Pharmacology

Question 1

What is needed for drugs to be able to work topically?

Answer 1

Corneal penetration

Question 2

What kind of drugs are able to penetrate the epithelium?

Answer 2

Lipid soluble drugs

Question 3

What kind of drugs are able to penetrate the stroma?

Answer 3

Water soluble drugs

Question 4

What is added to topical steroids to make them more hydrophillic?

Answer 4

Phosphate

Question 5

When is prednisolone acetate used?

Answer 5

Post operatively as has good penetration in uninflamed cornea and isn’t washed away by tears

Question 6

When is prednisolone phosphate used?

Answer 6

Cornea disease or when want low dose steroids

Use for surface of eye

Question 7

What is added to topical steroids to make them more hydrophobic?

Answer 7

Acetate or alcohol

Question 8

What is the role of Benzalkonium in topical drops?

Answer 8

Preservative
Disrupts lipid layer of tear film
Aids penetration of some drugs

Question 9

What is bimatoprost used to treat?

Answer 9

Lower IOP in glaucoma

Question 10

What are steroids used topically to treat?

Answer 10

Post op cataracts
Uveitis
Prevent corneal graft

Question 11

Local side effects of steroids on the eye

Answer 11

Glaucoma
Cataract
Exacerbation of viral infection

Question 12

Systemic side effects of steroids

Answer 12

Gastric ulceration 
Immunosuppression 
Osteoporosis 
Weight gain 
DIabetes 
Neuropsychiatric side effects

Question 13

What other snti-inflmmatory gents (other than steroids) are used in hayfever/allergic conjunctivitis?

Answer 13

Antihistamines

Mast cell stabilisers

Question 14

When would NSAIDs be used in ophthamology?

Answer 14

Pain relief (e.g. post refractive laser)

Question 15

What is glaucoma?

Answer 15

A group of diseases characterised by progressive optic neuropathy resulting in characteristic field defects

Question 16

What currently is the only modifiable risk factor for glaucoma?

Answer 16

Raised intra-ocular pressure

Question 17

What classes of drugs are used to treatment glaucoma?

Answer 17

Prostanoids 
Beta blockers 
Carbonic anhydrase inhibitors 
Alpha adrenergic agonist 
Parasympathomimetic

Question 18

Example of prostanoid

Answer 18

Latanoprost

Question 19

How do beta blockers work in glaucoma?

Answer 19

Work on cilliary bodies (turn off tap)

Question 20

Example of topical & systemic carbonic anhydrase inhibitors

Answer 20

Topical - Dorzolamide

Systemic - Acetazolamide

Question 21

How do carbonic anhydrase inhibitors help in glaucoma ?

Answer 21

Work on cilliary bodies (turn off ta)

Question 22

How to alpha adrenergic agonists help in galucoma?

Answer 22

Increase outflow

Question 23

Example of parasympathomimetic drug

Answer 23

Pilocarpine

Question 24

How do parasympathomimetics help in glaucoma?

Answer 24

Pulls iris tight to open up trabecular meshwork

Question 25

Local side effects of parasympathomimetic

Answer 25

Difficulty seeing in the dark

Question 26

What is first line management in glaucoma?

Answer 26

Prostanoid

Question 27

When is the intraitreal route of administration used?

Answer 27

Antibiotics in endophthalmitis Intra-ocular steroids Anti-VEGF

Question 28

How does local anaesthetic work on the eye?

Answer 28

Blocks doium channels and impedes nerve conduction

Question 29

When is local anaesthetic used in ophthalmology?

Answer 29

FB removal Tonometry (IOP measurement) Corneal scraping Comfort

Question 30

What is most common diagnostic dye used?

Answer 30

Fluorescein

Question 31

When is fluorescein used?

Answer 31

Show corneal abrasion Tonometry Diagnosing nasolacrimal duct obstruction Angiography

Question 32

Examples of mydriatics

Answer 32

Tropicamide | Cyclopentolate

Question 33

How do mydriatics work?

Answer 33

Cause pupil dilation by blocking parasympathetic supply to iris

Question 34

Side effects of mydriatics

Answer 34

Blurring | AACG

Question 35

How do sympathomimetics work?

Answer 35

Act on sympathetic system Cause pupil to dilate Do not affect the ciliary muscle (accomodation)

Question 36

Example of sympathomimetics

Answer 36

Phenylephrine | Atropine

Question 37

What are the ocular side effects of ethambutol?

Answer 37

Colour vision abnormalities | Optic neuropathy

Question 38

Side effects of chloroquine

Answer 38

Maculopathy