Pharmacology And The Eye Flashcards

(37 cards)

1
Q

What prevents many systemic medications from reaching the intra-ocular tissues?

A

The blood-ocular barrier

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2
Q

What is the result of most chemotherapeutic agents not being able to enter the eye?

A

Makes it a sanctuary site for cancer, particularly ALL

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3
Q

Is absorption of topical therapy through the cornea good?

A

Yes

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4
Q

What is the result of absorption of topical therapy through the cornea being good?

A

Most anterior segment problems can be treated with drops

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5
Q

When is systemic therapy required for ocular problems?

A

Posterior segment disease

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6
Q

When might drops not be tolerated?

A

When applied intensively, or when contact lenses are worn

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7
Q

Why are many drops not tolerated when applied intensively or when contact lenses worn?

A

Due to preservatives in the drops

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8
Q

What % of the active drug is absorbed into the eye when a drop is instilled in the eye?

A

10%

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9
Q

What happens to the drug that is not absorbed into the eye when using drops?

A
  • Spills
  • Enters the systemic circulation via the conjunctival vessels
  • Enters nasal mucosa via the nasolacrimal ducts
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10
Q

After what time is the peak plasma concentration of drugs administered by eye drops?

A

Within 30 mins

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11
Q

Can drugs administered through eye drops cause systemic side effects?

A

Yes, particularly in neonates

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12
Q

How should systemic side effects caused by eye drops be minimised?

A

The lowest concentration of active ingredient should be used, and the nasolacrimal duct was occluded with a fingertip for a couple of minutes after drop instillation

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13
Q

What can prevent adequate examination of the eye?

A

Severe eye pain and blephrospasm

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14
Q

What might be helpful when examining the eye when there is severe pain or blepharospasm?

A

Topical anaesthetics

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15
Q

Should topical anaesthetics for the eye be used on a routine basis?

A

No

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16
Q

Why should topical anaesthetics for the eye not be used on a routine basis?

A

Corneal anaesthesia prevents epithelial healing and risks infection

17
Q

What topical anaesthetics for the eye are in common use?

A
  • Proxymetacaine 0.5%

- Tetracaine 0.5%

18
Q

How long does proxymetacaine 0.5% last for?

19
Q

Why is proxymetacaine a good choice for children?

A

Does not sting

20
Q

What is the advantage of tetracaine 0.5%?

A

Longer lasting

21
Q

What is tetracaine useful for?

A

Surgical procedures

22
Q

What is the disadvantage of tetracaine 0.5%?

A

Severe stinging on instillation

23
Q

Why is flourescein useful for diagnosis?

A

It lights up areas of conjunctival and corneal epithelial loss if illuminated with blue lights

24
Q

Why can fluorescein light up areas of corneal and conjunctival epithelial loss?

A

Because it absorbs blue light and re-emits it in the green spectrum

25
In what forms is fluorescein available?
- Fluoret impregnated strip | - Eye drops
26
What do anti-muscarinic eye drops do?
Block the parasympathetic innervation of the ciliary muscle and pupil sphincter
27
What are anti-muscarinic eye drops commonly used for?
To allow accurate objective refraction in clinic
28
What are the side effects of anti-muscarinic eye drops?
- Stinging - Blurred vision - Photosensitivity - Flushing - Dry mouth
29
What anti-muscarinic eye drops are used?
- Tropicamide 1% - Cyclopentolate 1% (0.5% for infants) - Atropine 1%
30
What is the onset of tropicamide 1%?
15 minutes
31
How long does tropicamide active for?
3-6 months
32
What is the onset of action of cyclopentolate?
20 minutes
33
What is the duration of action of cyclopentolate?
24 hours
34
What is the onset of action of atropine?
30 minutes
35
What is the duration of action of atropine?
7 days
36
What are sympathomimetic eye drops used for?
Used synergistically with anti-muscarinic eye drops for intense mydriasis needed for intra-ocular surgery or ROP screening and treatment
37
What are the side effects of sympathomimetic eye drops?
- Stinging - Blurred vision - Sensitivity to light Rarely, tachycardia and hypertension can occur