Flashcards in Pharm Quiz 4 TS Deck (78):
Where may a drug distribute to after it has been topically administered to the eye?
iris, lens, ciliary body
What are the disadvantages of topical administration for solution eye drugs?
short contact time, dilution effects, expense, increased systemic absorption
What are the advantages for topical administrations of ointment on the eye?
longer contact time, not diluted, protects cornea from drying, less expensive
What drugs are administered by subconjunctival therapy?
antibiotics and corticosteroids
What determines the absorption after topical administration of eye drugs?
time in culdesac and precorneal tear film
drug binding to tear proteins
drug metabolism in tear and tissue proteins
diffusion across cornea and conjunctiva
What enzymes are used to biotransform drugs in the eye?
What determines systemic distribution of topically administered drugs in the eye?
nasal mucosal absorption
local ocular distribution
What can bind certaind drugs in the eye?
What types of drugs cause the eye to dilate?
What types of drugs cause the eye to constrict?
What drugs cause pinpoint pupils?
What should you do before treating the eye with antibiotics?
identify the agent! lots of resistance possibilites
What bacterial infections do dogs get in their eye?
staph and strep
What bacterial infections do cats get in their eye?
same as dogs plus mycoplasma felis and chlamydophila felis
What bacterial infections do horses get in their eye?
staph, strep, pseudomonas
What are the 2 first choice antibiotic combos for corneal ulcers and bacterial conjuctivitis?
BNP - neo, bac, poly
NPG - neo, poly, gramicidin
What antibiotic combo can cause fatalities in cats?
polymyxin B (BNP)
What is the 1st choice in small animals for antimicrobials for eye infection dependent on culture? Why should caution be taken?
beware: doesnt treat pseudomonas
What 3 classes of drugs can be used for keratomycosis?
polyene antibiotics, imidazoles, nucleoside analogs
What combination of drugs is specific for treating corneal ulcers?
natamycin, tobramycin, cefazolin in serum
What 2 things cause collagen and glycosaminoglycans to be broken down during corneal ulceration?
host derived proteinases and exogenous microbial hydrolases
What can be used from the serum of the patient to inhibit proteinases in the eye?
What chelating agent impairs epitheliazation in the eye to help it heal from the inside out?
What chelating agent has additional mucolytic action and makes more water tears?
What antibiotic is a chelating agent and inhibits proteinases in the eye?
What proteinase inhibitor has indirect activity and impedes extravasation of leukocytes?
What proteinase inhibitor inhibits endogenous and pseudomonas proteinases?
What proteinase inhibitor is used in artifical tears?
What signaling molecule can cause neural damage in glaucoma?
What group of drugs acts on the trabecular outflow of the eye?
What group of drugs act on uveoscleral outflow?
What group of drugs act on aqueous humor inflow?
a2 adrenergic agonists
carbonic anhydrase inhibitors
What are the 3 topical prostaglandin analogs?
latanoprost, bimatoprost, travoprost (all end in -prost)
What is the MOA of prostaglandin analgos?
facilitate outflow thru uveoscleral pathway by IP3 and Ca+2 pathway
What are the 3 beta adrenoreceptor antagonists?
timolol, metipranolol, betaxolol
What is the MOA of beta antagonists?
cAMP - PKA pathway that regulates aqueous humor production
What do alpha 2 agonists act through?
inhibition of adenylate cyclase
What are the 2 local CAI drugs?
dorsolamide and brinzolamide
What are the 3 oral CAI drugs?
methazolamide, dichlorphenamide, acetazolamide
What is the MOA of CAI?
reduce bicarbonate, reduction in fluid transport
What is a topical miotic used to treat glaucoma?
What is the MOA of pilocarpine?
increase aqueous outflow via trabecular outflow
What calcium channel blocker can be used for neuroprotection during glaucoma?
What NMDA channel blocker can be used for neuroprotection during glaucoma?
What type of drugs should never be used on a damaged cornea?
What anti inflammatory drug is highly lipophilic and used in glaucoma?
cyclosporin A (subconjuctival injection)
What is the most widely used autonomic drug group used in the eye?
What 3 drugs are antimuscarinic and cause dilation?
atropine, tropicamide, scopolamine
What 2 sympathomimetic drugs cause dilation?
What 2 anesthetic drugs are used topically on the eye?
proparacaine and tetracaine
What 2 anesthetic drugs are used as infiltrative anesthetics?
lidocaine and bupivacaine
What disinfectant can be used on the eye?
2% povidone iodine
What 3 drugs can be used systemically to treat nasal fungal infections?
ketoconazole, fluconazole, voriconazole (imidazoles)
What are the 3 side effects of imidazoles?
inhibition of CY-450, GI disturbances, liver toxicity
What drug can treat idiopathic lympho-plasmacytic rhinitis?
immune mediated dz --> glucocorticoids
What causes gutteral pouch mycosis?
What local drugs can treat gutteral pouch mycosis?
thiobendazole, nystatin, enilconazole
What anti-tussive has limited SE that include vomiting and CNS depresion?
codeine and hydrocodone
What anti-tussive has beneficial effects in horses for a BAL procedure?
What anti-tussive has low potency and is used for horses and cattle?
What drug breaks up mucus by disrupting disulphydryl bonds?
What drugs increase mucous gland production and mucociliary clearance?
Ach M3 antagonists, B2 agonists and PDE inhibitors all do what action?
modify airway resistance
Crotethamide, lobeline, doxapram, etamiphylline all do what action?
What are the 2 stimulating expectorants?
guajacol and guaifenisine
What are the 2 reflex expectorants?
ammonium carbonate/chloride, potassium iodide
What anticholinergic is used for emergency treatment and is bronchodilatory?
What anticholinergic is used per inhalation and is restricted to respiratory tract?
What are the 3 drugs that act through B2 agonists and Gs coupled to modify airway resistance?
clenbuterol, salbutamol, and albuterol
What is a side effect of the buterol drugs?
tocolytic - sperm abnormalities
What receptor does phenylephrine act through?
alpha 1 adrenergic decongestant, topical vasoconstriction
What are the 3 sympathetic amines?
phenylephrine, ephedrine, pseuodephedrine
What can be a side effect of the sympathetic amines?
What is the MOA of theophylline?
stimulates adenosine receptors to increase cAMP --> increase mucociliary clearance
What are the SE of theophylline?
What condition are NSAIDs contraindicated?
What drug is a dual inhibitor of prostaglandins?