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Pre Reg 2021 GPHC > Chapter 11 & 12: Eyes, ears, nose, and oropharynx > Flashcards

Chapter 11 & 12: Eyes, ears, nose, and oropharynx Flashcards

1
Q

Whats is Timolol? What is it used for?

A

Its an ophthalmic beta blocker

Used for cranial hypertension and open angle glaucoma

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2
Q

When can Timolol be administered in relation to other eye drops?

A

In order to prevent the active substance(s) from being washed out when additional ophthalmic medication is used, an interval of at least 5 minutes between each application is recommended.

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3
Q

How often are anti-infective eye drops usually applied? What about ointment?

A

Drops: Usually every 2 hours

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4
Q

What age can chloramphenicol eye drops be used in?

A

2 years plus

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5
Q

Steroid eye drops e.g. prednisolone eye drops can be used to treat short-term inflammatory eye conditions. What are there side effects?

A

Steroid Glaucoma
Steroid Cataracts
May worse the condition

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6
Q

What can sodium cromoglicate eye drops be used for?

A

Allergic conjunctivitis

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7
Q

What are the prostaglandin analogues and what are they used in?

A

Latanoprost
Travoprost
Bimatoprost
Used in closed angle glaucoma combined with beta blocker eye drop e.g. timolol

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8
Q

What can the prostaglandin analogues do to the eye colour?

Latanoprost Travoprost Bimatoprost

A

Discolour it- turn it brown

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9
Q

Hypromellose, carbomers and sodium chloride eye drops can be used for what?

A

Tear deficiency

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10
Q

What drugs can discolour contact lenses?

A

Rifampicin- red/ orange Sulfasaline- orange/ yellow

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11
Q

A branded product, Xalatan, containing which product, can now be stored at room temp as opposed to in the fridge?

A

Latanoprost All other preps must be kept in fridge, but this one can be kept at room temp.

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12
Q

What must patients tell their GP if they experience with Latanoprost?

A

eye irritation (excessive watering) Can also make eye lashes darker, thicker and longer

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13
Q

Which eye drops are contra-indicated in Heart Failure?

A

Timolol (non-cardioselective beta blocker) can worsen heart failure

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14
Q

What preparation, used in glaucoma, is taken orally?

A

Acetazolamide

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15
Q

What eye drops can lead to blurred vision and therefore effect driving??

A

Pilocarpine

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16
Q

If a dose states ONE gutta/g What does this mean?

A

ONE drop - using eye drops

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17
Q

What is the typical expiry date for eye drops when used in the following situations

Community

Hospital ward

A

community: 4 weeks

Hospital wards: 1 Week

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18
Q

When two different eye drop preparations are used at the same time of the day, what time interval should be left between administration of the two eye preparations?With what preparations would a longer interval be required?

A

5 minutes between the two

The interval should be extended when eye drops with a prolonged contact time, such as gels and suspensions, are used

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19
Q

If a patient needs eye drops and eye ointment at the same time of the day, what should be applied first?

A

Eye drops then eye ointments

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20
Q

When a patient is applying eye drops, what can be done after to reduce naslacrimal drainage (and therefore systemic absorption)?

A

Pressure on the lacrimal punctum for at least a minute

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21
Q

What is a rare side effect of using phosphate-containing eye drops in patients with damaged corneas?

A

Corneal calcification

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22
Q

What is the expiry date for multiple application eye drops after opening at home?

A

4 weeks

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23
Q

Are preservative or preservative free eye drops preferred in soft contact lens patients?

A

Preservative free

Some drugs and preservatives in eye preparations can accumulate in hydrogel soft lenses and may induce toxic and adverse reactions.Ideally, patients should not wear contact lenses during treatment period

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24
Q

Can eye drops be used in patients wearing rigid corneal contact lenses?

A

Yes

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25
Q

Can eye ointments be applied at the same time as contact lenses?

A

No Patient should not use contact lenses if being treated via eye ointment

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26
Q

How does aspirin interact with contact lenses?

A

Salicylic acid appears in tears and can be absorbed by contact lenses—leading to irritation

27
Q

What eye side effect can be caused by isotretinoin?

A

Conjunctival inflammation

28
Q

what are the three main dangers associated with CCS eye drops

A

Red eye - when the diagnosis is unconfirmed this may be due to HSV, a CCS might aggravate this leading to corneal ulceration.

Steroid Glaucoma - can follow the use of CCS eye preparations

Steroid cataract - may follow prolonged use

29
Q

When are combination corticosteroid + anti-infective drug eye drops used?

A

Sometimes used after ocular surgery to reduce inflammation and prevent infection Only under specialist supervision, not routinely used

30
Q

Does atropine eye drops result in pupil constriction or pupil dilation?

A

Pupil dilation, otherwise known as mydriasis

31
Q

Are lighter or darker pigmented eyes more resistant to pupil dilation with atropine?

A

Darker pigmented eyes are more resistant

32
Q

What is Sjögren’s syndrome?

A

Disorder of your immune system identified by its two most common symptoms — dry eyes and a dry mouthUsually accompanies lupus, rheumatoid arthritis, and other immune system disorders

33
Q

What is the traditional choice of treatment for tear deficiency?How often can you apply this?

A

HypromelloseCan apply frequently e.g. hourly

34
Q

If a patient is finding it troublesome applying hypromellose eye drops hourly for dry eyes, what can be an alternative that requires reduced application frequency?

A

Carbomers cling to the eye surface may help reduce frequency of application to 4 times daily.

35
Q

What is a side effect of chloramphenicol eye drops in babies?

A

Grey baby syndrome

36
Q

What is the MHRA advice regarding the use of latanoprost eye drops Xalatan?

A

Increased reporting of eye irritation e.g. excessive watering since reformulation

37
Q

What is the patient advice regarding prostaglandin analogue eye drops e.g. latanoprost?

A

Patients should be warned of a possible change in eye colour as an increase in the brown pigment in the iris can occur, which may be permanent

Changes in eyelashes can also occur, and patients should also be advised to avoid repeated contact of the eye drop solution with skin as this can lead to hair growth or skin pigmentation

38
Q

Acetazolamide is a sulfonamide derivative - what is a main side effect with this group of medicines?

A

Blood disorders, rashes, and other sulfonamide-related side-effects occur occasionally—patients should be told to report any unusual skin rash.

39
Q

What antibiotic eye drops are used for treating bacterial conjuctivitis?

A

Chloramphenicol

40
Q

What antibiotic eye drops are used for corneal ulcers?

A

Ciprofloxacin

41
Q

How often are antibacterial eye drops usually administered?

A

Apply 1 drop at least every 2 hours then reduce frequency as infection is controlled and continue for 48 hours after healing.

42
Q

How often is antibacterial eye ointment usually applied?

A

Either at night if eye drops are applied throughout the day

Or if used alone, 3-4 times daily

43
Q

What are the two types of glaucoma?

A

Chronic open angle glaucoma

Acute angle-closure glaucoma

44
Q

People with occular hypertension are at an increased risk of developing chronic open-angle glaucoma. What intra-ocular pressure is this?

A

> 21mmgHg

45
Q

What is the difference in the onset of symptoms in chronic vs acute glaucoma?

A

Chronic is asymptomatic at first and then vision loss presents

Acute - abrupt onset of symptoms

46
Q

What is 1st line for occular hypertension >24 mmHg and for chronic open-angle glaucoma?
What is second line?
What is 3rd line?
What is 4th line?

A
  1. Prostaglandin analogue e.g. latanoprost
  2. Try an alternative prostaglandin analogue for occular hypertension
  3. Beta blocker e.g. timolol
  4. Carbonic anhydrase inhibitors such as brinzolamide or dorzolamide, a topical sympathomimetic such as apraclonidine. Combination therapy can be offered at this point
47
Q

At what age is it recommended that children start fluoride supplement?

A

6 months

48
Q

Does acute sinusitis require antibacterial treatment straight away?

A

Symptoms usually improve within 2 to 3 weeks without requiring treatment.

Antibacterial therapy is indicated if serious condition or showing signs that the patient is systemically unwell

For symptoms around 10 days and less - paracetamol or ibuprofen

For symptoms 10 days or more -high dose nasal corticosteroid

49
Q

What is xerostomia?

A

Dry mouth

50
Q

What mouthwash causes reversible brown staining of teeth and tongue?

A

Chlorhexidine

51
Q

If there are systemic signs of infection in gingivitis, what antibiotics are used?

A

Metronidazole

Alternative = amoxicillin

52
Q

What antibiotics can you use for a tooth abscess?

A

Amoxicillin or metronidazole

53
Q

How is mild rhinitis treated?

A

Antihistamine or topical nasal corticosteroids

54
Q

In seasonal allergic rhinitis, when is it recommended the patient starts treatment?

A

2-3 weeks before the season commences

55
Q

Should corticosteroid nasal preparations be used in nasal infections?

A

No- should be avoided until after healing has occurred

56
Q

Is the risk of systemic effects greater with nasal drops or nasal sprays?Why?

A

Drops as they are administered incorrectly more often than sprays

57
Q

How do you manage nasal polyps?

A

Corticosteroid nasal drops to help shrink them(Oral corticosteroids can be used if the polyps are large) Corticosteroid nasal spray can be used for maintenance

58
Q

Which drug is known for causing Rhinitis medicamentosa

A

Xylometazoline and phenylephrine

59
Q

What is the initial treatment for oral thrush? If this does not work, what can then be used?

A

Nystatin or miconazole (local treatment)

Fluconazole - this is especially needed in immunocompromised patients

60
Q

What is stomatitis?

A

Inflammation of the mouth and lips

61
Q

What are used in the prevention of oral candidiasis in immunocompromised patients?

A

Antiseptic mouthwashes

62
Q

Intravitreal is administration into where?

A

The eye

63
Q

Blepharitis management usually consists of good eyelid hygiene. What can you use if staphylococcal infection is suspected?

A

Fusidic acid

64
Q

What medicine for glaucoma is taken orally?

A

Acetazolamide

Pre Reg 2021 GPHC (19 decks)

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