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Flashcards in Pharmacology Deck (39)
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1

What kind of drugs do the corneal epithelium like?

Lipophilic

2

What kind of drugs do the corneal stroma like?

Hydrophilic

3

Which drug has both a lipophilic and hydrophilic component

Chloramphenicol

4

How can a drug be made more lipophilic?

Addition of an alcohol

5

How can drugs be made more hydrophillic?

Addition of a phosphate group

6

Which steroid is given for an uninflamed cornea?

Prednisolone acetate
Acetate group - hydrophobic so good in the epithelium.

7

Which steroid is given for corneal disease?

Prednisolone phosphate.
Phosphate- hydrophillic so good in the stroma

8

How can hydrophilic drugs be better absorbed into the stroma?

Benzalkonium.
It disrupts the lipid layer of the tear film

9

What is the name of the benzalkonium?

Bimatoprost

10

How are topical steroids incorporated systemically?

Tears spread the topical drug into the punctum which leads to the nasopharynx so is swallowed

11

How can steroids be prevented from spreading systemically?

Pressing on punctum (nasal side) stops the drops getting to the nasopharynx.

12

What side effect may be present with topical steroids?

Bad taste in mouth

13

When are steroids given intravitreally?

Wet macular degeneration

14

When are topical steroids used? (3)

Post op cataracts to prevent inflammation
Uveitis
Preventing corneal graft rejection

15

What are the signs of uveitis?

Injecting vessels
Photophobia
Misshapen pupil
WBC on slit lamp

16

What signs are bad in a corneal graft?

New blood vessels.
Graft rejection line - darker infiltrate inferiorly

17

What are the local side effects of steroids?

Cataracts
Glaucoma
Exacerbation of viral infection

18

In what infective ocular process should steroids not be used?

Viral conjunctivitis

19

What systemic side effects can steroids cause?

Osteoporosis
Weight gain
Diabetes
Gastric ulceration

20

What dosage of steroids should be given for temporal arteritis?

80mg
(high!)

21

What is glaucoma?

Progressive optic neuropathy resulting in loss of peripheral vision

22

What are the risk factors for getting glaucoma?

Family history
Over 40
Steroids
Diabetes

23

What is thought to cause glaucoma?

A raised intracranial pressure

24

What investigation needs to be done in glaucoma?

Visual field test.
If double sided then driving is not allowed.

25

Which glaucoma treatment can be given by drops?

Pilocarpine - miotic
Latanoprost
Timolol - B blocker

26

What is acetazolamide?

reduces ICP by reducing production of aqueous humour. Given IV/IM.

27

What is important to note with latanoprost?

Can change the colour of the iris

28

Which drug is given first in glaucoma?

Prostanoids e.g. latanoprost

29

What is anti-VEGF given for?

To prevent new blood vessels from forming

30

When are drugs given intra-vitreally?

Endophthalmitis

31

Why can local anaesthetic not be used regularly?

Stops epithelium from regenerating so prevents healing

32

How and why is fluorescein used?

With a blue light.
Shows corneal abrasion

33

What is tonometry?

Measures pressure

34

How can fluorescein be used to diagnose nasolacrimal duct obstruction?

Will run out of lateral sides of eye instead of into the puncture.

35

How do mydriatics work?

Cause pupil dilation by blocking parasympathetic (CN III) supply to ciliary muscles

36

What damage can ethambutol cause to the eye?

Optic neuropathy

37

What drug can cause maculopathy?

Chloroquine.
Hydroxychloroquine now used.

38

What drug can cause tears to turn red?

Rifampacin

39

What does amiodarone cause in the eye?

Corneal verticullata
Looks like a whirl of spindle like cream lines in the pupil