Pharmacology

Question 1

What are the two main routes of admin of drugs to the eye?

Answer 1

Topical

Injection

Question 2

Why can’t most systemic drugs make it to the eye?

Answer 2

Blood eye barrier

Question 3

What two forms do topical drug preparations come in?

Answer 3

Drops

Ointment

Question 4

Give some advantages of drops

Answer 4

Easier to administer

Less messy

Question 5

Give some advantages of ointment

Answer 5

Lasts for longer

Soothes eye

Question 6

What is the major side effect associated with topical drugs?

Answer 6

Systemic absorbance through pharynx after loss in tears

Question 7

What is corneal penetrance?

Answer 7

The ability of a drug to pass into/through the cornea.

Question 8

What regulates corneal penetrance?

Answer 8

Molecular weight

Hydrophobic/philic state

Question 9

Do most LMW drugs have good corneal penetrance?

Answer 9

Yes

Question 10

Where do hydrophobic drugs (lipophilic) penetrate best?

Answer 10

Epithelium

Question 11

Where do hydrophilic drugs penetrate (lipophobic) best?

Answer 11

Stroma

Question 12

What is the stroma?

Answer 12

Connective tissue

Question 13

What can increase lipid soluble drug absorption?

Answer 13

Inflammation

Question 14

What can increase corneal penetrance?

Answer 14

Benzalkonium- disrupts tear layers

Question 15

How do you make a steroid more hydrophobic?

Answer 15

Add alcohol or acetate group

Question 16

How do you make a steroid more hydrophilic?

Answer 16

Add a phosphate group

Question 17

Where can injections into the eye be given?

Answer 17

Subconjunctival
Subtenous- Back of orbit
Intravitreal- Vitreous fluid
Intracameral- Anterior chamber

Question 18

Where does a subtenous injection deliver the drug?

Answer 18

Back of orbit

Question 19

Where does an intravitreal injection deliver drug?

Answer 19

Vitreous fluid

Question 20

Where does an intracameral injection deliver drug?

Answer 20

Anterior chamber

Question 21

What is a disadvantage of intravitreal injections?

Answer 21

Drugs often toxic to retina

Question 22

What drugs are given subconjunctival?

Answer 22

Steroids

Question 23

What drugs are given intravitreal?

Answer 23

Anti-VEGF
Steroids
Antibiotics

Question 24

Where do you place the needle when injecting into the eyeball?

Answer 24

Gap between iris and retina

Question 25

What are steroids used for in the eye?

Answer 25

Suppress inflammation- Uvitis and post op Allergy Suppress immune response- Corneal graft

Question 26

What 4 strengths of steroid are available?

Answer 26

Mild- Fluorometholone Moderate- Prednisolone phosphate Potent- Betamathasone Very potent- Dexamathasone or Prednisolone acetate

Question 27

Give an example of a mild steroid

Answer 27

Fluorometholone

Question 28

Give an example of a moderate steroid

Answer 28

Prednisolone phosphate

Question 29

Give an example of a potent steroid

Answer 29

Betamathasone

Question 30

Give an example of a very potent steroid

Answer 30

Dexamathasone or Prednisolone acetate

Question 31

What kind of steroid is Dexamathasone or Prednisolone acetate?

Answer 31

Very potent

Question 32

What kind of steroid is Betamathasone?

Answer 32

Potent

Question 33

What kind of steroid is Prednisolone phosphate?

Answer 33

Moderate

Question 34

What kind of steroid is Fluorometholone?

Answer 34

Mild

Question 35

What are some of the local side effects of steroids?

Answer 35

Cataracts Glaucoma Viral infection

Question 36

What are some of the systemic side effects of steroids?

Answer 36

``` Weight gain Osteoporosis Neuropsychotic Gastric ulcers Immunosuppresion Diabetes ```

Question 37

What is the most commonly used antibiotic in ophthalmology?

Answer 37

Chloramphenicol

Question 38

What drugs are used to control inflammation in the eye?

Answer 38

Steroids NSAIDs Anti-histamines Mast cell stabilizers

Question 39

What five classes of drugs are used for glaucoma?

Answer 39

Prostanoids- Open drain. Latanoprost BB- Turn off tap CAI- Turn off tap. End in -zolamide A2 adrenergic agonists. Both. Brimonidine. Parasympathomimetic- Shrinks pupil. Pilocarpine

Question 40

What two mechanisms do glaucoma drugs have of working?

Answer 40

Open drain | Turn off tap

Question 41

Give an example of a prostanoid and how it works

Answer 41

Open drain. Latanoprost

Question 42

How do BB work in glaucoma?

Answer 42

Turn off tap

Question 43

GIve an example of a CAI and how it works

Answer 43

Turn off tap. End in -zolamide

Question 44

Give an example of an A2 adrenergic agonist and how it works

Answer 44

Both. Brimonidine.

Question 45

Give an example of a Parasympathomimetic and how it works

Answer 45

Shrinks pupil to increase angle. Pilocarpine

Question 46

What drug is used for diagnosis in ophthalmology?

Answer 46

Fluorescein

Question 47

Describe how to use fluorescein

Answer 47

Add dye to eye Shine blue light on Normally blue, damage shows as green

Question 48

How do LA work?

Answer 48

Inhibit Na channels

Question 49

What do Mydriatics and sympathomimetics do?

Answer 49

Dilate pupil

Question 50

How do you dilate the pupil?

Answer 50

Mydriatics and sympathomimetics