Pharmacology and Microbiology Flashcards
(145 cards)
1
Q
How are step pneumonia resistant to phagocytosis?
A
Due to capsular polysaccharide layer
2
Q
Treatment of actinomyces and nocardia?
A
SNAP
Actinomyces; Sulphonamide
Nocardia; Penicillin
3
Q
Legionella.. Type of bacteria? Agar and stain ?
What electrolyte imbalance occurs?
A
Legionella gram negative
Silver stain
Grows on charcoal yeast extract medium with iron and cysteine
Hyponatremia
4
Q
Pseudomonas Aeruginosa - type of bacteria? What does it produce - PEEP
A
Aerobic
Gram negative
Produces:
Phospholipase
ENdotoxin
Exotoxin A inhibits EF2
Pigments; Pyocyanin - blue /green
5
Q
Examples of Exotoxin bacteria?
A
Botulin Toxin
Diphtheria cholera
6
Q
Examples of endotoxin bacteria ? What does they activate.
What are more toxic - endo or exotoxin
A
Endotoxin
outter cell memberane of most gram negative bacteria
Lipid A component of LPS - sturcutural part of lps
Bacterial chromospme
Festure include fever, shock, DIC
Indices TNF, IL1 and Il6,
Poorly antigenic
No toxoids formed and no vaccinable available
Stable at 100eg for 1 hr
Menigoccous
7
Q
All DNA are double stranded except
A
Parovirus
8
Q
All RNA are single stranded except
A
Reovirdiae
9
Q
Features of DNA
A
DSDNA
Linear genome
Are isocahederal - except pox
Replicate in nucleus - indenpent f RNA polymerase
10
Q
Viral replication process?
A
Adhesion
-collision
-electrostatic attachement
-host cell replication
Penetration
Capsid removal by host cell
Nucleic acid replication
11
Q
HSV binds to what glycoprotein to enter host ?
A
Binding to gD receptors include:
Nectin 1; membrane of igG superfamily
Nectin 2; HVEM aka herpes viral entry mediator - TNF superfamily -facilitate penetration of capsid into host cell
12
Q
HSV1 -
HSV2
A
1 - cold sores
2 - genital sores
13
Q
Vaccination for herpes zoster ? type of vaccine
A
Zosatrix - live attenuated vaccine. not used in IC people. One dose required
Shingarix - used in IC people
contains VZV glycoprotein
Vaccine effocency - Phase 3: 2 doses 97% in >90yo, 91% in 71yo
14
Q
Shingrx efficacy after one dose and two dose
A
One dose 57
Two dose 70
15
Q
Adenovirus - type of bacteria?
Subtype that leads to
epidemic keratoconjunctivitis
Pharyngoconjunctivitis fever
Acute haemorrhagic conjunctivitis
Acute follicular
A
epidemic keratoconjunctivitis 8.9.27
Pharyngoconjunctivitis fever 3,7
Acute haemorrhagic conjunctivitis 11,21
Acute follicular 1-10
16
Q
CMV affects on the eye, describe the histology, what it binds to ?
A
Causes aids retinitis; show full thickness retinal necrosis, affects the retina prematurely at posterior pole
Features include; haemorrhage, exudates, cotton wool spots, vision lost
Owl eye includson bodies
Latent in mononuclear cells
Binds to integrin - heparin sulphate
17
Q
Features of the epidemic keratoconjunctivitis?
A
Unilateral onset of preauricular lymphadenopathy
nilateral follicular conjunctivitis
Epithelial opactities fade in 4 week
Subepithelial opactiies –> 2 year
18
Q
Time course of epidemic keratoconjunctivitis?
A
Foreign body sensation, periorbital ain, Diffuse superficial keratitis,
Subepithelial opactieis form under focal epithelal infilterates
19
Q
Diagnosis of epidemic keratoconjunctivitis?
A
Immunoassay
20
Q
Rubella ? rash? other name for it ? Infectivity
Transmission
Incubation
A
Blueberry muffin rash
3 days pre and post rash
Respiratory
12-24 days
21
Q
Congenial features of Rubella ?
A
Pigmentary retinopathy
Catract
Glaucoma
Cloudy corena
Micro-ophthalmia
22
Q
Measles - type of virus
Transmission
Treatment
Infectivity ?
A
ssRNA
Nasopharygneal secretions
Mother to child
4 days pre and post rash
23
Q
Severe complication of Measles ?
A
Subacute sclerotising pancephalitis - unvaccinated children get disease 6-8 yeaer after infection
24
Q
Symptoms of subacute scleroising pancephalitis
acute
delayed
A
Acute:
Memory impairment, behavioural delay, visual impairment
Delayed: Myoclonos, spastic, paresis, dementia, death 1-3 eyars
25
In subacute scleroising pancephalitis do nerological or ocular feature occur first ?
and by how many years ?
Ocular features by 2 year
feautres includ; focal retinits, RPE change, Pailloedema, OD swelling, optic atrophy,
26
Diagnosis of subacute scleroising pancephalitis do neurological
EEG abnormality
IgG antibody in plasma/ CSF
27
What are the 3 structural genes in HIV?
Env - gp120, gp41
Gag - p24 and p17
POL - TIP
28
Disease that occur when the CD 4is
<500
<200
<100
<50
<500 - candida, EBV, HPV,TB
<200 - pneumocystis pneumonia - ground glass
<100 - CMV, toxoplasmosis, cryptococcus neoformans
<50 - mycobacterium avium
29
Cancer associated wit hHIV most common and second most common
Most common - Kaposi
Second: Non Hodgkin B cell lymphoma
29
chlamydia?
2 forms
Obligate intercellular parasite of mucsal epithelial cells
2 form: InfectiousL Elementary - outside of host
Reproduction: reticulate; inside of eukaryote, replicate by binary fission
30
Infectious conjunctivitis more common;
children
Adult
Child: bacteria ;HIB and strep
Adult: Adenovirus, herpes and herpes zoster
31
Immune mechanism in Helminth
Mast cell and IgE
32
Bacteria and virus
IgG, complemetns, neutrophils
33
Pneumonia and encapsulated organism ?
IgM, Macrophage and complement
34
Myobacterium
Cytotoxic T cells, macrophages, delayed hypersensitivity
35
Sphyllis
Macrophages, delayed hypersensitivity
36
Most common anaerobe seen in chronic endophthalmitis ?
Propionibacterium
37
Bacteria most common with older people and type of bacteria?
Gram Negative
Demodex folliculorm
Demodex Brevis
38
Toxoplasmosis ? causes what uveitis
How is it transmitted ?
What are the 3 forms?
Posterior uveitis
Transmitted via feline
3 forms;
Oocyst - contains sporozoites 10-12 micrometer
Tachyzoite - infectious form 4-8 micrometer
Bradyzoite - latent in tissue 10-200 micrometer
39
Bacterial protein synthesis inhibitors at the 50s subunit
Cephalosporin
Clindamycin
Linezolid
Macrolides; Azithro,
40
Bacterial protein synthesis inhibitors at the 50s subunit
Aminoglycosides; gent
Tetracyclines; tetra, doxy, erythromycin
40
DNA Gyrase inhibitor binding to what? Examples
Work by binding to topi II and IV Fluroquinolone
Quinolone
41
Peptidoglycan crosslinking inhibitors ?
Penicillin
Cephalosporin
42
1-4 generation cepharlosporin are resistant against
LAME
Listeria
MRSA
Enterococci
Atypical - chlamydia and mycobacteria
43
Benefit of 3rd generations cephalosporin? and examples
Crosses BBB
effective against gram -ve
Example; Ceftazidine; Psuedomonads
Ceftriaxone: meningitis gonorrhoea
44
Mechanism of action of chloroquine?
What parasite is toxic to it ?
SE
Prevents the break down of haem. Haem builds up and is toxic to plasmodia
P. Falcifarum resistance by intracellular pump.
Retinioathy
Rash
45
MOA of amphoceterin?
Affect cell memberane integerity. Binds to ergosterol and form pores which allows leakage of electrolyes.
CLinical use; serous systemic myocese
46
MOA of azoles
Inhibit fungal ergoesterol synthesis by inhibiting cyp450 tat required to convert lanesterol to ergsterol
47
MOA of grisefluvin?
Interferese with microtubules function --> disrupts mitosis deposits in keratin rich tissues
48
Inhibitions of nucleic acid synthesis in viral cells
Inhibitions of nucleic acid synthesis in viral cells
Guanosine analogs; Acyclovir/ Famcloir, Ganclovir
Viral DNA polymerase inhibitor; Cidofvir, Foscarnet
49
Guanosine analogs; Acyclovir/ Famcloir, Ganclovir MOA
Monophosphorlyate by HSV and VZV thymidine kinase. Not phosphorylated in uninfected cells . Not effective against CMV as does not have any TK.
50
Guanosine analogs used for CMV and MOA
Gangcliovir
MOA guanosine analog 5' monophosphate formed by CMV viral kinase
51
Are staph and strep anaerobic or aerobic
Gram positive cocci
Staphylococcus-occurs in clusters
Streptococcus-occurs in chains
All gram positive cocci are aerobes
52
Gram positive bacilli
Gram positive bacilli
Aerobes-bacillus
Anaerobes
Sporing-Clostridium
Non sporing-Actinomycetes, Propionibacterium
53
Foscarnet antiviral MOA ?
Viral DNA / RNA polymerase inhibitor and HIV reverse transcriptase inhibitors. Binds to pyrophosphate binding site of enzyme. Does not requires
FOScarnet=pyroFOSphate analog
54
What is the typical time period from inoculation to symptoms in Adult chlamydial conjunctivitis ?
1-2 weeks
55
Vancomycin
MOA
Effective against
Use
Vancomycin is a glycopeptide antibiotic
2) Mechanism of action: Binds to pentapeptide chains and prevents the assembly of peptidoglycans in the cell wall causing cell lysis
3) Bactericidal activity against gram-positive organism
4) Use: Intravitreal treatment of endophthalmitis
56
What are the virulence factor of acathanomeba
Virulence factors involve adhesion capabilities to the ocular surface
Mannose-binding lectin is associated with virulence and has a higher level of expression in pathogenic strains
Mannose induced protein (MIP) is a protease with collagenase activity that can damage the cornea epithelium.
57
What is the classification of acanthamoeba?
Acanthamoeba Species Classification:
Species classified by morphological characteristics and cyst size
Alternatively, classified by 18S ribosomal RNA gene sequencing
Genotype Distribution:
23 genotypes identified (T1-T23) using 18S ribosomal RNA sequencing.
T4 genotype is the most common causative agent of Acanthamoeba keratitis (AK)
Other genotypes implicated in AK include T2, T5, T6, T10, T11, T12, and T1
58
Which of these is found in adult C.trachomatis conjunctivitis but not neonates ?
Greater discharge
Membrane formation
Follicular reaction
Hyperaemia
Follicular reaction - children dont have any lymphoid tissue
59
Three forms of toxoplasmosis and size
4) Three forms:
Oocyst/ soil form, contains sporozoites ( between 10-12 micrometres)
Tachyzoite ( between 4 to 8 micrometres)
This is the infectious form
Tissue cyst/ latent form (between 10-200 micrometres)
Can contain up to 3000 bradyzoites
60
Propionibacterium acnes anerobic or aerobic ?
Anaerobic
60
What type of organism is toxocariasis caused by?
Round worms
61
Where can viral replication take place ?
Nucleus or cytoplasm
62
RNA viral replication process.. what type of replication bodies?
RNA virus replication occurs in cytoplasm which produces cystoplasmic inclusion, and uses reverse transcriptase to make DNA from RNA template . RNA virus are unable to use host cell enzymes and use reverse transcriptase to synthesize their own proteins.
63
RNA versus DNA replication bodies?
DNA - inclusion bodes
RNA - cytoplasmic bodies
64
Antimetabolites example? what phase of the cell cycle do they affect ?
S phase
As Zara says FU to meth
Azathioprine - antimetabolite precursor of 6 mercaptopurine inhibits lymphocyte proliferation by blocking nucleotide synthesis
5FU - pyrimidine analog bioactivated to 5Fdump -> thymidine synthetase inhibitor inhibits DNA synthetase
Methotrexate - Folate syntheses antimetabolite
Mitomycin inhibits DNA synthesis
65
The relationship between potency and duration of action for
Duration of action
ACH
HCA
66
Drugs and their MOA for myelosuppression
Mycophenolate Mofetil: reversibly inhibits IMP dehydrogenase preventing purine
synthesis if B and T cells
Azathioprine - Purine analogue
It is converted to Mercaptopurine.
Conversion of metabolically active 6 mercaptopurine into 6-thioguanine inhibits cell proliferation
Inhibit purine synthesis, blocks RNA and DNA synthesis
4) Metabolism:
6 mercaptopurine is metabolized by thiopurine methyltransferase.
TPMT levels should be measured when using Azathioprine.
A non-functional TPMT gene can lead to life-threatening myelosuppression (if 2 non-functional alleles).
In the heterozygotes, there is increased risk of myelosuppression
6MP inhibited by allopurinol --> increase toxicity of the azathioprine
5FU -> Pyrimidine analog bioactivated to 5Fdump --> thymidylate synthesize inhibitor --> Inhibit DNA synthese
Mitomycin C -> Inhibits DNA synthesase
67
MOA of isoniazid ?
Inhibits myolic acid. Bacterial catalase-peroxidase (encoded by katG) need to convert INH to active metabolite
68
Ethambutol - eat carbh
Inhibits carb polymerization f mycobacterium wall by blocking arabinosyltransferase
69
Rifampicin ?
Inhibits RNA polymerase
CYP45- inducer
70
Difference between clindamycin and metronidazole ?
Clinda-treats above diaphragm
Metro - treats below the diaphragm
71
Tetracycline is effective against ?
Borellia Burgofdi
M. Pneumonia
Drugs ability to accumalate intracellularly; very effective against rickettsia and chlamydia
72
Linezoid is effective against what bacteria ?
MRSA and VRE
73
Macrolides are effective against what bacteria?
Atypicals; mycoplasma, chlamydia, legionella
STI
Gram +ve cocci
B pertussis
74
Aminoglycoside are ineffective against what bacteria ?
Anaerobes
75
Vancomycin is effective against what bacteria ?
MRSA
S. Epidermis,
Clostridium difficle
76
1-4 generation cephalosporin are not effectvie against what bacteria ?
LAME
Listeria
Atypicals - mycoplsma, chlamydia
Myoplasma/MRSA
Enterocci
77
Piperacillin is effective against what bacteria?
Pseudomonas
78
Penicillin sensitive bacteria against ? Examples include?
Gram positive bacteria - cocci
H.influenzae, H.pylori, E.coli, Entercocci, Listeria, Proteus mirabilis, salmonella, shigella
79
Species that can penetrate the cornea
Corynebacterium diphtheriae, Haemophilus influenzae, Neisseria gonorrhoea, Neisseria meningitidis, and Listeria species.
80
Antimicrobials to avoid in pregnancy ?
Sulphonamide
Aminoglycoside
Fluroquinolones
Clarithromycin
Tetracycline
Ribavirin
Grisofleuci
CHloramphenicol
SAFe Children Take Really good care
81
Nuclear condensation ?
Phyknosis
82
Nuclear fragmentation caused by endonuclease mediated cleavage
Karyorrhexis
83
Nuclear discoloration ?
Karyolisis
84
Lipophilic metabolism of drugs; 2x phases and examples of the processes that occur at each phase?
Phase I - slightly polar metabolites. Reduction, Oxidation, hydrolysis
Phase II - very polar
85
ideal viscosity ?
WHat happens if it is too high
Agents to increase viscosity ?
12 -15 centipost
too high excessive blinking
Methylcellulose, polyvinyl alcohol
86
Difference between a1 and b2?
Alpha 1 decrease IOP
Beta 2 - increase IOP
87
Anesthetic used in corneal scrape ?
proxymetacaine/ procaine
88
Examples of biologics?
Etanercept - Decoy TNFalpha receptor , inhibits IgG1 and F2 - produced by recombinant DNA
89
MOA of Etanercfept, produced by ?
Etanercept - Decoy TNFalpha receptor , inhibits IgG1 and F2 - produced by recombinant DNA
90
MOA ecluizmab?
Comlement protein C5, increased risk of meningoccal infection
91
MOA of infliximab / adalimumab?
Anti TNFa monoclonal antibody
92
MOA of rituximab?
Binds t CP 20. Infusion rxn due to cytokine release following rxn with Bcells
93
MOA of toxoluzimb? used to treat
Binds competitively to IL1 and IL6
94
Tacrolimus MOA ?
Inhibits NF T cells, Ca2+, Il2 and Thelper
95
MOA of cyclophosphamide ?
Nitrogen mustard alkylating agent, binds to DNA in cells with low levels of aldehyde dehydrogenase
96
lipophilic versus hydrophilic steroids?
Lipophilic - acetate - more potent
Hydro - phosphate - less potent
97
Dresden protocol for keratoconus crosslinking - % and what UV ?
1) Dresden Protocol-standard treatment protocol for keratoconus. Other concentrations of riboflavin are experimental.
Instillation of topical anaesthetic
Debride central 7-9mm of corneal epithelium
0.1% riboflavin 5 phosphate, 20% dextra solution every 5 minutes for 30 minutes
Exposure to UVA ( 370nm, 3mw/cm2) for 30 minutes while instilling above drops
Apply topical antibiotics and BCL at the end.
98
You have a Parkinson's patient who is complaining of severe dry eyes. You note from his ophthalmic history that he developed angle closure glaucoma a few months ago. Which of the following medications is most likely to be to associated with his symptoms?
Benztropine
Bromocriptine
Carbidopa
Levodopa
Selegiline
Benztotropine
99
MOA of entacapone?
Amantadine and the effect it has on the eye ?
Dopamine agonist and example
Monoamine Oxidase inhibitor example?
Anticholinergic medication example
Treatment:
Levodopa and carbidopa
Carbidopa delays conversion of levodopa to dopamine until it reaches the brain
Entacapone
Catechol O-methyltransferase inhibitor, extend duration of levodopa
Amantadine
Antiviral but can be used in early stages of disease
Associated with cornea infiltrate and cornea oedema
Dopamine agonist such as:
Bromocriptine, pramipexole, ropinerole, rotigotine, apomorphine
Monoamine oxidase inhibitors such as:
Selegiline, rasagiline, safinamide
Anticholinergic drugs
For controlling tremor, rigidity
Examples: Trihexyphenidyl, benztropine
100
Which of the following best describes adalimumab?
Fully human anti-TNF alpha monoclonal antibody
Genetically engineered chimeric murine/ human monoclonal antibody
Mouse-derived chimeric monoclonal antibody against TNF-alpha
Recombinant human antibody against TNF-alpha
Fusion protein consisting of CTLA4
Which of the following best describes adalimumab?
Fully human anti-TNF alpha monoclonal antibody
101
MOA of adalimumab - what receptors does it bind to ?
is it used in non infectious or infectious uveitis ?
SE of adliumab?
Mechanism of action:
Blocks interaction of TNF alpha with p75, p55 cell surface receptors
Non infectios uvieits - GCA, JIA,
SE Most common side effect are related to injection site reaction with pain, redness, swelling, itching, bruising
Drug induced lupus
Multiple sclerosis
Skin cancer
Basal cell carcinoma, squamous cell carcinoma
102
Which of the following is a mast cell stabiliser + eosinophil suppressor used to treat allergies?
Lodoxamide
103
Cromoglycate?
Mast cell stabiliser
Cromoglycate
104
Dosage of pilocarpine in presbyopa and adies pupil
Pilocarpine 1.25% has recently been approved by the US FDA as a treatment for presbyopia
Pilocarpine 0.125% is used as part of pharmacological testing for denervation hypersensivity to diagnose Adie's pupi
105
Ranibizumab binds to what ?
Half life
Profile
) Ranibizumab
Also known as Lucentis
Humanized Fab fragment of monoclonal antibody
High affinity to VEGF A
Binds to soluble VEGF isoforms 110,121, 165
Also binds to tissue-bound isoforms 189,206
Short intravitreal half life of 2-4 days, rapid systemic clearance, good safety profile
Tend to be used as reference standard for treatment
106
SE of pilocarpine
) Side effects:
Conjunctival toxicity
Iris Cyst
Cataract
Systemic parasympathetic effect:
Sweating
Salivation
Bradycardi
107
Dosage and form of administration of foscarent
intravitreal foscarnet 2.4mg/0.1ml can be used as treatment for acute retinal necrosis
108
Dosage of acyclovir?
Acyclovir ointment is available in 3% doses
109
Dosage of ganciclovir ophthalmic gel?
Ganciclovir ophthalmic gel is available in 0.15% dose
110
Moa of acyclovir and ganclovir
Acyclic analogue of guanosine
Mechanism of action:
Inhibition of viral DNA polymerase following viral thymidine kinase phosphorylation, its action is catalysed by thymidine kinase.
111
Muscarinic antagonist examples
1) Atropine and Cyclopentolate
Muscarinic antagonist:
Blocks action of acetylcholine on muscarinic receptors
Causes dilation with the paralysis of the iris sphincter.
3) Duration of action :
Cyclopentolate:
1-2 days
Homatropine:
3 days
Atropine sulfate:
7-14 days
112
Duration of action of Muscarinic antagonist
CHA
CHAT
Duration of action :
Cyclopentolate-maximal action 30 mins, duration 12-24 hours
Homatropine-maximal mydriasis at 40 mins, duration of action 1-2 days
Atropine sulphate-maximal mydriasis at 40 mins, duration of action 7-10 days
Tropicamide-maximal action 20 mins, duration 3-4 hours
113
What are the uses of muscarinic antagonist ?
2) Uses:
Dilated fundal exam
Prevention of iris-lens adhesion ( posterior synechiae)
Paralysis of the ciliary muscle
Inhibits accommodation for refraction in children
Malignant glaucoma/ Aqueous misdirection ( atropine)
114
Factors that affect the degree of accommodation of the cycloplegic medication?
Degree of accommodation affected by
Iris colour
Patient age
Number of drops applied
115
Effect of cycloplegic on anterior uveitits?
Effect on anterior uveitis:
Paralyses inflamed muscle
Reduce vascular permeability
Less inflammatory mediators
Breaks posterior synaechiae by inducing dilation
116
Cell barriers at the corneal epithelium and endothelium ?
Epithelium: desmosomes
Endothelium: gap junctions
117
2x H1 blocker + mast cell stabiliser:
Nedocromil
Opatanol
118
Mast cell stabiliser and eosinophil inhibitor?
Liminoid
119
VFd with vagibatrin
Visual field defect
Bilateral, concentric, predominantly nasal
120
Rho kinase
size, type of nucleic acid, where is it found?
3 main classes?
Rho kinase ( ROCK):
Is a Serine/ threonine kinase
Downstream effector of Rho GTPase
2) Rho family of GTPase:
Small 21kDa signaling G proteins
Found in cytoplasm
3 main classes-Rho, Rac, Cdc42
121
Arachidonic acid is converted into prostaglandins and thromboxane by >
Arachidonic acid is converted into prostaglandins and thromboxanes by cyclo-oxygenase.
122
The function of I2 , F2 alpha, and E2
Prostaglandin actions:
I2:
Vasodilation, decreases platelet adhesion
F2alpha:
Contraction of bronchial smooth muscle
E2:
Vasodilation, bronchodilation, the release of pituitary hormones, the release of insulin and contraction of the uterus
123
The purpose of phase I versus phase II elimination of drugs?
1) Drug metabolism has two different stages and occur mainly in the liver
2) Stage I ( Oxidation, Reduction, Hydrolysis):
Affected by cytochrome p450
After stage I metabolism the drug can become inactive, or its metabolites become active (original substance known as prodrug)
3) Stage II ( Conjugation):
Occurs with glucuronic acid, glycine, glutamine and sulphate acetate
The purpose is to make drug or its metabolite soluble to be excreted in urine
124
Dosage of CAI topical and oral/iv
8) Topical form: Dorzolamide/ Brinzolamide
Usually given 2-3 times/day
Reduce IOP by 14-17%
9) Topical adverse effects: Burning sensation, punctate keratitis and bitter taste
10) Oral/ IV form : Acetazolamide ( usually 500mg BD or 250mg up to 4 times/day). It is a type of sulfonamide.
125
Ciliary body needs to be inhibited by what percent before illicting an effect?
Carbonic anhydrase in the ciliary body needs to be 99% inhibited to reduce aqueous flow.
126
Topical adverse effects of CAI inhibitors
Topical adverse effects: Burning sensation, punctate keratitis and bitter taste
127
difference in MOA between infliximab and adaliumab
Infliximab interferes with binding of TNF-alpha to TNFr1 and TNFr2
Adaliumab interferes with binds by TNFa at the p75 an P55 receptors
128
Difference between Pegcetacoplan and avainacted pegol?
What are they used to treat?
Pegcetacoplan targets C3 and C3b, while avacincaptad pegol targets C5.
Used to treat - Geographic atrophy of AMD - late sign
129
Alpha 1 agonist increase or decrease IOP?
Decrease
130
Your uveitis consultant has decided to start a patient with panuveitis on second-line immunosuppressive drugs. The patient is a 25 year old female who is trying for pregnancy, which of the following would you consider?
Azathioprine
Mycophenolate Mofetil
Methotrexate
Cyclophosphamide
Rituximab
Azathiopurine
131
Washout period of brimonidine?
Brimonidine ( alpha 2 agonist)
5 weeks
132
Bacteria associated with ocular rosasea
Some research has also shown a possible link between rosacea and the Helicobacter pylori bacteria.
133
Benzalkonium chloride effect of drug absorption and how?
Benzalkonium chloride increase ocular absorption of drug by decreasing corneal integrity
134
Drugs are pass through the cornea by?
diffusion
135
A drug that inhibits nuclear factor of activated T cells?
Tacrolimus
136
MOA of glucocorticoids
Mechanism of action:
Penetrate cell membrane
Bind to receptors in cytosol
Translocation of glucocorticoid receptor complex to nuclear binding sites
Induce or suppress mRNA.
137
Pilocarpine act on what type of muscle in the ciliary body?
Contraction of the longitudinal ciliary muscle fibres causes tension on the scleral spur and improves outflow.
138
What form does the LA come and what happens when it meets the pH of the eye?
Usually supplied in hydrochloride salt form/ protonated-becomes unprotonated when exposed to human tissue at pH7.4
139
side effect of tetracaine ?
Epithelial toxicity
140
The size of the conjunctival sac
The conjunctival sac has a capacity of 15-30ul.
141
Cationic surfaces increase or decrease absorption ?
Decrease absorption
142
Which of the following topical steroid is available as a preservative free ophthalmic preparation?
Dexamethasone sodium phosphate
