Ophthalmic drugs

Question 1

What is the normal physiology of autonomic actions on intraocular structures?

Answer 1

Involves the parasympathetic nervous system (PNS) constricting the pupil and allowing accommodation, while the sympathetic nervous system (SNS) dilates the pupil.

Question 2

Define the term mydriatic.

Answer 2

A drug that causes pupil dilation (mydriasis).

Question 3

What is the definition of cycloplegic?

Answer 3

A drug that causes temporary paralysis of the ciliary muscle, preventing accommodation.

Question 4

What does the term miotic refer to?

Answer 4

A drug that constricts the pupil (miosis).

Question 5

What are the actions of cycloplegic drugs?

Answer 5

Cause temporary paralysis of ciliary muscle, prevent accommodation, and cause pupil dilation.

Question 6

List the main cycloplegic drugs.

Answer 6

• Cyclopentolate 0.5 & 1.0%
• Atropine 1.0%
• Tropicamide 0.5 & 1.0%

Question 7

What are the indications for using mydriatic drugs?

Answer 7

Used for fundus examination and to achieve mydriasis with minimal cycloplegic effect.

Question 8

List the main mydriatic drugs.

Answer 8

• Phenylephrine 2.5 & 10.0%

Question 9

What is the effect of a parasympathomimetic drug?

Answer 9

Stimulates the parasympathetic nervous system, causing pupil constriction.

Question 10

What is the effect of a parasympatholytic drug?

Answer 10

Blocks the effects of the parasympathetic nervous system.

Question 11

What is the effect of a sympathomimetic drug?

Answer 11

Stimulates the sympathetic nervous system, causing pupil dilation.

Question 12

What is the effect of a sympatholytic drug?

Answer 12

Blocks the effects of the sympathetic nervous system.

Question 13

What are the effects of miotic drugs?

Answer 13

Constrict pupil, can cause accommodative spasm, and improve aqueous drainage.

Question 14

What is pilocarpine hydrochloride used for?

Answer 14

Used as a miotic drug to treat glaucoma and for presbyopia correction.

Question 15

What is the purpose of local anaesthetics in ophthalmology?

Answer 15

Reduce stinging of cycloplegic drops and increase the effectiveness of anti-muscarinics.

Question 16

What precautions should be taken when using local anaesthetics?

Answer 16

Patient may be unaware of foreign body in the eye; must monitor corneal sensations.

Question 17

How does iris pigmentation affect drug efficacy?

Answer 17

Dilation and cycloplegia can take longer in brown irides due to thicker anterior limiting layer and pigment binding.

Question 18

What should be included in a case history for investigation?

Answer 18

• Current and previous eye health problems
• Current medications
• Allergies
• Previous experience with drops

Question 19

What are the general information points for parents/patients regarding drops?

Answer 19

• Effects of drops/ointment
• Minor side effects
• Serious adverse reactions
• Instructions for stopping use

Question 20

Fill in the blank: To administer drops, gently pull down the lower lid and place drops into the _______.

Answer 20

lower central fornix

Question 21

What is the proper technique for administering ointment?

Answer 21

Squeeze about 0.5cm of ointment into lower central fornix and massage lids gently.

Question 22

What information should be documented in patient notes?

Answer 22

• Accurate drug used
• Dosage
• Eye(s) treated
• Time of administration
• Instructions for home use

Question 23

What are the storage requirements for ophthalmic drugs?

Answer 23

Store out of reach of children, locked cupboard, may need refrigeration, correct disposal.

Question 24

What is the role of orthoptists regarding drug administration?

Answer 24

Do not have prescribing rights but can be annotated as exempt from legislation.

Question 25

What are exemptions in drug administration?

Answer 25

Allows certain medicines to be administered by identified health professionals without a prescribing mechanism.

Question 26

Which drug is appropriate for a 13-year-old for refraction?

Answer 26

Cycloplegic or mydriatic drug appropriate for age.

Question 27

Which drug is appropriate for a 6-month-old for refraction?

Answer 27

Cycloplegic or mydriatic drug appropriate for age.

Question 28

Which drug is appropriate for a 3-year-old with very dark eyes for refraction?

Answer 28

Consideration for longer dilation and cycloplegia times due to iris color.

Question 29

Which drug is suitable for a 43-year-old for fundus and media check?

Answer 29

Mydriatic drug suitable for adult examination.