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02 Clinical care Flashcards

1
Q

What is the most common negligence for malpractice

A

failure to diagnose

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2
Q

Schedule I definition

A

high abuse, no known medical use, lack of safety

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3
Q

Schedule II definition

A

high abuse, some medical use, high risk of dependency

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4
Q

Schedule III definition

A

lower abuse, medical use, moderate dependency risk

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5
Q

Schedule IV definition

A

limited abuse, high medical use, limited dependency risk

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6
Q

Schedule V definition

A

minor problems, may be available without Rx

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7
Q

What is an example of a Schedule I drug?

A

heroin

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8
Q

What is an example of a Schedule II drug?

A

hydrocodone

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9
Q

What is an example of a Schedule III drug?

A

valium

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10
Q

What is an example of a schedule IV drug?

A

codeine

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11
Q

What is an example of a Schedule V drug?

A

penicillin

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12
Q

Which drug schedules are ODs permitted to prescribe in California?

A

schedule III, IV and V, with the exception that we can Rx hydrocodone (schedule II)

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13
Q

Pregnancy Category A definition

A

no evidence of risk in women

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14
Q

Pregnancy Category B definiton

A

no evidence of risk in animals

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15
Q

Pregnancy Category C definition

A

evidence of toxicity in animal studies

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16
Q

Pregnancy Category D definition

A

risks may be about equal to the benefits of the drug

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17
Q

Pregnancy Category X definition

A

risks outweigh benefits of the drug

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18
Q

Anaphylaxis definition

A

a systemic hypersensitivity reaction with a substance to which the body has been previously sensitized

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19
Q

Off-Label definition

A

prescribing a drug for a non-FDA approved indication

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20
Q

What are the FDA requirements for drugs?

A

minimum 90% activity, greater than 18 month shelf life

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21
Q

What are the ocular routes of drug injection? (6)

A

subconjunctival, subtenon’s, retrobulbar, peribulbar, intracameral, intravitreal

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22
Q

Describe subconjunctival injections.

A

low dose, high local concentration, no compliance concerns; eg. treating a bacterial ulcer

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23
Q

Describe subtenon’s injections.

A

in sub-tenon’s space; often used to administer steroids for equatorial uveitis, CME, DME, or post cataract surgery

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24
Q

Describe retrobulbar injections.

A

into the muscle cone, high penetration risk, much less common today

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25
Describe peribulbar injections.
safer but slower alternative to retrobulbar injection; anesthesia and akinesia
26
Describe intracameral injections.
into anterior chamber; can protect corneal endothelium and anterior chamber collapse during cataract surgery, or post-op lidocaine for comfort
27
Describe intravitreal injections.
into vitreous; treating endophthalmitis, retinitis, DME, AMD
28
Morgan Lens definition
extended irrigation system, like contact lens connected to an IV bag; eg. rinsing the eye with saline after a chemical burn
29
What types of ophthalmic drug formulations exist? (7)
gel, ointment, solid, solution, suspension, colloid, spray
30
What is the most common ophthalmic drug formulation?
solution
31
What type of drug formulation must be shaken?
suspension
32
Ointment definition
oil based; enhances retention time up to 6hrs when applied correctly
33
What are some examples of solid drug formulations?
contact lenses, collagen shields, filter strips, cotton pledgets, lacrisert, vitrasert, lucentis
34
How can sectoral dilation be achieved?
cotton pledgets or a schirmer strupsoaked with phenyl (pre-anesthetizing the eye reduces tear response for a better local effect)
35
What are the types of excipients/vehicles commonly used for ophthalmic drugs? (8)
emollient, demulcent, emulsifier, buffer, viscosity enhancers, osmoprotectant, stabilizers, tonicity stabilization
36
What is an example of an emollient?
mineral oil
37
Excipient definition
all elements of a preparation other than the active ingredient and preservative, ideally inert
38
What are examples of demulcent? (5)
HPMC, CMC, PEG, PG, glycerin
39
HPMC, CMC, PEG, PG and Glycerin are what type of excipient?
demulcent
40
Emulsifier definition
emulsifiers keep solids in liquids well dispersed
41
What are examples of emulsifiers? (6)
polyoxyl 40 searate, sorbitan tristerate, dimyristoyl phosphatidylglycerol, PVA, gellan gum, polyacrylic acid
42
Polyoxyl 40 Stearate, Sorbitan Tristerate, Dimyristoyl Pohsphatidylglycerol, PVA, Gellan Gum, and Polyacrylic acid are what type of excipient?
emulsifier
43
What are examples of buffers? (2)
borate, citrate
44
Borate and Citrate are examples of what type of exipients?
buffers
45
What are examples of viscosity enhancers? (6)
hydroxypropyl guar, sodium hyaluronate, xanthan gum, gellan gum (gelrite), polyacrylic acid (durasite), PVA
46
Hydroxypropl Guar, Sodium Haluronate, Xanthan Gum, Gellan Gum (Gelrite), Polyacrylic acid (Durasite), and PVA are examples of what type of vehicle?
viscosity enhancers
47
What are examples of osmoprotectants? (2)
erythritol, levocamitine
48
Erythritol and Levocamitine are examples of what type of vehicle?
osmoprotectants
49
What are examples of stabilizers? (2)
hydroxyalkyl-phosphonate, gellan gum
50
Hydroxyalkyl-phosphonate and Gellan Gum are examples of what type of vehicle?
stabilizers
51
What are examples of tonicity stabilization vehicles?
KCl, NaCl, CaCl, MgCl, ZnCl, sorbitol
52
KCl, NaCl, CaCl, MgCl, ZnCl, and Sorbitol are examples of what type of vehicle?
tonicity stabilization
53
What type of substances typically stabilize tonicity?
electrolytes
54
What are the four main types of preservatives?
chelators, chemical toxins, surfactants, oxidants
55
What do chelators do?
preservative with an affinity to bind metallic ions
56
Which preservative is a chelator?
EDTA
57
What type of preservative is EDTA?
chelator
58
What preservative is recognized for its risk of contact dermatitis?
EDTA
59
Which preservatives are chemical toxins? (3)
povidone (PVP), thimerosal, chlorobutanol
60
Which preservative is mercury-based?
thimerosal
61
What are the two categories of preservatice surfactants?
biguanides, quaternary ammonium compounds
62
What is the most common preservative used in topical ophthalmic drops?
benzalkonium chloride (BAK)
63
Which preservatives are biguanides? (4)
polyhexamethylene biguanide (PHMB), polyaminopropyl biguanide (PAPB), chlorhexidine, alexidine
64
PHMB, PAPB, Chlorhexidine, and Alexidine are what type of preservative?
biguanide surfactants
65
Which preservatives are quaternary ammonium compounds?
benzalkonium chloride (BAK), polyquaternium (quats)
66
BAK and Polyquaterium are wht type of preservative
quaernary ammonium compound surfactants
67
What are the two categories of disappearing oxidants?
borate complexes, chlorite complexes
68
What is the defining characteristic of Borate complexes?
pH inactivated
69
What are examples of Borate complexes? (3)
genteal, thera tears (sodium perborate), tears again (dissipate)
70
Genteal, Thera Tears, and Tears Again use what type of preservative?
borate complexes
71
What is the defining characteristic of Chlorite complexes?
light inactivated
72
What are examples of Chlorite complexes? (3)
allergan refresh (purite), blink (ocupure), brimonidine (purite)
73
Allergan Refresh, Blink, and Brimonidine use what type of preservative?
chlorite complexes
74
After how long can a re-capped preservative-free vial be used?
12 hours
75
Which drug is self-preserved?
moxifloxacin 0.5%
76
Which ophthalmic drug uses a yellow cap?
beta blockers
77
Which ophthalmic drug uses a dark blue cap?
beta blocker combos
78
Which ophthalmic drug uses a red cap?
mydriatics and cycloplegics
79
Which ophthalmic drug uses a dark green cap?
miotics
80
Which ophthalmic drug uses an orange cap?
carbonic anhydrase inhibitors (CAIs)
81
Which ophthalmic drug uses a gray cap?
non-steroidal antiinflammatories (NSAIDs)
82
Which ophthalmic drug uses a pink cap?
steroids
83
Which ophthalmic drug uses a tan cap?
anti-infectives
84
Which ophthalmic drug uses a teal cap?
prostaglandin analogs
85
Which ophthalmic drug uses a purple cap?
adrenergic agonists
86
What color cap would you find on a bottle of beta-blocker?
yellow
87
What color cap would you find on a bottle of beta blocker combo?
dark blue
88
What color cap would you find on a bottle of mydriatic or cycloplegic?
red
89
What color cap would you find on a bottle of steroid?
pink
90
What color cap would you find on a bottle of NSAID?
gray
91
What color cap would you find on a bottle of CAI?
orange
92
What color cap would you find on a bottle of anti-infective?
tan
93
What color cap would you find on a bottle of miotic?
dark green
94
What color cap would you find on a bottle of prostaglandin analog?
teal
95
What color cap would you find on a bottle of adrenergic agonist?
purple

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