Opthalmology pharmacology Flashcards Preview

Year 2 > Opthalmology pharmacology > Flashcards

Flashcards in Opthalmology pharmacology Deck (56):
1

What are the two requirements for topical ocular drugs?

Ability to act on the surface of the eye
Ability to penetrate the cornea

2

The epithelium of the cornea is hydrophilic and the stroma of the cornea is hydrophobic. T/F

False:
Epithelium = hydrophobic/lipid loving
Stroma = lipophobic/water loving

3

Which type of drugs penetrate the corneal epithelium and stroma respectively?

Epithelium - lipid soluble
Stroma - water soluble

4

Which ocular antibiotic possesses both lipophilic and hydrophilic qualities?

Chloramphenicol

5

What can alter the properties of the epithelium and in what way?

Inflammation can cause the epithelium to become more hydrophilic

6

What can alter the properties of the stroma and in what way?

The tear film can cause the epithelium to become more hydrophobic

7

How can topical steroids be altered to make them more 1) hydrophobic and 2) hydrophilic?

1 - alcohol/acetate
2- phosphate

8

When does prednisolone acetate penetrate the cornea best?

When it is uninflamed

9

When is prednisolone acetate used?

Post-operatively

10

When does prednisolone phosphate penetrate the cornea best?

When it is inflamed

11

When is prednisolone phosphate used?

In corneal disease or when low dose steroids are required

12

What chemical can alter the properties of the tear film? What else is it useful for?

Benzalkonium (makes it less hydrophobic). Also a preservative

13

Where can excess topical ocular drugs get systemically absorbed? How can this be halted?

Nasopharynx (via nasolacrimal duct). Punctal occlusion for five minutes

14

Other than topical, what are some routes of administration?

Subconjunctival, subtenons, intravetral, intracameral

15

Name some frequently used ocular antibiotics

Chloramphenicol, gentamicin, ofloxacin

16

Name an ocular antiviral

Zovirax

17

What are the types of anti-inflammatory agents used in the eyes?

Steroids, topical NSAIDs, anti-histamines and mast cell stabilisers

18

When are steroids used?

Post-op cataract surgery
Uveitis
Prevention of corneal graft rejection

19

What steroid is typically used in uveitis?

Prednisolone acetate

20

What are the local effects of steroids?

Cataract, glaucoma and exacerbation of viral infection

21

What are the systemic effects of steroids?

Osteoporosis, weight gain, gastric ulcers, immunosuppression

22

How is temporal arteritis treated?

Oral steroids

23

List the strengths of topical steroids from weakest to strongest

Fluorometholone (FML) >
Predsol (prednisolone phosphate) >
betamathasone >
dexamethasone/prednisolone acetate

24

When are anti histamines or mast cell stabilisers used?

Hayfever, allergic conjunctivitis

25

When might topical NSAIDs be used?

For pain e.g post laser surgery

26

What is glaucoma?

A group of diseases which bring about progressive and irreversible optic neuropathy (often with raised IOP) resulting in visual field defects

27

What is the only modifiable risk factor for glaucoma?

Raised IOP

28

How does glaucoma typically present?

Asymptomatic

29

Who screens for glaucoma?

Optometrists

30

What is the relationship between glaucoma and age?

Glaucoma increases with age

31

What are the categories of glaucoma medication?

Prostanoids
Beta blockers
Carbonic anhydrase inhibitors
Alpha2 adrenergic agonist
Parasympathomimetric
Combination

32

Name a prostanoid medication

Latanoprost

33

Name beta blockers used in glaucoma

Timolol, betaxolol, levobunolol, carteolol

34

Name a topic and systemic carbonic anhydrase inhibitor

Topical - dorzolamide
Systemic - acetazolamide

35

Name an alpha2 adrenergic agonist

brimonidine

36

Name a parasympathomimetric

pilocarpine

37

Name a combination medication for glaucoma

dorzolamide and timolol (cosopt)

38

What are the side effects of alpha2 agonists?

Red eye

39

What is the main side effect of parasympathomimetric?

Night blindness

40

Name three scenarios in which intra-vitreal injections are used

Antibiotic delivery in endopthalmitis
Intra-ocular steroids
Anti-VEGF in wet macular degeneration

41

How does local anaesthetic work in the eye?

Blockage of sodium channels responsible for nerve conduction

42

List scenarios when local anaesthetic would be used

Foreign body removal
Tonometry
Corneal scraping
Comfort

43

What is a side effect of local anaesthetic?

Limited healing

44

List scenarios where diagnostic dye would be used

Detecting corneal abrasions
Tonometry
Detecting nasolacrimal duct obstruction
Angiography

45

What do mydriatic drugs do?

Dilate the pupil

46

How do mydriatic drugs work?

Block parasympathetic supply to the iris

47

What are the side effects of mydriatic drugs?

Vision blurring
AACG (acute angle closure glaucoma)

48

What do sympanometrics do?

Dilate the pupil

49

How do sympanometric drugs work?

Act on the sympathetic nerves suppling the iris causing them to dilate

50

Do sympanometric drugs affect the accomodation reflex?

No

51

Name some sympanometric drugs

Phenylephrine, atropine

52

Name some mydriatic drugs

Tropicamide, cyclopentolate

53

What is a side effect of the epilepsy medicine vigabatrin?

Constricted visual fields

54

What is a side effect of the TB drub ethambutol?

Optic nerve neuropathy

55

What is a side effect of the antimalarial/DMARD drug hydroxychloroquine?

Bullseye maculopathy when used long term

56

What is a side effect of amiodarone?

Corneal verticillata

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