Special Senses Therapeutics Flashcards
(62 cards)
1
Q
Atropine 1%
A
- Mydriatic; cycloplegic - paralyses ciliary mm., relieves intraocular pain + decongestant of iris (parasympathomimetic)
- Longer onset + duration
- Hyphaema; uveitis; ciliary spasm; cataract management; reflex uveitis in corneal ulceration
- Contradicted in glaucoma - tonometry before Tx
- Consider: dec tear production - dry eye (KCS); hypertension + inc IOP (glaucoma); salivation - bitter taste; mydriasis (lens luxation)
2
Q
Tropicamide (Mydriacyl, Mydriaticum)
A
- Anticholinergic medication
- Short-acting mydriatic
- Paralyses smooth muscles or iris + ciliary body (holds lens in place) = cycloplegic agent (parasympathomimetic)
- Hyphaema; uveitis; dilate pupil to look at retina
- Consider: dec tear production = dry eye (KCS); hypertension + inc IOP (glaucoma); salivation - bitter taste; mydriasis (lens luxation)
3
Q
Intracameral tPA
A
- Tissue plasminogen activator -> blood clot lysis
- Resolves blood clot - if clot substantial, severe or threatening
- 25 ug
- Hyphaema; uveitis
4
Q
Prednisolone (Prednisolone acetate)
A
- Corticosteroid
- Oral/topical (1% drops)
- Good corneal penetration
- Acute uveitis; hypertensive retinopathy; optic neuritis; perioperative Tx in cataract Sx
- AE: systemic absorption -> PUPD, difficulty stabilising diabetic patients, subcapsular cataracts in cats + corneal lipidosis
5
Q
Dexamethasone
A
- Corticosteroid
- Topical drops (4 - 6 x daily)
- Acute uveitis; conditions of ocular surface e.g. eosinophilic keratoconjunctivitis (cats)
- AE: systemic absorption -> PUPD, difficulty stabilising diabetic patients, subcapsular cataracts in cats + corneal lipidosis
6
Q
Aspirin
A
- NSAID
- Oral dogs - 10 mg/kg 3 x weekly in chronic cases
- Cats - 75 mg every 48 - 72 h
- Acute uveitis/when corticosteroid contraindicated
7
Q
Acular, Keratolac, Naclof/Voltaren, Ocufen
A
- NSAIDs
- Topical drops
- Acute uveitis/when corticosteroids contraindicated
8
Q
Rimidyl
A
- NSAID
- Acute uveitis/when corticosteroids contraindicated
9
Q
Metacam
A
- NSAID
- Acute uveitis/when corticosteroid contraindicated
10
Q
Azathioprine (Imuran)
A
- Immunosuppressive
- Refractory cases of uveitis (to corticosteroids) - canine uveodermatological syndrome, long-term therapy in combo w/ prednisolone
- AE: hepatotoxicity, BM suppression - don’t give to cats
11
Q
Epinephrine (adrenaline), phenylephrine (preferred option)
A
- Adrenergic drug
- Localisation of Horner’s syndrome/Dx (denervation hypersensitivity) - if mydriasis in <20 min = post-ganglionic lesion = Horner’s
- Uveitis (mydriatic) - AE: risk of 2y glaucoma
12
Q
N-Acetylcysteine (Stromease), EDTA
A
- Antiproteolytic agent - autologous serum
- Stromal corneal ulceration; melting ulcer
13
Q
Fluoroquinolones, Gentamicin, Tobramycin, Neomycin, PolymyxcinB
A
- Pseudomonas infection - melting ulcer
- Companion animal
- Gentamicin = equine
14
Q
Bacitracin, Gramicidin, Cephalosporins, Penicillins
A
- Streptococcus spp. (G+) infection - melting ulcer
15
Q
Ciprofloxacin (Ciloxan)
A
- Fluoroquinolone AB, bactericidal, conc dependent, broad spectrum
- G+ - staphylococcus; G- - Pseudmonas aeruginosa
- Melting ulcer - first line; reserved for cases where other AB ineffective; complicated (infectious keratitis) corneal ulceration, melting ulcers
- May cause local irritation
- Companion animal, equine
16
Q
Ofloxacin (Exocin)
A
- Quinolone AB, bactericidal, conc dependent, broad spectrum
- G+ - staphylococcus; G- - Pseudmonas aeruginosa
- Better corneal penetration than ciprofloxacin, reserved when other AB are ineffective
- Melting ulcer (second line) - when AB ineffective; complicated (infectious keratitis) corneal ulceration
17
Q
Famciclovir
A
- Antiviral
- FHV-1 keratitis; corneal sequestrum
- Expensive
- Cat
- AE: GI signs
18
Q
L-lysine
A
- Essential AA
- Replaces/antagonises arginine AA in virus, slows down replication, reduces in-vitro replication of FHV-1, may reduce viral shedding latently infected cats
- BID bolus, not added to food
- FHV-1; corneal sequestrum
- Cats
19
Q
Cyclosporine (Optimmune)
A
- Immunosuppressant/immune-modulator - inhibits T-cells
- Stimulates tear production (direct lacrostimulant)
- Licensed
- Feline eosinophilic keratitis; tear film deficiency (KCS)
20
Q
Chloramphenicol
A
- Broad spectrum AB, bacteriostatic
- G+: Streptococcus, Staphylococcus
- G-: Brucella, Salmonella, Haemophilus
- E. coli, enterobacter spp, proteus, mycoplasma spp (unreliable), clostridium, bacteroides
- Conjunctivitis; uncomplicated + complicated (infectious keratitis); corneal ulceration
- Equine, companion animals
21
Q
Fusidic acid - Isathal
A
- Narrow spectrum AB, bacteriostatic
- Penetrates through cornea into anterior chamber
- Staphylococcus (particularly S. pseudintermedius), streptococcus
- Conjunctivitis
- Companion animal
22
Q
Gentamicin (Tiacil, clinagel vet)
A
- Aminoglycosides broad spectrum, bactericidal AB, conc dependent
- Requires O2-rich environment (ineffective in abscesses, exudates)
- Pseudomonas aeruginosa, E. coli, enterobacter spp, proteus spp, G-
- Some G+: staphylococcus + streptococcus (S, faecalis)
- Conjunctivitis; complicated (infectious keratitis) corneal ulceration
- (Resistant = all anaerobes + haemolytic Streptococcus)
- Epitheliotoxic, don’t use for > 7 d or will delay healing = toxic to corneal epithelial cells
23
Q
Polymyxin B (polyfax ointment, maxitrol)
A
- Cyclic polypeptide, broad spectrum, bactericidal AB, cationic surface acting agent - interacts w/ phospholipids in cell mem (G+ bacteria resistant)
- Requires O2-rich environment (ineffective in abscesses, exudates)
- Contains steroids
- G-: Pseudomonas aeruginosa, E. coli, Klebsiella
- Some G+: Staphylococcus + Streptococcus (S. faecalis)
- Resistant to all anaerobes + haemolytic streptococcus
24
Q
Cloxacillin
A
- Topical AB
- Infectious bovine keratoconjunctivitis (IBK); pink eye (sheep) infectious keratoconjunctivitis (IKC) = orbenin + opticlox
25
Penicillin, oxytetracycline
- Sub-conjunctival injection AB
- Infectious bovine keratoconjunctivitis (IBK); listeria uveitis (ruminants)
26
Oxytetracycline
- Single dose long-acting
- (+/- dexamethasone)
- Silage eye/listeria uveitis (cattle); IBK
27
Mannitol
- Osmotic diuretic - hyperosmotic agent
- IV over 20 min
- Glaucoma
- (Reduced efficacy in uveitis due to breakdown of blood aq barrier)
28
Trusopt, cosopt
- Carbonic anhydrase inhibitors -> inc fluid transport into corneal endothelium
- Glaucoma
29
Iopidine
- Alpha-adrenergic agonist
- Dec production of aq, dec outflow, reduces episcleral venous pressure, dec HR
- AE - V+
- Glaucoma
30
Timolol
- Beta-2 adrenergic blocker
- Miosis, aggravate pupil block glaucoma
- Glaucoma
- AE; miosis, conjunctival hyperaemia, local irritation, bradycardia
- Contraindicated: uveitis, anterior lens luxation, heart failure
31
Demecarium bromide
- Cholinesterase inhibitor -> inc aqueous flow
- Miotic
- Drops
- Glaucoma
32
Latanoprost/xalatan, travoprost/travatan, bimatoprost/lumigan
- Prostaglandin analogue - reduce IOP through interaction w/ PG F receptors in uvea + trabecular meshwork -> inc uveoscleral outflow
- Drops
- Glaucoma
- Don't use when there is concurrent uveitis + anterior lens luxation
- AEs: conjunctival hyperaemia, marked miosis, disruption of blood aq (latanoprost), vitreous entrapment in pupil -> inc IOP
- Ineffective in most cats (latanoprost)
- Dogs + primates
33
Dextropmethophortan, memantine
- Neuroprotection
- Glaucoma
34
Lutein, xeazanthin, grape seed extract, lycopene (eyes Rx plus), ocuglo)
- Antioxidant medication
- Inherited Retinal Degenerations (Progressive Retinal Atrophy/PRA)
35
Amlodipine
- Calcium channel blocker
- Hypertensive retinopathy
36
Fortekor
- Contains benazepril (ACE inhibitor)
- Hypertensive retinopathy
36
Amox-clav (amoxicillin/clavulanate), cephalosporin
- Broad spectrum systemic AB
- Infection e.g. orbital abscessation/bacterial cellulitis
37
Tacrolimus (Proptopic)
- Calcineurin inhibitor (immunosuppressant) -> dec T-cell activation -> dec inflammatory response
- Unlicensed
- (2nd line Tx of tear film deficiency, if unresponsive to cyclosporine)
38
Pilocarpine
- Cholinergic agonist - direct parasympathomimetic -> tear stimulation
- Unlicensed
- Neurogenic KCS only (when innervation affected) - tear film deficiency
- Anti-glaucoma
- Inc dose until improvement/GI signs
- Eye drops orally
- Contradicted: uveitis, anterior lens luxation
39
Tetracaine, lidocaine, proxymetacaine
- Local anaesthetic
- Onset 5 min; duration 1 - 2 h
- Dx purposes only - tonometry, exploration of conjunctiva, Dx sampling
- Consider: dec corneal sensation -> inc risk of trauma; reduced reflex tearing; epitheliotoxic if long-term; systemic toxicity if in small patients
40
Celluvisc, Ocry-gel, Remend, Viskyal, Lacrilube
- Tear substitutes
41
Chlorotetracycline (Ophtocycline)
- Bacteriostatic AB, inhibits protein synthesis, conc dependent
- Staphylococcus, streptococcus, proteus, pseudomonas
- Keratitis; conjunctivitis; blepharitis; feline chlamydial conjunctivitis
- Cornea ulceration - inhibits collagenolytic degradation of the cornea
42
Doxycycline
- Systemic AB
- Oral
- Feline chlamydial conjunctivitis
43
Cefalexin + metronidazole
- Orbital abscessation/bacterial cellulitis
44
Cefalexin + clindamycin
- Orbital abscessation/bacterial cellulitis
45
Trifluorothymidine (Trifluridine)
- Antiviral - virostatic, nucleoside analogue
- Cats - x 5 daily
- May be extremely irritating to eye
- V expensive
- FHV-1
46
Betamethasone sodium phosphate, prednisolone sodium phosphate, fluoromethalone, hydrocortisone
- Less commonly used corticosteroids
47
Carprofen, meloxicam, tepoxalin
- NSAIDs - non-selective COX-2 inhibitors
- Systemic
- Dog
- Avoid in cases with intra-ocular haemorrhage because of inhibitory effect of NSAIDs on platelet function
48
Firocoxib, robenacoxib, mavacoxib
- NSAIDs - COX-2 inhibitors
- Systemic
- Dog
- Avoid in cases with intra-ocular haemorrhage because of inhibitory effect of NSAIDs on platelet function
49
Carprofen, meloxicam, robenacoxib
- Systemic NSAIDs for cats
- Avoid in cases with intra-ocular haemorrhage because of inhibitory effect of NSAIDs on platelet function
50
Keratolac, flurbiprofen, diclofenac
- Topical NSAIDs, when corticosteroids contra-indicated (unauthorised)
- Diclofenac and Flurbiprofen increase IOP significantly in cats - avoid in cats with ocular hypertension
- Avoid in cases with intra-ocular haemorrhage because of inhibitory effect of NSAIDs on platelet function
51
Chlorphenamine
- Oral antihistamine
- Dogs
- Allergic conjunctivitis
52
Sodium cromoglicate
- Anti-allergy - mast cell stabiliser
- Dogs, cats
- Allergic conjunctivitis
53
Glycerol
- Osmotic diuretic
- Oral
- Glaucoma
54
Dorzolamide hydrochloride
- Carbonic anhydrase inhibitor
- Drops
- Glaucoma
55
Acetazolamide
- Carbonic anhydrase inhibitor
- Oral, IV, IM
- Glaucoma
55
Brinzolamide
- Carbonic anhydrase inhibitor
- Drops
- Glaucoma
56
Dichlorphenamide
- Carbonic anhydrase inhibitor -> dec aq production
- Oral
- Glaucoma
57
Metipranilol, levobunolol, betaxolol
- Beta-adrenergic blocker
- Glaucoma
58
Bromfenac
- Topical anti-inflam
- Acute uveitis (equine)
59
Enilconazole, voriconazole
- Anti-fungal (ringworm wash)
- Non-healing corneal ulcer (equine)
60
Ciclosporin
- Calcineurin inhibitor (immunosuppressant) -> dec T-cell activation
- Direct lacrostimulant
- Licensed 0.3% BID
- Expensive
- For KCS