Pharmacology in Ophthalmology

Question 1

What is the role of ocular antihypertensives

Answer 1

Reduce IOP and have been shown to slow progression of glaucoma

Question 2

Examples of ocular antihyptensives

Answer 2

Beta blockers, carbonic anhydrase inhibitors, alpha agonists, muscarincic agonists, prostaglandin analogues

Question 3

What is the role of beta blockers

Answer 3

Reduce aqueous production

Question 4

Eg of beta blocker

Answer 4

Timolol eye drops

Question 5

What is the role of carbonic anhydrase inhibitors

Answer 5

Reduce aqueous production

Question 6

Eg of carbonic anhydrase inhibitors

Answer 6

Acetazolamide tablets or drops

Question 7

What is role of a2-agonists

Answer 7

Reduce aqueous production and increases uveoscleral outflow of aqueous

Question 8

Eg of a2-agonists

Answer 8

Brimonidine drops

Question 9

What is the role of muscarinic agonists

Answer 9

Increase trabecular outflow of aqueous

Question 10

Eg of muscarinic agonists

Answer 10

Pilocarpine drops

Question 11

What is the role of prostaglandin analogues

Answer 11

Increase uveoscleral outflow of aqueous

Question 12

Eg of prostaglandin analogues

Answer 12

Latanoprost drops

Question 13

S/E of beta blockers

Answer 13

Local irritation, systemic absorption causing bronchospasm and bradycardia

Question 14

S/E of carbonic anhydrase inhibitors

Answer 14

Allergy, ocular irritation, paraesthesia, deranged renal function

Question 15

S/E of a2-agonists

Answer 15

Allergy, mydriasis, dry mouth, hypotension

Question 16

S/E of muscarinic agonists

Answer 16

Miosis, sweating, bradycardia, GI disturbances

Question 17

S/E of prostaglandin analogues

Answer 17

Asthma, lash growth, iris darkening

Question 18

Role of lubricants for the eye

Answer 18

Topical drops, gels, and ointments for tear film enhancement and replacement

Question 19

Eg of lubricants for the eye

Answer 19

Hypromellose, lacrilube, viscotears, sodium hyaluronate

Question 20

S/E of lubricants for the eye

Answer 20

Some allergic reactions, but generally well tolerated, some long acting gels can blur vision so used overnight instead

Question 21

When are mydriatics and cycloplegics used

Answer 21

used for examination of the back of the eye and to prevent iris spasm

Question 22

What do mydriatics do

Answer 22

Induce pupillary dilation via iris radical muscle contraction

Question 23

What do cycloplegics do

Answer 23

Induce pupillary dilation via paralysis of the iris sphincter ring-muscle with accompanying paralysis of accomodation

Question 24

Examples of mydriatics

Answer 24

a2-agonists such as phenylephrine

Question 25

Examples of cycloplegics

Answer 25

Muscarinic antagonists such as tropicamide, atropine, cyclopentolate

Question 26

S/E of mydriatics

Answer 26

Acute angle closure glaucoma, blurred vision, glare, hypertension

Question 27

S/E of cycloplegics

Answer 27

Acute angle closure glaucoma, blurred vision, glare, tachycardia, dry mouth, tremor

Question 28

Examples of anti-inflammatorys

Answer 28

Steroids, mast cell stabilisers, antihistamines, NSAIDs

Question 29

Eg of steroids used in the eye

Answer 29

Prednisolone, dexamethasone

Question 30

Uses of steroids

Answer 30

Anterior uveitis, GCA

Question 31

S/E of steroids

Answer 31

Glaucome, cataracts, HSV exaccbation, systemic side-effects

Question 32

Eg of mast cell stabilisers

Answer 32

Cromoglicate

Question 33

Uses of mast cell stabilisers

Answer 33

Allergies

Question 34

Eg of antihistamines

Answer 34

Antazolline drops, chlorphenamine tablets

Question 35

Eg of NSAIDs used

Answer 35

Diclofenac drops

Question 36

Antibiotics used for the eye

Answer 36

Chloramphenicol, Ofloxacin, Gentamicin, Cefuroxime

Question 37

Antivirals used for the eye

Answer 37

Aciclovir, Valaciclovir

Question 38

S/E of antimicrobials

Answer 38

Corneal toxicity

Question 39

Side effects of delivery method of intravitreal injections

Answer 39

Risk of intra-ocular infection, floaters, cataracts, elevated IOP

Question 40

Examples of intravitreal injections

Answer 40

Steroids, anti-microbial, anti-VEGF

Question 41

When are anti-VEGFs used

Answer 41

Prevent neovascularisation in wet AMD and proliferative diabetic disease

Question 42

Eg of anti-VEGFs

Answer 42

Ranibizumab and Bevarcizumab

Question 43

What is used in endophthalmitis

Answer 43

Intravitreal injections of steroids and antibiotics