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Ophthalmology > Lecture XIII > Flashcards

Lecture XIII Flashcards

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1
Q

What are the ocular manifestations of AIDS?

A

-Cotton wool spots

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2
Q

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

A
  • CMV retinitis

- Cotton wool spots

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3
Q

What is the leading cause of visual loss in AIDS?

A

CMV retinitis

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4
Q

What is the treatment for CMV retinitis?

A
  • Oral/IV ganciclovir

- Cidofovir

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5
Q

What determines if there is ocular involvement with systemic candidiasis?

A
  • Redness and pain

- VA changes

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6
Q

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

A
  • Conjunctivitis
  • Keratitis
  • Uveitis
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7
Q

What is the treatment for HZO?

A
  • Acyclovir

- Ophthalmic products PRN

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8
Q

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

A
  • Drops
  • Ointment
  • Drug-containing wafers
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9
Q

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

A
  • Subconjunctival
  • Intravitreal
  • Retrobulbar
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10
Q

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

A

Close eye immediately, and occlude the lacrimal sac

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11
Q

What is fluorescein used for?

A

Intraocular pressure and epithelial defects

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12
Q

When is IV fluorescein used?

A

Angiography for retinal disorders

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13
Q

What are the indications for topical anesthetics agents?

A
  • Measuring IOP
  • Performing superficial eye surgery
  • Evaluating a painful eye
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14
Q

What are the three major topical anesthetic agents?

A
  • Proparacaine
  • tetracaine
  • Lidocaine
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15
Q

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

A

Corneal toxicity

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16
Q

What is the effect of anticholinergics on the eye?

A

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

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17
Q

What is the effect of adrenergic stimulants on the eye?

A

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

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18
Q

What are the two major parasympatholytic agents?

A
  • Tropicamide

- Cyclopentolate

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19
Q

What are the systemic toxic effects of parasympatholytics?

A
  • N/v
  • Flushing of the skin
  • Tachycardia
  • Diaphoresis
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20
Q

What muscle do sympathomimetic agent stimulate?

A

Iris dilator

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21
Q

What is the effect on accommodation with sympathomimetic agents?

A

No effect

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22
Q

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

A
  • Phenylephrine

- HTN

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23
Q

What is the treatment for allergic conjunctivitis?

A
  • Tear substitutes

- Decongestants

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24
Q

What is the MOA of cromolyn?

A

Mast cell stabilizer

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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

Ophthalmology (14 decks)

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