Ophthamology: Ocular Pharm Flashcards Preview

Clinical Neuro Exam 1 > Ophthamology: Ocular Pharm > Flashcards

Flashcards in Ophthamology: Ocular Pharm Deck (38):
1

How many mg of atropine are in 5cc of a 1% solution?

50mg

1% = 1 gram/ 100cc

1 gram/ 100cc x 5 grams = 0.05 grams = 50mg

2

Tetracaine

Topical Anesthetic (Eye Drop)

MOA: blocks sodium channels

Toxicity: corneal toxicity, never prescribe for home use (corneal melting)

3

Epinephrine

Glaucoma treatment

MOA: non-selective adrenergic agonist
-increases trabecular outflow from anterior chamber to decrease IOP

4

Phenylephrine

Treatment for glaucoma

MOA: direct-acting alpha agonist
-Mydriasis with NO EFFECT ON THE CILIARY MUSCLE

Contraindicated: INFANTS (do not use)

5

Aproclonidine

Treats glaucoma

MOA: alpha 2 agonist
-suppresses aqueous humor production

Adverse effects: somnolence in children (doesn't cross BBB in adults)

6

Brimonidine

Treats Glaucoma

MOA: alpha 2 agonist
-suppresses aqueous humor production

Adver effects: causes sedation by binding to alpha 2 receptors in the CNS, somnolence in children

7

Timolol

Treats Glaucoma

MOA: blocks Beta 1 and Beta 2
-suppresses aqueous humor production
-NO EFFECT ON OPTIC NERVE BLOOD FLOW

Adverse Effects: may exacerbate Myasthenia Gravis

8

Betaxolol

Treats Glaucoma

MOA: selective Beta 1 blocker
-decreases aqueous humor production
-SAFE TO USE ON PATIENTS WITH LUNG DISEASE

9

Carteolol

Treats Glaucoma

MOA: blocks Beta 1 and Beta 2
-suppresses aqueous humor production
-NO EFFECT ON OPTIC NERVE BLOOD FLOW

Adverse Effects: may exacerbate Myasthenia Gravis

10

What is an intracameral injection?

Injection into the anterior chamber of the eye

11

Acetylcholine

Used during cataract suergy to induce miosis.

MOA: binds to muscarinic receptors on the iris.

Must be injected intracameral to avoid corneal cholinesterases

12

Methacholine

Used topically to cause miosis. Used to diagnose Adie's Tonic Pupil

MOA: binds to muscarinic receptors on the iris

Resistant to corneal cholinesterases so it can be administered as eye drops

13

Carbachol

Glaucoma treatment

MOA: combo of ACh and Physostigmine (AChase inhibitor)

Causes miosis and increases trabecular flow for reabsorption of aqueous humor.

Side Effects: Accommodative spasms, conjunctival hyperemia

14

Pilocarpine

Used for angle closure glaucoma or to reverse pupil dilation

MOA: muscarinic agonist

Causes miosis, myopia, increases trabecular outflow, but decreases uveoscleral outflow.

Side Effects: Salivatio, Lacrimation, Sweating nausea, vomitting, diarrhea, Bronchiolar spasm/ pulmonary edema

15

Physostigmine

Used for anticholinergic overdose

MOA: AChase inhibitor

16

Atropine

Used for iritis: relaxes ciliary body
Amblyopia: alternative to patching
Hyphema
Reverses oculocardiac reflex

MOA: competitive ACh antagonist

17

In what populations are carbonic anhydrase inhibitor drugs contraindicated.

Patients with sulfa drug allergies

Sickle Cell disease patients (causes increased sickling of RBCs)

Renal or Liver failure

Addison's Disease

18

What drug class if the 1st line for glaucoma treatment?

Prostaglandin Analogs

19

Latanoprost

Glaucoma Treatment

MOA: prostaglandin analog
Increases uveoscleral outflow of aqueous humor, relaxes the ciliary muscle

Side Effects: irreversible darkening of the iris, hypertrichosis (long lashes)

20

Travoprost

Glaucoma Treatment

MOA: prostaglandin analog
Increases uveoscleral outflow of aqueous humor, relaxes the ciliary muscle

Side Effects: irreversible darkening of the iris, hypertrichosis (long lashes)

21

Bimatoprost

Glaucoma Treatment

MOA: prostaglandin analog
Increases uveoscleral outflow of aqueous humor, relaxes the ciliary muscle

Side Effects: irreversible darkening of the iris, hypertrichosis (long lashes)

22

5 major uses of corticosteroids in ophthamology.

1. Uveitis
2. Conjunctivitis
3. Macular Edema
4. Corneal Edema
5. Hyperemia

23

Contraindications for using corticosteroids.

Herpes Simplex Infections
Fungal infections

24

Side Effects of corticosteroids used in the eye.

1. Delayed Healing
2. Bacterial Proliferation
3. Cataracts
4. Increased IOP

25

Levocabastine

Treats allergic conjunctivitis

MOA: H1 receptor antagonist

Contraindications: do not use with contact lens wearers

26

Olopaditine

Treats allergic conjunctivitis

MOA: H1 receptor antagonist and Mast cell stabilizer

27

Fluoroquinolones
(-oxacins)

Antiobiotic eye drops useful in contact lens wearers to cover pseudomonas infection

MOA: inhibits DNA gyrase

28

Aminoglycosides

gentamicin, tobramycin
-used to treat mostly gram (-) eye infections

MOA: binds 30S ribosomal subunit

Side Effects: vestibular, renal, and auditory toxicity

29

Macrolides

Erythromycin
-coverage of gram (+) eye infections, not effective against pseudomonas

MOA: binds 50S ribosomal subunit

30

Most common cause of bacterial conjunctivitis.

Staph Aureus

(usually use macrolides to treat, need fluoroquinolones if the patient wears contact lenses)

31

Trifluridine

Treats viral eye infections (HSV)

MOA: fluorine nucleoside analog

32

Digitalis

Systemic ocular medication

Side Effects: changes visual perception, snowy white, green, yellow

33

Estrogen Progesterone contraceptives

Systemic ocular medication

Side Effects: optic neuritis, papilledema, contact lens intolerance

34

Tamsulosin

Systemic ocular medication

Side Effects: floppy iris syndrome

35

Amiodarone

Systemic ocular medication

Side Effects: Vortex Keratopathy (corneal deposits in the epithelium) after 1 month.

36

Hydroxychloroquine

Systemic ocular medication

Side Effects: drug binds to melanin causing bulls-eye maculopathy

37

Topamax

Systemic ocular medication

Side Effects: myopia, bilateral angle closure, ciliary body swelling

38

Sildenafil

Systemic ocular medication

Side Effects: blue haze in vision, light sensitivity, pupil sparing 3rd nerve palsy