71

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

Fluoroquinolones

72

True or false: antivirals are generally effective against adenovirus

False

73

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

Cholinergic agonists

74

Which type of drugs cause nearsightedness and decreased vision?

anticholinergics

75

What is the safest glaucoma medication for pregnant women?

Brimonidine

76

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

Muscarinic