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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
Q

Describe peribulbar injections.

A

safer but slower alternative to retrobulbar injection; anesthesia and akinesia

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26
Q

Describe intracameral injections.

A

into anterior chamber; can protect corneal endothelium and anterior chamber collapse during cataract surgery, or post-op lidocaine for comfort

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27
Q

Describe intravitreal injections.

A

into vitreous; treating endophthalmitis, retinitis, DME, AMD

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28
Q

Morgan Lens definition

A

extended irrigation system, like contact lens connected to an IV bag; eg. rinsing the eye with saline after a chemical burn

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29
Q

What types of ophthalmic drug formulations exist? (7)

A

gel, ointment, solid, solution, suspension, colloid, spray

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30
Q

What is the most common ophthalmic drug formulation?

A

solution

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31
Q

What type of drug formulation must be shaken?

A

suspension

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32
Q

Ointment definition

A

oil based; enhances retention time up to 6hrs when applied correctly

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33
Q

What are some examples of solid drug formulations?

A

contact lenses, collagen shields, filter strips, cotton pledgets, lacrisert, vitrasert, lucentis

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34
Q

How can sectoral dilation be achieved?

A

cotton pledgets or a schirmer strupsoaked with phenyl (pre-anesthetizing the eye reduces tear response for a better local effect)

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35
Q

What are the types of excipients/vehicles commonly used for ophthalmic drugs? (8)

A

emollient, demulcent, emulsifier, buffer, viscosity enhancers, osmoprotectant, stabilizers, tonicity stabilization

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36
Q

What is an example of an emollient?

A

mineral oil

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37
Q

Excipient definition

A

all elements of a preparation other than the active ingredient and preservative, ideally inert

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38
Q

What are examples of demulcent? (5)

A

HPMC, CMC, PEG, PG, glycerin

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39
Q

HPMC, CMC, PEG, PG and Glycerin are what type of excipient?

40
Q

Emulsifier definition

A

emulsifiers keep solids in liquids well dispersed

41
Q

What are examples of emulsifiers? (6)

A

polyoxyl 40 searate, sorbitan tristerate, dimyristoyl phosphatidylglycerol, PVA, gellan gum, polyacrylic acid

42
Q

Polyoxyl 40 Stearate, Sorbitan Tristerate, Dimyristoyl Pohsphatidylglycerol, PVA, Gellan Gum, and Polyacrylic acid are what type of excipient?

A

emulsifier

43
Q

What are examples of buffers? (2)

A

borate, citrate

44
Q

Borate and Citrate are examples of what type of exipients?

45
Q

What are examples of viscosity enhancers? (6)

A

hydroxypropyl guar, sodium hyaluronate, xanthan gum, gellan gum (gelrite), polyacrylic acid (durasite), PVA

46
Q

Hydroxypropl Guar, Sodium Haluronate, Xanthan Gum, Gellan Gum (Gelrite), Polyacrylic acid (Durasite), and PVA are examples of what type of vehicle?

A

viscosity enhancers

47
Q

What are examples of osmoprotectants? (2)

A

erythritol, levocamitine

48
Q

Erythritol and Levocamitine are examples of what type of vehicle?

A

osmoprotectants

49
Q

What are examples of stabilizers? (2)

A

hydroxyalkyl-phosphonate, gellan gum

50
Q

Hydroxyalkyl-phosphonate and Gellan Gum are examples of what type of vehicle?

A

stabilizers

51
Q

What are examples of tonicity stabilization vehicles?

A

KCl, NaCl, CaCl, MgCl, ZnCl, sorbitol

52
Q

KCl, NaCl, CaCl, MgCl, ZnCl, and Sorbitol are examples of what type of vehicle?

A

tonicity stabilization

53
Q

What type of substances typically stabilize tonicity?

A

electrolytes

54
Q

What are the four main types of preservatives?

A

chelators, chemical toxins, surfactants, oxidants

55
Q

What do chelators do?

A

preservative with an affinity to bind metallic ions

56
Q

Which preservative is a chelator?

57
Q

What type of preservative is EDTA?

58
Q

What preservative is recognized for its risk of contact dermatitis?

59
Q

Which preservatives are chemical toxins? (3)

A

povidone (PVP), thimerosal, chlorobutanol

60
Q

Which preservative is mercury-based?

A

thimerosal

61
Q

What are the two categories of preservatice surfactants?

A

biguanides, quaternary ammonium compounds

62
Q

What is the most common preservative used in topical ophthalmic drops?

A

benzalkonium chloride (BAK)

63
Q

Which preservatives are biguanides? (4)

A

polyhexamethylene biguanide (PHMB), polyaminopropyl biguanide (PAPB), chlorhexidine, alexidine

64
Q

PHMB, PAPB, Chlorhexidine, and Alexidine are what type of preservative?

A

biguanide surfactants

65
Q

Which preservatives are quaternary ammonium compounds?

A

benzalkonium chloride (BAK), polyquaternium (quats)

66
Q

BAK and Polyquaterium are wht type of preservative

A

quaernary ammonium compound surfactants

67
Q

What are the two categories of disappearing oxidants?

A

borate complexes, chlorite complexes

68
Q

What is the defining characteristic of Borate complexes?

A

pH inactivated

69
Q

What are examples of Borate complexes? (3)

A

genteal, thera tears (sodium perborate), tears again (dissipate)

70
Q

Genteal, Thera Tears, and Tears Again use what type of preservative?

A

borate complexes

71
Q

What is the defining characteristic of Chlorite complexes?

A

light inactivated

72
Q

What are examples of Chlorite complexes? (3)

A

allergan refresh (purite), blink (ocupure), brimonidine (purite)

73
Q

Allergan Refresh, Blink, and Brimonidine use what type of preservative?

A

chlorite complexes

74
Q

After how long can a re-capped preservative-free vial be used?

75
Q

Which drug is self-preserved?

A

moxifloxacin 0.5%

76
Q

Which ophthalmic drug uses a yellow cap?

A

beta blockers

77
Q

Which ophthalmic drug uses a dark blue cap?

A

beta blocker combos

78
Q

Which ophthalmic drug uses a red cap?

A

mydriatics and cycloplegics

79
Q

Which ophthalmic drug uses a dark green cap?

80
Q

Which ophthalmic drug uses an orange cap?

A

carbonic anhydrase inhibitors (CAIs)

81
Q

Which ophthalmic drug uses a gray cap?

A

non-steroidal antiinflammatories (NSAIDs)

82
Q

Which ophthalmic drug uses a pink cap?

83
Q

Which ophthalmic drug uses a tan cap?

A

anti-infectives

84
Q

Which ophthalmic drug uses a teal cap?

A

prostaglandin analogs

85
Q

Which ophthalmic drug uses a purple cap?

A

adrenergic agonists

86
Q

What color cap would you find on a bottle of beta-blocker?

87
Q

What color cap would you find on a bottle of beta blocker combo?

88
Q

What color cap would you find on a bottle of mydriatic or cycloplegic?

89
Q

What color cap would you find on a bottle of steroid?

90
Q

What color cap would you find on a bottle of NSAID?

91
Q

What color cap would you find on a bottle of CAI?

92
Q

What color cap would you find on a bottle of anti-infective?

93
Q

What color cap would you find on a bottle of miotic?

A

dark green

94
Q

What color cap would you find on a bottle of prostaglandin analog?

95
Q

What color cap would you find on a bottle of adrenergic agonist?

Oc P (3 decks)

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