Pharmacology

Question 1

What is aflibercept (Eyela)?

Answer 1

Anti VEGF molecule

Fusion protein consisting of VEGF receptors bound to IgG Fc

Question 2

What is ranibizumab (Lucentis)?

Answer 2

Anti VEGF antibody fragment

Question 3

What is bevacizumab (Avastin)?

Answer 3

Humanised antibody against VEGF

Question 4

What is pegaptinib?

Answer 4

First anti-VEGF agent to be discovered in 2004

Aptamer (oligonucleotide fragment) that binds VEGF

Question 5

Give an example of an ester local anaesthetic and anamide LA.

Answer 5

Ester: Cocaine, procaine (“Esther loves cocaine”)
Amide: Lidocaine, bupivacaine

Question 6

State the effects of H1 histamine receptors.

Answer 6

Vasodilation
Smooth muscle contraction (bronchospasm)
Mucus secretion
CNS depression

Targeted by ceterizine

Question 7

State the effects of H2 histamine receptors.

Answer 7

Stomach: increased pepsin and acid production

Targeted by ranitidine

Question 8

Which corneal layer offers the most resistance to drug penetration?

Answer 8

Corneal epithelium

Question 9

Why does a higher amount of atropine need to be used in patients with dark irides?

Answer 9

Binding of atropine to melanin reduces its bioavailability

Question 10

Side effect of hydroxychloroquine?

Answer 10

Bull’s eye maculopathy

• 7.5% incidence with long term use
• Chloroquine is even more toxic

Question 11

3 ocular side effects of amiodarone?

Answer 11

1. Corneal deposits
2. Coloured rings around lights
3. Optic neuropathy

Question 12

Side effect of topiramate?

Answer 12

Acute angle closure glaucoma

Question 13

Side effect of vigabatrin?

Answer 13

Bilateral visual field constriction due to RNFL loss

Question 14

Side effect of bisphosphonates?

Answer 14

Eye inflammation: Conjunctivitis, keratitis, scleritis

Question 15

Side effect of ethambutol?

Answer 15

Optic neuritis

Question 16

Side effect of alpha-blockers e.g. tamsulosin?

Answer 16

Intra-operative floppy iris syndrome

Question 17

Side effect of tamoxifen?

Answer 17

Maculopathy with crystalline deposits

Question 18

Side effect of rifampicin

Answer 18

Hepatotoxic + red secretions

Question 19

Side effect of isoniazid

Answer 19

Hepatotoxic + B6 deficiency

Question 20

Side effect of pyrazinamide

Answer 20

Hepatotoxic + gout / hyperuricemia

Question 21

Side effect of ethambutol

Answer 21

Optic neuritis

Question 22

What class of drugs causes cyst-like proliferation of the pupillary margin?

Answer 22

AChesterase inhibitors e.g. physostigmine, neostigmine

Question 23

Which prostaglandin is the main inflammatory prostaglandin?

Answer 23

PGE2 (pyrexia, vasodilation)

Question 24

H1 antihistamine eye drop used to treat conjunctivitis

Answer 24

Emedastine