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Pharmacology Fall 2016 > Ocular Pharmacology > Flashcards

Ocular Pharmacology Flashcards

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1
Q

What is uveitis?

A

Inflammation of the uvea, iris, and ciliary body

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2
Q

Is the epithelium of the cornea hydrophobic or hydrophilic?

A

Hydrophobic

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3
Q

Is the endothelium of the cornea hydrophobic or hydrophilic?

A

Hydrophobic

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4
Q

Is the stroma of the cornea hydrophobic or hydrophilic?

A

Hydrophilic

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5
Q

Would an oil-based medication more easily penetrate the corneal epithelium or stroma?

A

Epithelium

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6
Q

Would a water-based medication more easily penetrate the corneal endothelium or stroma?

A

Stroma

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7
Q

When suspicious of a corneal ulcer, you would use a fluorescing stain toe identify the ulcer. Which layer of the cornea does this stain adhere to?

A

Stroma

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8
Q

What are the 2 possible ways of drug absorption when topically administered?

A
  1. Penetration of the cornea

2. Systemic absorption through the conjunctiva and the nasolacrimal system

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9
Q

Higher drug ____ or higher ____ of treatment can be used in order to increase the drug concentration in a treated tissue?

A

Higher drug CONCENTRATION or higher FREQUENCY of treatment can be used in order to increase the drug concentration in a treated tissue.

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10
Q

Wait at least ___ minutes between different eye drops.

A

5 minutes

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11
Q

Which MUST be shook well prior to application, an ophthalmic solution or suspension?

A

Suspension

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12
Q

Which is more stable, ophthalmic drops or ointment?

A

Ophthalmic ointment

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13
Q

Explain the penetration of subconjunctival injections.

A

Bypass the conjunctival and corneal barriers for direct scleral absorption

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14
Q

What are the indications for subconjunctival injection?

A
  1. Bolus of medication for animals not permitting repeated topical application (Ex: wildlife, aggressive animal)
  2. For water-soluble drugs that would penetrate the cornea poorly
  3. For long-acting drugs
  4. To confine a drug’s effect to the eye
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15
Q

Again, what are the indications for subconjunctival injections?

A
  1. For long-acting drugs
  2. For water-soluble drugs (unable to penetrate the cornea)
  3. To confine a drug’s effect to the eye
  4. For animals that will not permit repeated topical administration
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16
Q

True or False: Systemically administered drugs have no effect on the anterior or vitreous chambers of the eye.

A

FALSE - systemic drugs do have an effect on these chambers.

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17
Q

True or Falase: Most antibiotics penetrate the cornea well.

A

FALSE - most antibiotics have poor corneal penetration.

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18
Q

Name the 3 polypeptide ocular drugs.

A
  1. Polymyxin B
  2. Gramicidin
  3. Bacitracin
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19
Q

Are the polypeptides bacteriostatic or bactericidal?

A

Bactericidal

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20
Q

Describe the spectrum of the polypeptides.

A

Broad spectrum

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21
Q

True or False: The polypeptides can be administered topically, subconjunctivally, or systemically.

A

FALSE - the polypeptides are toxic when administered subconjunctivally or systemically. The polypeptides should only be used topically.

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22
Q

Name 3 aminoglycosides used in ocular pharmacology.

A
  1. Gentamicin
  2. Tobramycin
  3. Amikacin
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23
Q

Describe the spectrum of the aminoglycosides.

A

Broad spectrum

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24
Q

Are the aminoglycosides bactericidal or bacteriostatic?

A

Bactericidal

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25
True or False: These aminoglycosides can be used systemically.
FALSE - aminoglycosides are toxic when used systemically.
26
Which of the following is the most effective aminoglycoside, tobramycin or gentamicin?
Tobramycin
27
Which of the following is least epitheliotoxic, tobramycin or gentamicin?
Tobramycin
28
What is the most commonly used quinolone in ocular pharmacology?
Ofloxacin
29
Describe the spectrum of the quinolones.
Broad spectrum (limited against anaerobes)
30
Which antibiotic is effective against resistant staphylococcus?
Cephalosporins: Cefazolin
31
The cephalosporin cefazolin is used mainly for what type of ocular infections?
Staph and strep infections
32
True or False: The cephalosporin cefazolin easily penetrates the cornea.
FALSE - cefazolin has LOW corneal permeability.
33
Which of the following are the tetracyclines, antibacterial, anti-inflammatory, anti-protozoal, anti-protease.
1. Antibacterial 2. Anti-inflammatory 3. Anti-protease
34
Are the tetras bacteriostatic or bactericidal?
Bacteriostatic
35
The tetras are effective against ____ and ____.
1. Mycoplasma | 2. Chlamydophila (mainly in kittens)
36
What is the only ophthalmic preparation of tetracycline?
Ointment
37
Which fungal organism is miconazole effective against?
Aspergillus
38
True or False: Miconazole has poor penetration of the cornea.
TRUE
39
Which 2 fungal species is voriconazole effective against?
1. Fusarium | 2. Aspergillus
40
True or False: Voriconazole has good penetration of the cornea.
TRUE
41
What type of antivirals are currently the main antivirals used in veterinary ophthalmology?
Nucleoside analogs
42
Nucleoside analogs are most frequently used to treat which virus?
Feline herpesvirus
43
Nucleoside analogs are virostatic or virocidal?
Virostatic
44
What is the administration protocol for Idoxuridine?
Every 2 hours for 2 days then 4-6 x/day for 3-4 weeks
45
Which of the following is not effective against feline herpesvirus: Nucleoside analogs, Cidofovir, Acyclovir.
Acyclovir
46
Which dose of Famciclovir has been reported to have a positive clinical effect?
90 mg/kg every 12 hours
47
How does L-lysine interfere with viral replication?
Ties up arginine so it is not available for viral replication
48
What can you use as a life-long food additive for chronic recurring feline herpesvirus infections?
L-lysine
49
What is the administration protocol of L-lysine in PREVENTION of feline herpesvirus?
250-500 mg/cat every 24 hours
50
What is the administration protocol of L-lysine in TREATMENT of feline herpesvirus?
250-500 mg/cat every 12 hours
51
Do NOT use topical steroids on an eye with what?
Ulcerative keratitis
52
Corticosteroids decrease the release of ____ from injured cell membranes.
Arachidonic acid
53
Corticosteroids block degranulation of what 3 cell types?
1. Neutrophils 2. Mast cells 3. Basal cells
54
Corticosteroids prevent release of histamine, ____, and ____.
1. Proteases | 2. Bradykinin
55
Corticosteroids increase or decrease capillary permeability?
Decrease
56
Corticosteroids increase or decrease vasodilation?
Decrease
57
Corticosteroids increase or decrease neovascularization?
Decrease
58
What are the 3 general indications for corticosteroid use?
1. Allergies 2. Hypersensitivities 3. Immune-mediated diseases
59
How do corticosteroids affect fibroblast responses?
Inhibit fibroblast responses
60
How do corticosteroids affect epithelial regeneration?
Interfere with epithelial regeneration
61
How do corticosteroids affect collagen?
They potentiate proteinases that break down collagen
62
What affect do corticosteroids have on intraocular pressure?
Increase intraocular pressure
63
What affect do corticosteroids have on corneal epithelium and stroma?
Cause degeneration with long term use
64
True or False: Just like in the human being, corticosteroids cause cataracts in animals.
FALSE - corticosteroids do NOT cause cataracts in animals.
65
True of False: Corticosteroid can facilitate viral infections in prolonged use.
FALSE - corticosteroids can facilitate FUNGAL infections in prolonged use.
66
Corticosteroids should be avoiding with metabolic diseases, especially ____ in small animals.
Diabetes
67
Which of the following topical corticosteroids has the best corneal penetration: acetate, alcohol, or phosphate?
Acetate
68
What would you use for intraocular inflammation?
Prednisolone acetate
69
What would you use for extraocular inflammation?
Dexamethasone sodium phosphate
70
Which corticosteroid is systemically used in small animals?
Prednisone or prednisolone
71
Which corticosteroid is systemically used in horses?
Dexamethasone
72
Which is preferred in exotic animals, steroids or NSAIDs?
NSAIDs
73
How do NSAIDs work?
Prevent the formation of prostaglandins from arachidonic acid
74
What are the primary mediators of ocular inflammation?
Prostaglandins
75
What NSAID can be used in horses to treat SCC?
Piroxicam
76
What are the 2 most common treatments for KCS to date?
1. Tacrolimus | 2. Cyclosporin (Optimmune)
77
What affect do Tacrolimus and Cyclosporin have on tear production?
Stimulate tear production
78
What are serum, N-acetylcysteine, EDTA, and tetracyclines?
Anti-proteases
79
How do carbonic anhydrase inhibitors work?
Block the carbonic anhydrase enzyme, decreasing aqueous humor production
80
For what condition would you use carbonic anhydrase inhibitors?
Glaucoma
81
How do prostaglandin anaglogs decrease intraocular pressure?
By increasing uveoscleral outflow
82
What are Latanoprost and Travoprost?
Prostaglandin analogues
83
Which of the following is most cost effective, Latanoprost or Travoprost?
Latanoprost
84
How are beta-adrenergic blockers anti-glaucoma?
Decrease aqueous humor production They do this by blocking beta receptors on the ciliary epithelium
85
What is the adverse effect of using a beta blocker?
Bradycardia
86
True or False: Beta blockers can be used alone in the treatment of glaucoma.
FALSE - Beta blockers are not adequate in treating glaucoma when used alone. They are preferably used in combination with a carbonic anhydrase inhibitor.
87
Osmotic diuresis can be used to lower intraocular pressure. What is the mechanism of this?
Shrinks the vitreous of the eye
88
What is an example of a drug that can cause osmotic diuresis and shrinkage of the vitreous by association?
Mannitol
89
In what patients would Mannitol be contraindicated?
Renal disease patients

Pharmacology Fall 2016 (17 decks)

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