1.2.3: Systemic disease & ocular impact, tx & possible ocular side effects of meds

Question 1

HBP in Layman’s

Answer 1

Blood is carried from heart to all parts of body in BVs. Each time heart beats, it pumps blood into BVs. Blood pressure is created by force of blood pushing against walls of BVs (arteries) as it is pumped by heart. The higher the pressure, the harder the heart has to pump. Meds help to lower pressure, to reduce strain on heart.

Question 2

Common meds for HBP

Answer 2

• Ramipril: ACE inhibitor (angiotensin enzyme)- 1st line, Lisinopril, Perindopril, Enanapril
• Amlodipine: Calcium Channel blocker- decreases uptake of calcium into cells. Nifedipine (Adalat)
• Losartan: Angiotensin II blocker. Blocks effect of hormone angiotensin II. Candesartan
• Atenolol: Beta blocker - reduces heart rate & cardiac ouput. BP lower as less stress on heart. Betaxolol, propranolol, bisoprolol
• Bendroflumethiazide: thiazide diuretic. Reduces sodium absorption. Furosemide
• Doxazosin: Alpha blocker- dilates BVs - blocks postsynaptic receptors. Note for cataract surgery, floppy iris syndrome –> weakens zonules

Question 3

DM in Layman’s

Answer 3

When you eat, food is broken down into glucose (sugar) & released into blood. Glucose gives energy. A hormone called insulin is made by pancreas & allows glucose in blood to enter cells to fuel us.
In type 1, body cannot make insulin so it is often injected into body.
In type 2,insulin made either cannot work properly or there is not enough insulin produced.
DM left uncontrolled can cause damage to BVs which supply eye with blood & nutrients - v delicate & fragile & can easily be damaged by elevated blood sugar.
Causes BVs to leak fluid & blood into eye which over time can cause permanent scarring & loss of vision.

Question 4

Common meds for DM

Answer 4

Insulin - type 1
Lifestyle - diet & exercise
Increases sensitivity to insulin (type2):
* Metformin
* Gliclazide
* Sitagliptin
* Glipizide
* Saxagliptin

Question 5

Hyperlipidemia in Layman’s, common meds

Answer 5

Excessive lipids or fats in blood. Causes blood to not flow as easily through BVs (arteries). Can increase risk of heart attack or stroke. Liver creates cholesterol to help digest food & make hormones but can also eat cholesterol (which is extra) - from meats etc.
Good diet & exercise can help.
Meds: Atorvastatin - reduces production of cholesterol. 1st line.
Simvastatin, Rosurvastatin, Pravastatin
Look for Arcus & Xanthelasma