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Flashcards in Ocular Intro Deck (70)
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1

If you are having a Anaphylactic reaction what should you do?

This will lead to obstruction in airways
Should care with EPINEPHRINE
1) IV Steroids
2) O2
3) Intubation - insert a tube to the airways
4) Airway management

2

What is FDA REQUIREMENT FOR Drugs?

90% have to be active
>18 mo shelf life
Antimicrobial preservation vs non preserved until dosing vials

3

What are the routes of Injection?

1) Sub-junctival
2) Intra-cameral
3) Intra-veitreal
4) Peri-bulbar
5) Retro-bulbar
6) Subtenon's

4

In what case and what drugs would you use SUB-TENON'S for the injection?

If you have EDEMA, UVEITIS, and Post cataract Surgery

Use : Steroids

5

In what case and what drugs would you use SUBCONG for the injection?

Lower dosage
High local concentration***
No compliance concerns
Useage: Severe corneal disease
ex. Treating bacterial ulcer or using 5 FU post trabeculoplasty

6

In what case and what drugs would you use Intracameral for the injection?

Visco elastic for glaucoma filtration and cataract surgery to protect corneal endothermic and anterior chamber collapse

1% Post OP LIDOCAINE for comfort at ciliary body iris

7

In what case and what drugs would you use INTRA-VITREAL for the injection?

Endopthalmitis with subconj injection
Retinitis
ex. cytomegalovirus
Triamicnolone for diabetic macular edema
Antiangiogenic inserts for macular degeneration's

8

In what case and what drugs would you use PERIBULBAR for the injection?

Anesthesia and Akinesia
-- Slower than retrobular injection
-- Considered safer alternative from early days

9

In what case and what drugs would you use RETROBULBAR for the injection?

Into the muscle cone
- High penetration risk
Much lesson common today than early days

10

What chemical class does EDTA belong to?

Chelators (metals )
They bind to heavy metals

11

What are chemical toxins? and what are the types?

ALCOHOL
HEAVY MEALS
Bacteriostatic

12

Which ones are Bacteriostatic?

PROVIDONE (PVP)
--- This is a water soluble synthetic
-- Non ionic polymer
-- Absorbs 40% its weight in water
-- Used in WWII as plasma expander for trauma
-- It complexes with iodine, mercury, nicotine, cynanide
-- *** it reduces their toxicity but preserves bactericidal action

13

Which ones are mercury based?

Thimersol
-- Used in CL solutions in early days
--- Toxicity caused reactions
-- then they found dilution of this that can reduce the toxicity
-- Still used in VET products

14

What is often combines with EDTA?

Chlorobutanol
-- Less allergenic than benzalkonium chloride
-- When combined with alcohol it will be a potent preservative

15

What are PRESERVATIVE SURFACTANTS?

Biguanides
Quaternary Ammonium compounds

16

What drugs are includes under Biguanides?

PHAMB
PAPB
Chlohexidine
Alexidine

17

What are quaternary Ammonium compounds?

Benzalkonium Chloride (BAK)
Polyquaternium (Quats)
PQ-1 (polyquad)
PQ-10

18

What does the Ammonium compounds do to the cell membranes?

Cationic surfactants are ammonium containing molecules that disrupt cell membranes and destablize enzyme structure and function
--- anionic solutions mixed with cationic surfactants will inactivate them

19

whats good about Cationic surfactants compared to anionic surfactants?

Cationic surfactants are less toxic to the ocular surface owning to ineractions with the negatively charge corneal cells

20

What is Poly-amino-propyl-buguanide forumated as?

1ppm DYMED Baush + Lomb

21

Whats the advantage of Chlorhexidine?

2 separated plus charges and less membrane intercalation compared to BAK

22

What is advantage Alexidine?

it is similar chlorhexidine and that has ehtylhexyl end grps making it more BACTERCIDAL

23

Whats so convterversioal about BAK?

it has 0.01% reduces TBUT by 50% through corneal epithelial toxicity, thts why using this product on artifical tears is controversial

24

What are drugs that included in OXIDANTS category?

Sodium perborate
= this is inactivated pH sensitive and questioned in use on dry eyes

Metabolized frm hydrogen peroxide to water and oxygen

Sodium Chlorite
== Light inactivated
= Convertes it to water and Sodium

25

What drugs are included in sodium Perborate?

Genteal (gen aqua)
Thera Tears

26

What drugs are included in Sodium chlorite?

Allergan Refresh (Purite)
Blink
Brimonidine (purite)

27

Why Brimondine with purite is better choice?

it is more pH neutral and absorbed better than higher preserved formulations

28

What are Preservative Free (PF) drugs?

Artifical tears
Cyclosprine
Timolol
Zioptan
Ketoralac
Cosopt- PF

29

What are Self preserved drugs?

Moxifloxacin 0.5%

30

Can you reuse PF?

YES as long as they are recapped, can be used over 12hr period