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Pharmacotherapeutics > Ophthalmology > Flashcards

Ophthalmology Flashcards

(76 cards)

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1
Q

Primary Open Angle Glaucoma Pathophysiology

A

increase in IOP due to decrease outflow of aqueous humor through trabecular meshwork and schlemm’s canal

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2
Q

Primary Open Angle Glaucoma symptomatology

A

rarely experience symptoms until progression of central tunnel vision

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3
Q

ocular hypertension

A

two instances of IOP over 25 mmHg

sometimes 22

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4
Q

angle closure glaucoma

A

closure of the anterior chamber angle
medical emergency
30 mmHg or higher

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5
Q

acute Angle closure glaucoma symptomatology

A

decreased vision
halos around lights
headache
severe eye pain
N/V

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6
Q

chronic angle closure glaucoma symptomatology

A

symptom free
or decrease in central vision

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7
Q

Normal flow rate of aqueous humor

A

8-22 mmHg

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8
Q

IOP > 40 mmHg

A

Emergency referral

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9
Q

IOP 30-40 mmHg

A

Urgent referral if no symptoms suggesting acute glaucoma

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10
Q

IOP 25-29 mmHg

A

Evaluation within one week

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11
Q

IOP 23-24 mmHg

A

Repeat measurement to confirm and/or referral for eye exam

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12
Q

Individuals over age ____ should undergo periodic comprehensive eye evaluations.

A

40

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13
Q

The rapidity and degree of _____ elevation from _____ determines whether symptoms occur.

A

IOP

angle-closure

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14
Q

Diagnostic Techniques for Glaucoma

A

Tonometry
Fundoscopic Exam
Visual Field Exam

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15
Q

Contraindication for asthma or COPD with glaucoma

A

Ipratropium bromide (Atrovent)
Tiotropium bromide (Spiriva)

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16
Q

Contraindication for cold/flu remedies with glaucoma

A

OTCs that contain decongestants like pseudoephedrine or phenylephrine

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17
Q

Contraindication for incontinence or overreactive bladder with glaucoma

A

Tolterodine (Detrol)
Oxybutynin (Ditropan)

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18
Q

Contraindication for allergy relief and decongestion with glaucoma

A

Diphenhydramine (Benadryl)
Loratadine (Claritin)
Fexofenadine (Allegra)
Cetirizine (Zyrtec)

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19
Q

Contraindication for migraine attacks with glaucoma

A

Sumatriptan (Imitrex)

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20
Q

Contraindication for prevention of motion sickness with glaucoma

A

Scopolamine patches

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21
Q

Contraindication for depression/anxiety with glaucoma

A

Fluoxetine (Prozac)
Paroxetine (Paxil)
Amitriptyline (Elavil)
Tofranil (Imipramin)
Duloxetine (Cymbalta)

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22
Q

Glaucoma Treatments

A

Direct-acting Cholinergic Agonists
Beta-Adrenergic Blockers
Alpha-2 Agonists
Carbonic Anhydrase Inhibitors
Prostaglandin Agonists
Rho Kinase Inhibitors

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23
Q

Direct-acting Cholinergic Agonists

A

Pilocarpine (Isopto-Carpine)
Carbachol (Miostat)

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24
Q

Direct-acting Cholinergic Agonists MOA

A

Enhances outflow of aqueous humor

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25
Direct-acting Cholinergic Agonists Side Effects
Miosis, periorbital pain, brow ache, myopia, blurred vision Cholinergic effects
26
Direct-acting Cholinergic Agonists Administration
Four times a day
27
Beta-Adrenergic Blockers
Timolol (Timoptic, Timoptic XE, Betimol) Betaxolol (Betoptic) Carteolol
28
Beta-Adrenergic Blockers MOA
Decreases production of aqueous humor
29
Beta-Adrenergic Blockers Side Effects
stinging, burning bradycardia, heart block, reduced BP bronchospasm depression
30
All beta blockers are nonselective except _____.
Betaxolol (Betoptic)
31
Alpha-2 Agonists
Brimonidine (Alphagan P) Apraclonidine (Iopidine)
32
Alpha-2 Agonists MOA
Decreased production and increased outflow of aqueous humor
33
Alpha-2 Agonists Side Effects
red eye and ocular irritation
34
Carbonic Anhydrase Inhibitors (topical)
Dorzolamide (Trusopt) Brinzolamide (Azopt)
35
Carbonic Anhydrase Inhibitors MOA
Decreased production of aqueous humor
36
Carbonic Anhydrase Inhibitors Side Effects (topical)
burning, stinging, altered taste contraindicated in sulfonamide allergies
37
Carbonic Anhydrase Inhibitors oral preparations
Acetazolamide (Diamox) Methazolamide (Neptazane) Most potent for reducing IOP
38
Prostaglandin Agonists
Lantoprost (Xalatan) Bimatoprost (Lumigan) Latanoprostene buniod (Vyzulta) Travoprost (Travatan) Tafluprost (Zioptan)
39
Prostaglandin Agonists MOA
Enhances outflow of aqueous humor
40
Prostaglandin Agonists Side Effects
darkening of eye color and eyelid, hyperemia, blurred vision, eyelash lengthening
41
Which medication is marked only for eyelash hypotrichosis?
Latisse (bimatoprost 0.03%)
42
Rho Kinase Inhibitors
Netarsudil (Rhopressa)
43
Rho Kinase Inhibitors MOA
Enhance outflow of aqueous humor
44
Rho Kinase Inhibitors side effects
red eye and ocular irritation
45
Combination Products
Combigan: timolol + brimonidine Cosopt PF: dorzolamide + timolol Simbrinza: brinzolamide + brimonidine Rocklantan: netarsudil + latanoprost
46
First Line Therapy for Glaucoma
Prostaglandin agonist OR Topical beta-blocker
47
Second Line Therapy for Glaucoma
Increase concentration Switch to alt first-line or add second first line Consider adding other class alternatives: brimonidine (alpha 2) or TOPICAL carbonic anhydrase inhibitor
48
Third Line Therapy for Glaucoma
Consider adding direct-acting cholinergic agonist or replace with cholinesterase inhibitor May add ORAL carbonic anhydrase inhibitor instead of topical
49
Blepharitis
Infectious disorder of eyelids caused by staph aureus and epidermidis or inflammation/hypersecretion of sebaceous glands
50
First Line Therapy for Blepharitis
Erythromycin oint OR Bacitracin oint OR Azithromycin solution
51
Second Line Therapy for Blepharitis
Topical glucocorticoids topical cyclosporine Oral antibiotics (doxycycline, tetracycline, azithromycin)
52
Hordeolum (Stye)
infection of hair follicles or seb glands of eyelids caused by seborrhea and staph infections
53
Hordeolum (Stye) Treatment
Hot compress
54
Conjunctivitis (pink eye)
inflammation of conjunctiva due to bacteria, viruses, chemical irritants, or allergies
55
Bacterial conjunctivitis
Adults and children: Staph and Strep Moraxella and Haemophilus Neonates: N. gonorrhoeae and chlamydia
56
First Line of Therapy for bacterial conjunctivitis
Erythromycin oint OR Polymyxin B - trimethoprim
57
Second Line of Therapy for bacterial conjunctivitis
Azithromycin solution OR Neosporin OR Bleph -10
58
Preferred agents to treat bacterial conjunctivitis in contact lens wearers or risk of keratitis (Pseudomonas)
Fluoroquinolones Aminoglycosides
59
Fluoroquinolones
Moxifloxacin (Vigamox) Gatifloxacin (Zymaxid) Besifloxacin (Besivance)
60
Preferred Fluoroquinolones and Aminoglycosides
Tobramycin (Tobrex) Gentamicin Ciprofloxacin Ofloxacin
61
First Line Therapy for Viral Conjunctivitis
Topical antihistamines/decongestants OR Artificial Tears
62
Treatment of Allergic Conjunctivitis
Mast Cell Stabilizers Antihistamine/Mast Cell Combination Topical Decongestants Topical Decongestants/Antihistamine Combo
63
Mast Cell Stabilizers
Cromolyn Nedocromil (Alocril)
64
Antihistamine/Mast Cell Stabilizer Combination
Azelastine Epinastine (Elestat) Ketotifen Olopatadine
65
Topical Decongestants
Naphazoline Tetrahydrozoline
66
Topical Decongestants/Antihistamine Combination
Naphazoline/Pheniramine (Naphcon)
67
Topical NSAIDs
Ketorlac (Acular) Flurbiprofen
68
Do NOT use topical decongestants for more than _____.
72 hours
69
Keratitis
Infections of cornea secondary to trauma or contacts Caused by pseudomonas aeruginosa, staph. aureus, strep. pneumoniae
70
Keratitis Treatment
Cefazolin or vancomycin in combo with gentamicin drops or subconjunctival injections Moxifloxacin Besifloxacin Gatifloxacin
71
Concurrent _____ should be avoided in acute phase of infectious keratits.
glucocorticoid eye drops
72
Ocular Herpes Simplex Infections
Keratitis cased by herpes simplex virus
73
Treatment of Ocular Herpes Simplex Infections
Oral/topical antiviral therapy Oral acyclovir or valacyclovir Topical acyclovir or ganciclovir (alternative) Trifluridine
74
Dry Eye Syndrome (DES) Symptoms
Stinging, burning Excessive tearing Sandy/gritty sensation Blurred vision Redness
75
First Line Therapy for DES
Artificial Tear Substitute
76
Second Line Therapy for DES
Cyclosporine emulsion Lifitegrast (Xiidra) Varenicline (Tyrvaya) Perfluorohexyloctane (Miebo)

Pharmacotherapeutics (28 decks)

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