Ocular Intro Flashcards
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
What is FDA REQUIREMENT FOR Drugs?
90% have to be active
>18 mo shelf life
Antimicrobial preservation vs non preserved until dosing vials
What are the routes of Injection?
1) Sub-junctival
2) Intra-cameral
3) Intra-veitreal
4) Peri-bulbar
5) Retro-bulbar
6) Subtenon’s
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
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
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
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
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
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
What chemical class does EDTA belong to?
Chelators (metals )
They bind to heavy metals
What are chemical toxins? and what are the types?
ALCOHOL
HEAVY MEALS
Bacteriostatic
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
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
What is often combines with EDTA?
Chlorobutanol
- Less allergenic than benzalkonium chloride
- When combined with alcohol it will be a potent preservative
What are PRESERVATIVE SURFACTANTS?
Biguanides
Quaternary Ammonium compounds
What drugs are includes under Biguanides?
PHAMB
PAPB
Chlohexidine
Alexidine
What are quaternary Ammonium compounds?
Benzalkonium Chloride (BAK)
Polyquaternium (Quats)
PQ-1 (polyquad)
PQ-10
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
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
What is Poly-amino-propyl-buguanide forumated as?
1ppm DYMED Baush + Lomb
Whats the advantage of Chlorhexidine?
2 separated plus charges and less membrane intercalation compared to BAK
What is advantage Alexidine?
it is similar chlorhexidine and that has ehtylhexyl end grps making it more BACTERCIDAL
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
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
